Table 1.

Core Forensic Psychiatry Competencies in General Psychiatry

Clinical Rotation or Experience	Forensic Training Topics	Didactic Learning	Experiential Learning	General Psychiatry Milestone
Postgraduate Year 1
Inpatient Psychiatry	Introduction to forensic psychiatry	Principles and practice of psychiatry	Applying basic principles of consent, capacity and commitment
	Suicide risk assessment	Suicide risk tools, suicide risk management and documentation	Inpatient supervision of care of suicidal patients, level of precautions, disposition plan	PC3, MK2
	Violence risk assessment	Violence risk tools, violence risk management and documentation, evaluation of psychopathy	Inpatient supervision of care of violent patients, level of precautions, disposition plan	PC3, MK2
	Civil commitment	Voluntary and involuntary commitment, outpatient commitment	Civil commitment court filings and proceedings, opportunity to testify
	Liability	Malpractice and other forms of liability	Standard of care; documentation in medical record	SBP1
Postgraduate Year 2
Emergency Psychiatry	Malingering	How to detect malingering	Assessment and documentation of suspected malingering	ICS2
	Suicide risk assessment	Suicide risk tools, suicide risk management and documentation	Emergency care of suicidal patients, disposition plan	PC3, MK2, ICS2
	Violence risk assessment	Violence risk tools, violence risk management and documentation	Emergency care of violent patients, disposition plan	PC3, MK2, ICS2
Psychosomatic Medicine	Capacity	Medical decision making	Clinical evaluation of medical capacity	MK6, SBP4, PROF1
	Informed consent	Competency, consent and substituted decision making	Obtaining informed consent for medical procedures	MK6, SBP4, PROF1
	Substituted decision making	Competency, consent and substituted decision making	Issues of medical guardianship, medical power of attorney, advance directives	SBP4, PROF1
	End of life care	Withdrawal or refusal of care, advance directives, POLST/MOLST laws, death determinations	Psychiatric consultation of palliative care patients	SBP4
	Right to and right to refuse treatment	Refusing medical treatment in competent patients	Advance directives, medical power of attorney	SBP4
Postgraduate Year 3
Outpatient Psychiatry	Liability	Malpractice and other forms of liability	Establishing and terminating care; standard of care	PROF2
	Forensic referral & consultation	When to consult a forensic expert	referrals for forensic evaluations	MK6
	Patient privacy regulations, HIPAA	Confidentiality and privilege	Limits of confidentiality in clinical treatment; release of information; collateral informants	MK6
	Disability	Disability evaluations	Clinical evaluation of disability applications
	Duty to warn, duty to protect	Tarasoff laws	Risk assessment
Outpatient Child and Adolescent Psychiatry	Consent and medical guardianship	Mature minor, assent/dissent in adolescent healthcare	Clinical treatment of child and adolescent patients
	Child abuse	Child abuse reporting laws	Making a child abuse report
	Consent and medical guardianship	Competency, consent and substituted decision making	Clinical treatment of geriatric patients, elder abuse
Addiction Psychiatry	Drug laws and regulations	Decriminalization of addiction	Treatment of addiction patients	MK2
Forensic Evaluation	Criminal responsibility	Introduction to forensic psychiatry, M'Naghten	Evaluation of criminal responsibility of criminal defendants	SPB4
Treatment of incarcerated populations	Correctional psychiatry	Principles of treating incarcerated patients	Treatment of incarcerated patients, accreditation standards, prisoners' rights, correctional culture	SPB2
Postgraduate Year 4, Elective/General
Forensic Unit of State Psychiatric Hospital	Competency to stand trial	Introduction to forensic psychiatry	Restoration of competency/sanity	SBP2
Mock Trial	Civil/criminal case scenarios	Expert witness qualifications	Mock court testimony
ABPN Board Prep	PRITE/general psychiatry board
Forensic Electives/Independent Study	Landmark cases in psychiatry

PC, Patient Care; MK, Medical Knowledge; PROF, Professionalism; SBP, Systems-Based Practice; ICS, Interpersonal and Communication Skills; POLST, Provider Orders for Life-Sustaining Treatment; MOLST, Medical Orders for Life-Sustaining Treatment; HIPAA, Health Insurance Portability and Accountability Act of 1996; ABPN, American Board of Psychiatry and Neurology; PRITE, Psychiatry Resident-In-Training Examination.