Ryan Colt Wagoner, MD, MBA, CPE, DFAPA, currently serves as President of the American Academy of Psychiatry and the Law. I first met Dr. Wagoner when he came to an American Academy of Psychiatry and the Law (AAPL) meeting with his friend, Dr. Abhishek (Beesh) Jain, who was senior to him in residency at the University of Pittsburgh Medical Center (UPMC). I was struck by his wit, intellect, and easy-going manner. Those who have had the pleasure of working together with him locally in Florida or at countless American Psychiatric Association (APA), American Academy of Psychiatry and the Law (AAPL), American Board of Psychiatry and Neurology (ABPN), or international meetings will undoubtedly find themselves noticing how incredibly perceptive he is. Since his childhood, Ryan’s path toward not only forensic psychiatry but toward leadership in our field was but a foregone conclusion.
Life in Florida, with Nickelodeon, and Bugs
Ryan was born in Clearwater, Florida and lived in Spring Hill, Florida. His father worked as an auto mechanic and his mother in a school. He was the eldest of three children, having a younger brother and sister. He enjoyed soccer, karate, baseball, and basketball as a kid. He was always an avid reader and particularly enjoyed science fiction and comic books. Ryan gained an interest in storytelling and a passion for exploring the possibilities of “what could be,” an interest and a passion that would serve him well in a future forensic ⇓career.
Ryan Wagoner, MD
During high school, Ryan was torn between becoming a doctor or an attorney, although he was looking for opportunities to better understand what practicing law truly meant. That day came sooner than anticipated, in the form of a volunteer opportunity as a teenager. Ryan took part in a then-new type of therapeutic jurisprudence. (Florida has traditionally been a leader in therapeutic jurisprudence, with the nation’s first drug court being opened in Miami in 1989.1) The Teen Court movement began as an alternative to the traditional juvenile court and had increasing popularity in the later years of the 20th century.2 Criteria for voluntary transfer to Teen Court typically include younger juveniles without prior arrests and less serious violations (such as vandalism or shoplifting).2 Although Teen Court defendants go through similar processes of review of charges, court hearings, and sentencing to community service, in distinction to traditional juvenile court, other youth are responsible for much of the process. This includes teenagers acting as prosecutors, defense attorneys, judges, jurors, and bailiffs. Adults remain involved, generally being responsible to supervise and coordinate the community service placements. The creative concept is that “the process takes advantage of one of the most powerful forces in the life of an adolescent—the desire for peer approval and the reaction to peer pressure” (Ref. 2, p 2). Teens in Ryan’s county were among those who were able to bypass juvenile court to be tried by their peers. Prosocial peers (such as Ryan Wagoner, the teen attorney), by this argument, can be more beneficial than adult administrators. Teen attorneys also benefit, learning more about the law than they could in a traditional classroom. Teen Courts have the potential to positively affect accountability, timeliness, cost savings, and community cohesion, and decrease recidivism.2
Ryan played the role of the defense attorney in Teen Court of Hernando County. In fact, he became sought after by the young defendants because of his ability to quickly analyze their cases and present facts in a way understandable to fellow teenagers. It was teen defense attorney Ryan Wagoner who would make his debut on Nickelodeon. On Sunday, November 3, 1996, Ryan and his fellow Teen Court participants were featured on NickNews.3 (As a psychiatrist, Ryan has subsequently been interviewed by the mass media on television for topics ranging from the national Adderall shortage to holiday fatigue to social media whistleblowers. He has been interviewed for his expertise in Florida, for national broadcasts, and even in South Korea.)
One of his earliest exposures to blending the law and medicine came with a trip to the video store, where he rented the movie Primal Fear.4 (Spoiler alert: Primal Fear involves a homicide defendant with a malingered multiple personality disorder and an activist forensic expert who lobbies the defense attorney that his diagnosis is real.5) To this day, he recalls his early impressions of Edward Norton’s portrayal of the malingerer as “captivating,” but he also was quite interested in the forensic psychologist character: “It was so cool someone would come in to evaluate him. That was someone’s job.”
