Forensic Psychiatry Fellowship

Director: Peter Ash, M.D.

Address:
Psychiatry - Room 325
49 Jesse Hill Jr. Dr., S.E.
Atlanta, GA 30303

Phone: (404) 727-3244
Fax: (404) 727-3155
E-mail: peter.ash@emory.edu

Level: PGY-5 and above
Positions: 2
Annual Stipend: $55,000 (2008-2009)
Accreditation: ACGME

Introduction
The Emory forensic fellowship began in 1993. The Psychiatry and Law Service is in large part supported by a grant from the State of Georgia, and, in consequence, is closely involved with various state departments which deal with forensic and mental health patients. This blend of state government interest and private university academic orientation has produced a growing program which emphasizes forensic teaching, public policy development, research, and, for child psychiatrists, a variety of child forensic experiences. In keeping with this orientation, the program strives to provide flexibility in experiences depending on a fellow's interests. The training program was accredited in forensic psychiatry by the ACGME in 1997 when the ACGME began accrediting forensic training programs, and has continued to be accredited since that time.

Clinical experiences
The fellowship program includes a wide variety of clinical experiences with civil evaluations and with inpatient and outpatient criminal populations. The home base for the fellows is Grady Memorial Hospital, a large county hospital in downtown Atlanta and the largest teaching site of the Emory University School of Medicine. The psychiatry service at Grady is an academic component of Emory University School of Medicine Department of Psychiatry and Behavioral Sciences.
Experience with criminal defendants
Outpatient evaluations: The service has a contract to provide court-ordered evaluations for defendants in Fulton County (Atlanta). The bulk of these evaluations are conducted on inmates in the Fulton County Jail on questions of competency, criminal responsibility, sentencing, and post-sentencing treatment recommendations. Fellows provide testimony on these cases if needed at trial, which averages several times each year.
Inpatient evaluations: Fellows spend three half days per week on a forensic inpatient unit conducting inpatient assessments of competency to stand trial, participating in the treatment of NGRI acquittees, and formulating opinions about release of NGRI acquittees. The primary inpatient site is the state hospital in Atlanta, which has two inpatient forensic units. Fellows spend about two weeks each year at Central State Hospital, which has the state's maximum security unit. Fellows are provided with temporary housing at that location. Each site attempts to have fellows take cases that are especially likely to require testimony, and fellows typically testify about 6 times/year on their inpatient cases.
Treatment of jail inmates: Experience in treating inmates occurs at the Atlanta City Jail where the service does not do pre-trial evaluations, which keeps the treatment and forensic evaluation roles distinct.
Sex offender treatment: Fellows rotate part-time for three months at a private clinic specializing in the outpatient treatment of sex offenders and professionals who have committed boundary violations.
Civil litigation evaluations
Residents serve as the primary evaluator in certain classes of cases, such as disability assessments, guardianship/ civil competency cases, and law school clinic referrals. Fellows also participate with more senior forensic psychiatrists in personal injury and malpractice cases.
Consultation/ legal regulation of psychiatry
Fellows serve as consultants on cases arising out of psychiatric hospital work, such as those involving commitment, dangerousness assessments, and competency to consent to treatment. They consult both to the inpatient psychiatry unit and to the general hospital.
Child forensic psychiatry
For fellows who have completed a child psychiatry fellowship, a wide range of experiences are available, including assessments in abuse/neglect issues, child custody, child personal injury, and a rotation at a juvenile detention center. Georgia law places large classes of violent adolescents in the adult criminal system, and so competency and criminal responsibility assessments of juveniles are more common here than in most other jurisdictions. The Service has a number of ongoing research projects on juvenile offenders.

Didactic experiences
The Director conducts a weekly case-oriented seminar and a weekly seminar on the non-criminal AAPL Landmark Cases. There are additional seminars at other sites on Landmark and important Georgia criminal cases. Considerable individual supervision is provided. Fellows may audit one course each term at the Emory University School of Law. The teaching conferences, grand rounds, etc., of the Emory psychiatry department are open to fellows. The Service pays travel and tuition expenses to the Forensic Psychiatry Review Course, which is given in conjunction with the annual meeting of AAPL, and pays expenses to the AAPL meeting.

Public policy development
The program has a close connection with state agencies that deal with forensic populations and mental health needs. Georgia is now rethinking many previous policies and developing new responses to a wide array of forensic issues. There are opportunities to participate at a state government level on policy development and in research projects aimed at informing public policy decision-making.

Research
The Emory fellowship is academically oriented, and the program strives to create new knowledge in forensic psychiatry. Fellows are encouraged in to participate in ongoing research projects or to develop their own. Fellows are required to submit proposals to present at the annual AAPL meeting, and extensive supervision is provided to enable them to do so.

Being a teacher
Fellows participate in training other professionals and in helping train psychiatry and child psychiatry residents who rotate through the program. Finally, fellows are responsible for running some seminars on forensic psychiatry for general psychiatry residents.

Staff
The staff currently consists of one full-time forensic psychiatrist at Grady and seven additional forensic psychiatrists who supervise at the other site placements (inpatient forensic, sex offender treatment clinic, etc.), and a number of forensic psychiatrists in private practice. The Director is Board-certified in child and adolescent psychiatry. Additional staff includes several psychologists, a social worker, and consulting attorneys.

Salary and fringe benefits
The anticipated annual salary for 2008-09 is $55,000. Fellows receive the standard benefit package associated with being a house officer at Emory. In addition, benefits include travel support to the annual AAPL meeting and various regional meetings and the expenses of taking the annual review course in forensic psychiatry given in conjunction with the annual AAPL meeting.

Application
Applicants must have completed a psychiatric residency prior to beginning the fellowship (PGY 5 and above) and be qualified to obtain a Georgia medical license.
There is no formal application form, but interested applicants should send a letter of interest and the following materials to Dr. Ash:
· Curriculum vitae
· Evidence of qualification for a Georgia medical license (in most cases this will be a copy of a current license from a state that has reciprocity with Georgia)
· A copy of the applicant's medical school diploma
· Three letters of reference. One of these must be from the training director of the resident's general psychiatry training program documenting expected satisfactory completion of general psychiatry training.
An interview with the Director is required, and a visit to the program is strongly advised. Interviews are scheduled after completed applications are received.  The program typically begins conducting interviews in August.  Applications may be submitted at any time.

Dr. Ash is happy to discuss the program with potential applicants by telephone.

 

 

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