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Research ArticlePresident's Address

Examining the Past and Advocating for the Future of Forensic Psychiatry Training

Richard L. Frierson
Journal of the American Academy of Psychiatry and the Law Online March 2020, 48 (1) 16-25; DOI: https://doi.org/10.29158/JAAPL.003919-20
Richard L. Frierson
Dr. Frierson is Alexander G. Donald Professor of Clinical Psychiatry, Vice Chair for Education, University of South Carolina School of Medicine, Columbia, SC. A version of this paper was presented as the Presidential Address at the 50th Annual Meeting of the American Academy of Psychiatry and the Law, Baltimore, MD.
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  • Figure 1.
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    Figure 1.

    Locations of forensic psychiatry fellowship programs in the United States.

Tables

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    Table 1

    Founding Members of AAPL

    Eugene BalcanoffAmes Robey
    Howard DavidmanRobert Sadoff
    Seymour HalleckJoseph Satten
    Melvin HellerJohn Suarez
    Jonas RappeportHerbert E. Thomas
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    Table 2

    The Five Fastest Growing Medical Specialties by Percentage of New Training Programs (2013–2018)

    SpecialtyTotal Programs in 2018, n5-Year Increase, % (n)
    Emergency medicine23140.9% (67)
    Internal medicine52933.9% (139)
    Psychiatry24831.9% (60)
    Family medicine62031.6% (149)
    Dermatology13820.0% (23)
    • From Ref. 26.

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    Table 3

    The Growth of Psychiatry Subspecialties by Percentage of New Training Programs (2013–2018)

    SubspecialtyTotal Programs in 2018, n5-Year Increase, % (n)
    Forensic psychiatry4720.5% (8)
    Consultation-liaison psychiatry6113.0% (7)
    Child and adolescent psychiatry13812.2% (15)
    Geriatric psychiatry607.1% (4)
    Addiction psychiatry496.5% (3)
    • From Ref. 26.

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    Table 4

    Complement of Approved Positions and Filled Positions by Psychiatry Subspecialty (2018–2019)

    SubspecialtyTotal Programs, nApproved Positions, nFilled Positions, nPercent Filled, %
    Addiction psychiatry501328564.4
    Child and adolescent psychiatry140113288378.0
    Consultation-liaison psychiatry621447854.2
    Forensic psychiatry481277357.5
    Geriatric psychiatry611575535.0
    • From Ref. 28.

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    Table 5

    Unique Skills Needed to Work with in Correctional Settings

    Establishing a working relationship with correctional officers who have no medical training
    Understanding custody levels
    Managing boundaries
    Balancing patient confidentiality with the facility's security needs
    Providing quality psychiatric care with formulary restrictions
    Understanding prison culture
    Dealing with medication diversion, including medications uniquely abused in correctional settings
    Advocating for patient needs in a system that is inherently not designed as a therapeutic milieu
    • From Refs. 26, 39.

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    Table 6

    Pass Rates in Psychiatry Subspecialty Examinations (2017–2018)

    Psychiatry SubspecialtyPass Rate, %
    Addiction psychiatry96
    Child and adolescent psychiatry75
    Forensic psychiatry94
    Geriatric psychiatry85
    Psychosomatic medicine (consultation-liaison)85
    • From Ref. 45, 46.

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Journal of the American Academy of Psychiatry and the Law Online: 48 (1)
Journal of the American Academy of Psychiatry and the Law Online
Vol. 48, Issue 1
1 Mar 2020
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Examining the Past and Advocating for the Future of Forensic Psychiatry Training
Richard L. Frierson
Journal of the American Academy of Psychiatry and the Law Online Mar 2020, 48 (1) 16-25; DOI: 10.29158/JAAPL.003919-20

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Examining the Past and Advocating for the Future of Forensic Psychiatry Training
Richard L. Frierson
Journal of the American Academy of Psychiatry and the Law Online Mar 2020, 48 (1) 16-25; DOI: 10.29158/JAAPL.003919-20
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  • Article
    • Abstract
    • GME in the United States
    • Forensic Training in Psychiatric Residency
    • Forensic Psychiatry Fellowship Training
    • Challenges and Professional Advocacy
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  • Searching for the Whole Truth: Considering Culture and Gender in Forensic Psychiatric Practice
  • AAPL Pivots to Thrive Post-COVID
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