Ryan met (his future wife) Melissa on an April Fool’s Day while they were both in high school. He was a year ahead of her in school and would soon stay nearby for college.
At the University of Florida, he had a fascinating course of study for a future forensic psychiatrist. He double majored in criminology and entomology (the study of bugs, not the study of language), graduating with a Bachelor of Arts (BA) and a Bachelor of Science (BS) degree. (Although the serial killer-police investigator show Dexter took place in Florida, this was after Ryan was already learning about both criminology and bugs.) Ryan’s daughter loves butterflies, and Ryan is still able to use his entomology knowledge to impress, particularly when he identifies insects he is courageously shooing out of the house.
Melissa followed Ryan to the University of Florida a year later, where she would study Health Science and obtain a master’s degree in occupational therapy. She recalled their loving to attend Gators games together. Ryan also attended medical school at the University of Florida. Ryan started medical school thinking that he wanted to be a pediatrician, but the brain was just too enticing.
Fortuitously, in medical school, there was an introduction to forensic psychiatry lecture, and Ryan loved it. He recalls thinking: “You’re telling me I can blend psychiatry and the law and still be a physician? This is the specialty for me.” He wryly describes that his interest in psychiatry came from his interest in forensic psychiatry.
Pittsburgh
In his psychiatry residency at the prestigious University of Pittsburgh Medical Center (UPMC), Dr. Wagoner was part of the Academic Administrator, Clinician Educator track. Administration and education are vast areas unto themselves, yet each was part of his strong vision for his future.
Melissa remembered he particularly enjoyed attending the psychiatric emergency room rotations and specialty clinics, including the clinic for obsessive compulsive disorder. He adapted to the north very quickly and got into the Pittsburgh sports culture, attending Steelers and Pirates games (in my own hometown, go black and gold!). They also enjoyed other Pittsburgh staples, including the Hofbräuhaus, pierogies, and the abundance of wildlife right outside their door.
While a resident at UPMC, Dr. Wagoner came to Case Western Reserve University in Cleveland for an elective forensic psychiatry rotation with Dr. Resnick and faculty. He looks back fondly on his residency and that elective and has remained good friends with his classmates from residency as well. It was during residency that he began attending AAPL. He immediately realized he had found his people. One of the most impactful experiences he had early on with AAPL was that he could approach the “titans of forensic psychiatry…and they would talk to you!” Ever since, Ryan has faithfully attended almost all AAPL meetings, loving to meet new people there and discuss emerging ideas, trying to be as accessible to newcomers as senior members once were to him. The sole AAPL meeting that Ryan missed in the past 14 years was when his daughter was born, which appeared to be an acceptable reason.
Dr. Jain recalled:When Ryan was a PGY-1 and I was his chief resident in Pittsburgh, he joined us senior residents for his first AAPL meeting in Baltimore. From the beginning, I was impressed with his clear goal of being a forensic psychiatrist and it was fun navigating AAPL together. He always had a way to quickly size up a situation, often with humor, whether in AAPL or residency.
During his final year of residency, Dr. Wagoner was selected as an AAPL Rappeport Fellow. The fellowship honoring AAPL’s founding president, Jonas R. Rappeport, MD, provided him the opportunity to develop his knowledge and skills at the Montreal AAPL meeting over a decade ago. (Dr. Wagoner is the fifth Rappeport fellow to later be selected as AAPL president, after the inaugural fellow Jeff Janofsky, MD; Patricia Recupero, MD, JD; Michael Norko, MD; and me.)
California
Subsequently, the couple moved to Sacramento. Dr. Wagoner completed his forensic psychiatry fellowship at the University of California-Davis in Sacramento under the tutelage of fellowship director (and past AAPL president) Charles Scott, MD. Melissa explained that Ryan worked hard his fellowship year but also understood the importance of work-life balance, enjoying biking and wineries and adventures such as the Chinese New Year parade in San Francisco, sea lions at the pier, and travels to Carmel, Coronado, and Yosemite. Ryan’s love of travel and love of learning remain prominent today.
Dr. Scott recalls when Ryan applied to the fellowship. His thinking was “crisp and sharp.” Reflecting on the adjective to best describe Dr. Wagoner in fellowship, Dr. Scott said “determined” is the word he most thought of during the year. He also described him as “goal-directed to master everything we tried to teach him.” He surpassed even Dr. Scott’s high expectations quickly, although Dr. Scott pointed out that even this was not surprising. He had “very good skills at digesting complex forensic cases, working collaboratively with the team, and would stand by his opinion with a firm confidence.” He was an “outstanding fellow, incredibly determined…one you’ll always remember, and know they will thrive.”
During fellowship, Dr. Scott noted that Ryan was “the consummate professional” in his work. He was always patient and tolerant. Dr. Scott remarked on Ryan’s “crisp dry wit,” something which many of us who have worked on projects with Ryan have also appreciated.
Then-future AAPL president Will Newman, MD recalls observing Dr. Wagoner’s first forensic testimony. Dr. Newman was the criminal case supervisor at the fellowship. Dr. Newman recalled a defendant who had two dozen prior competency evaluations that had opined him incompetent. Instead of being one in a long line, Dr. Wagoner put effort in to undo the logic errors in previous reports and demonstrate that the defendant’s behaviors were the product of willful non-cooperation, not a mental illness. The case went to trial during his fellowship year, and he testified brilliantly and memorably. For the first time in over 10 years, the defendant was found competent to stand trial.
Dr. Scott recalled that Dr. Wagoner had dreamed of being a leader in the field prior to fellowship. AAPL was an immediate home for him, and he “took every bit of advice” Dr. Scott gave, including immersing himself in the organization. Dr. Scott noted that Dr. Wagoner had a vision for AAPL and set about that task doggedly, as he had everything else.
After fellowship, Dr. Wagoner worked at an inpatient psychiatric hospital in Georgia, and the couple lived in a coastal town, enjoying downtime on the beach. They welcomed their daughter to the family when they lived in Georgia. Although continuing in Georgia was surely an option, a new opportunity was waiting on the horizon at the University of South Florida. A position had opened for a psychiatrist back in the Tampa Bay area, and they had an interest in recruiting a forensic psychiatrist who might want to start a fellowship. They considered whether this was the opportunity to both pursue his academic career dreams and be closer to family. The Wagoner family was moving back to Florida.
Florida 2.0
Florida Leadership and Clinical Work
Dr. Wagoner currently serves as Chair of the Department of Psychiatry and Behavioral Neurosciences at the University of South Florida (USF), where he oversees an academic department of over 40 faculty and more than 100 employees. Leading up to this position, he served for years as the program director of the forensic psychiatry fellowship and Chief of Forensic Psychiatry at USF. Becoming the Chair of Psychiatry at USF allowed him to continue many projects he was already leading. Dr. Wagoner has always been interested in innovative treatments, used ethically. He has been involved in a psilocybin trial, transcranial magnetic stimulation (TMS), nasal esketamine, and deep brain stimulation trials, seeking to find new ways to consider “what could be.”
As chair, he brings his passion for psychiatry, skills, and drive to not only his own work but an entire department. Dr. Glenn Currier was Dr. Wagoner’s predecessor as department chair. He described Dr. Wagoner as “an immediate asset to USF from the get-go.” He noted that Ryan had a “positive attitude under pressure” and one could always tell that he was headed to bigger things. Dr. Currier described the great pleasure of serving as a mentor to Dr. Wagoner and then a great pleasure to hand over the chairmanship to someone who was so trusted by both faculty in the department and senior leadership at the College of Medicine. On a personal note, he explained that, because Ryan is a home brewer, mentorship sessions sometimes occurred with Irish red beer that he made.
Dr. Currier also described that Dr. Wagoner was a huge advocate for forensic concerns in the state of Florida, a state which is often portrayed as different than other states in some aspects. (We all know the news trope, “Florida man.”) Dr. Currier described Ryan with the following: “He represents the best in the field…he never allows his ethics to slide.” Dr. Currier described him as “compassionate and intelligent.”
Dr. Wagoner, in his clinical and forensic work, enjoys working with professionals in high-performance jobs, such as with the Federal Aviation Administration (FAA), disability and fitness for duty evaluations of fire fighters and police officers, and others who hit a (metaphorical) wall in their difficult work.
In 2022, already an accomplished forensic psychiatrist, Dr. Wagoner completed his master of business administration (MBA) at USF’s Muma College of Business. This skill set serves him well as chair and as AAPL president. He brings his blend of clinical knowledge and business acumen to leadership in all aspects of his career, including sitting on the board of a psychiatric hospital that will open in 2025 and creating a new behavioral health service line at Tampa General Hospital, the teaching hospital partner with the University of South Florida.
Prior to his role as chair at USF, Dr. Wagoner took on several unique clinical roles, including evaluating pilots for the Federal Aviation Administration, interviewing players on stimulant medications for Major League Baseball teams, and providing treatment to individuals detained or civilly committed under Florida’s Sexually Violent Predator’s Act. On a regional level, Dr. Wagoner serves on multiple committees at the Florida Psychiatric Society, including the Ethics Committee, the Forensic Committee, and the Disaster Preparedness Committee. He is well known throughout the state of Florida as not only a premier forensic expert but also a mentor willing to provide guidance to the next generation of psychiatrists.
Florida Teaching
Another word to describe Dr. Wagoner is “hardworking,” perhaps elevated by making it look easy. In his teaching, Dr. Wagoner aims to take quite complex topics and make them understandable and available. In fact, this is the feedback he strives for at conferences.
After returning home to Florida, he built a fellowship from the ground up, a fellowship which would become sought after both regionally and nationally by applicants. Seeing this come to fruition has been gratifying, taking what he has learned and passing it on to the next generation, who have in turn become his new colleagues. Satisfyingly, several former fellows have stayed on at USF as faculty and volunteer faculty. Watching them develop into forensic psychiatrists and then continuing to work with them has been fulfilling. He helped mentor some amazing people.
Among those amazing people is Dr. Gregory Iannuzzi, who is Dr. Wagoner’s protégé in all things forensic and who succeeded him as the program director of the forensic psychiatry fellowship at USF. Dr. Iannuzzi first met Dr. Wagoner when Dr. Iannuzzi was in his PGY-2 year. Dr. Wagoner lectured about insanity and criminal responsibility. Dr. Iannuzzi explained: “His lectures were different than everyone else, he would wear a suit and tie and fit in equally well in a courtroom as a lecture hall.” Dr. Wagoner commanded the class’s attention, walking while speaking and speaking from memory with simple slides to support his points. Dr. Iannuzzi recalled, “I liked how clear his thinking was, so he drew me toward forensic psychiatry.” Dr. Iannuzzi described Dr. Wagoner’s teaching style as “all attention is on him when he’s speaking. He’s dynamic, knowledgeable, and clear.”
But Dr. Wagoner was not just a great lecturer and forensic psychiatrist. He also wanted those he trained to be successful. At even an early stage, Dr. Wagoner made efforts to pull Dr. Iannuzzi into national presentations, including at the APA as well as AAPL. Dr. Iannuzzi found that Dr. Wagoner’s feedback on content and mannerisms was precise and clear, but in an easy-to-stomach way. For example, after their first presentation together at APA, Dr. Wagoner told Dr. Iannuzzi, "It's good that you gesture when speaking, but it looked a little bit like you were kneading a biscuit." Ever since, Dr. Iannuzzi's mannerisms emphasize his content rather than his baking ability.
Dr. Wagoner would use role play frequently during his teaching in the fellowship. Nakul Batra, MD was a general psychiatry resident at USF before completing the forensic fellowship with Dr. Wagoner in 2022. Dr. Batra fondly recalled the first competency evaluation in the fellowship, in which Dr. Wagoner play acted as the evaluee. “He stated that his name was Jesse Pinkman (who you may recall as a character from Breaking Bad) and then proceeded to provide the best portrayal of an antisocial standardized evaluee, with some vague psychotic symptoms, that I have ever seen.” A serious analysis of competency and the potential for malingering ensued.
Dr. Batra expressed deep admiration of Dr. Wagoner’s mentorship and further explained:Some say he is hard on his trainees in residency and fellowship. In truth, he constantly pushes you to be better and adjusts to your range. He is an exemplary teacher with vast in-depth knowledge. I am lucky to have trained under his tutelage. In my own clinical and forensic practice, I continue to quote his direct lessons on a regular basis.
Megan Stockamp, MD joined the USF faculty in 2024, after completing her psychiatry residency and her forensic fellowship there. When Dr. Stockamp was a second-year resident, Dr. Wagoner had similarly welcomed her forensic interest. He shared tips, experiences, books, and AAPL lectures to discuss. She noted: “You can always tell how much he loves what he does, but does that mean during staffing as a third year you’ll be cross-examined on your diagnoses criteria and treatment recommendations? Probably.”
Florida Living
Melissa described Ryan as a “wonderful dad and husband.” In addition to his lovely and supportive wife and daughter, they have a chocolate lab named Kona. At home, he is helpful and caring, funny, and goal driven. He plays sports with his daughter, attends her dance recitals, and even did a father-daughter dance on stage. He uses his quick thinking at home often to solve problems, as exemplified by him building his daughter a desk when coronavirus disease (COVID) meant remote learning, without any preexisting knowledge of carpentry. He speaks at the Great American Teach In at a local school about our profession of forensic psychiatry, age appropriately, of course. The family loves to travel, recently visiting France, Prague, and Ireland. He recently surprised his daughter with a trip to Disney, where they were roller coaster buddies. He is also the dad with the cool Godzilla pinball machine, ready to play at any time in his office.
And Ryan, like me and millions of others, loves Star Wars. Drs. Wagoner and Iannuzzi presented alongside Dr. Ryan Hall at March 2023’s MegaCon in Orlando’s convention center, regarding learning about psychopathology from Star Wars and about psychiatrists as villains in comics. Dr. Hall, another Floridian forensic psychiatrist and former Rappeport fellow, who is a former president of the Florida Psychiatric Society, led the panels in which comic book aficionados and film fans were educated in a memorable way about mental illnesses.
Something that Melissa pointed out that I would echo is that Ryan, Dr. Wagoner, is exceptionally good in crises, with many people turning to him in their times of need. Yet still, this brilliant forensic psychiatrist dressed up like a banana when his daughter was a monkey for Halloween.
National Presence in Forensic Psychiatry
Publishing
Dr. Wagoner has published articles and chapters on wide-ranging topics. From lone-actor terrorism to sexual addiction to transcranial magnetic stimulation,6,–,8 Dr. Wagoner has written about it. Writing about lone-actor terrorism allowed him to bring light to this oft-sensationalized topic, separating the noise from the reality. Dr. Wagoner wrote a well-regarded addiction psychiatry chapter in the textbook that Peter Ash, MD, Richard Frierson, MD, and I coedited, Malpractice and Liability in Psychiatry.9 We served as coauthors writing about the difficult topic of boundary violations in corrections in Journal of the American Academy of Psychiatry and Law10 and wrote together about using film to teach about paraphilias in Academic Psychiatry.11 But in my opinion, his article with the best title was focused on job stress and shootings of police officers: “Not Easy Being Blue.”12
As noted above, he prides himself on his down-to-earth teaching and writing. A recent Current Psychiatry13 cover article he authored was about returning to work after being assaulted by a patient. This article was borne out of Dr. Wagoner’s experiences within his own department with a staff assault, the journey to return, and (always seeking to improve) what could be done better. This is Dr. Wagoner, taking his experience and learning and making it digestible for others who are later in a similar unfortunate situation.
AAPL
Dr. Wagoner has presented for regional, national, and international audiences. His first national presentation, of course, was at AAPL in Montreal over a decade ago. In addition to AAPL, he has presented at the International Congress on Law and Mental Health, the American Psychiatric Association, and numerous national and regional organizations.
He served as program co-chair with Dr. Trent Holmberg for AAPL’s meeting in 2020 in the chaos of COVID, when his former supervisor, Dr. Newman, was AAPL president. They worked hand in hand and evidenced their ability to think outside the box and shift paradigms then with an AAPL meeting that will not soon be forgotten.
As an AAPL Councilor, he became recognized for taking a step back and thinking of all the angles of proposals and how they affected the whole membership. He wanted to ensure that Council was the voice of the overall body of AAPL and did so transparently. He has stressed the notion that not only must AAPL’s decisions be made transparently but that we need to be transparent about where the science backing our field is and where the science fails. AAPL’s Resource Documents demonstrate the evidence behind the decision-making.
AAPL Secretary Dr. Jain, who is serving as the program co-chair for Dr. Wagoner’s upcoming presidential meeting, described: “Over the years, I’ve seen his practical, decisive, and efficient leadership style.” Dr. Newman noted that Dr. Wagoner is not afraid to call out when a process or procedure is wrong, even if it was practiced that way for years. Dr. Stockamp described Dr. Wagoner as “unflappable in all situations.”
At AAPL, Dr. Wagoner has served in leadership roles as co-chair of the Death Penalty Guidelines workgroup with Dr. Frierson, chair of the Addictions Committee, and co-chair of the Media and Public Relations Committee. Although the death penalty is contentious in the United States and around the world, the reality that American forensic psychiatrists working in a system that has a death penalty calls for leadership in the workgroup that is thoughtful about all sides of the topic, and he and Dr. Frierson embody this. Under Dr. Wagoner’s leadership, the Addictions Committee ramped up, giving presentations, writing newsletter articles, and developing younger members. During my presidency, he was a valued member of the Membership Engagement, Recruitment, and Retention (MERR) Task Force as well as serving on AAPL Council. When I served as Rappeport Fellowship co-chair, I actively recruited Dr. Wagoner to the committee for his keen mind and his vision for the future leaders of AAPL. He has also served as a member of the Virtual AAPL Committee, the Search Committee for review course director, Government Affairs Committee, Forensic Training of Residents Committee, and the Sex Offenders Committee.
Ever the mentor at AAPL, Dr. Wagoner has shepherded his former fellows through AAPL by encouraging them to join committees, give presentations, and pursue opportunities. Dr. Iannuzzi went on to be honored with the Research Poster of the Year award and the Rappeport fellowship. They also enjoyed seeing the movie Halloween lampooned at the Master Pancake Theater during Austin’s AAPL, attending a haunted house in New Orleans, and searching out the best deep-dish pizza in Chicago. This once again shows that Dr. Wagoner is not just someone you want to learn from and to lead you but also someone you can have a beer with. Dr. Iannuzzi described that Dr. Wagoner’s career could be a template.
Dr. Wagoner has received local as well as national awards. At USF, he has been repeatedly awarded the forensic educator of the year award as well as the clinical teaching award. In 2020, he was awarded the Best Teacher in a Fellowship Program award from AAPL.
Other National Organizations
At the Accreditation Council for Graduate Medical Education (ACGME), Dr. Wagoner served on the forensic psychiatry milestone work group. At the American Board of Psychiatry and Neurology, he has served on the Forensic Psychiatry Article-Based Assessment Committee since its inception. There, he brings a sharp eye to research articles in our growing field.
Conclusions
AAPL is fortunate to have Dr. Ryan Wagoner as a leader and as its President. His clear fascination with all things forensic dating back to his teenage defense attorney days, coupled with his clear thinking and goals of transparency for our field, are the embodiment of the AAPL that will sustain through the future.
Footnotes
Disclosures of financial or other potential conflicts of interest: None.
- © American Academy of Psychiatry and the Law
