University of Michigan/Center for Forensic Psychiatry Fellowship

The University of Michigan/Center for Forensic Psychiatry Fellowship is one of the oldest, most established fellowship of its kind in the country. Over the years, its faculty have included national leaders in forensic psychiatry, forensic psychology, public psychiatry and the interface between mental health and the law. Located in the Ann Arbor area of Michigan, the fellowship offers opportunities unique in the country and all within an easy drive (and even a bike ride on warm days). 

Center for Forensic Psychiatry (CFP)

Serving as the fellowship’s main rotation site, the Center for Forensic Psychiatry (CFP) provides diagnostic outpatient and inpatient evaluation and inpatient treatment of individuals committed to the Michigan Department of Health and Human Services by the criminal courts. Since its inception in 1974, CFP has been one of the nation’s premier training sites for professionals in psychiatry, psychology and social work specializing in the interface between mental health and the law. CFP is currently operated out of the Michigan Department of Health and Human Services, State Hospital Administration. The fellowship operates through a collaborative and contractual partnership within the graduate medical education framework of the University of Michigan Department of Psychiatry.

The fellowship program in forensic psychiatry is a one-year, post-residency training program for psychiatrists planning careers in forensic or correctional psychiatry. It is accredited by the Accreditation Council for Graduate Medical Education. Board certified general psychiatrists in good standing who complete this program are qualified to sit for the subspecialty examination in forensic psychiatry offered by the American Board of Psychiatry and Neurology.

Program Description

The fellowship program consists of rotations and experiences involving criminal evaluations, civil evaluations, risk assessments pertaining to release decisions for insanity acquitees, violence risk assessments, restoration of competency to stand trial, courtroom testimony and forensic consultation to general psychiatrists. Fellows work with the State Medical Director for Behavioral Health and Forensic Programs to learn about psychiatric administration, public policy and statutory development. Exposure to correctional psychiatry, police training, specialty courts and other alternatives to incarceration programs are among the opportunities available. Fellows interested in the intersection of child psychiatry and the law may be involved with case consultations related to juvenile justice programs and child welfare.

A key aspect of the program is its comprehensive didactic instruction including clinical and legal aspects of forensic psychiatry offered at CFP and taught by a rich faculty of board-certified forensic psychiatrists, forensic psychologists, program-affiliated attorneys and guest lecturers. CFP frequently hosts larger conferences on topics of forensic relevance. The mock trial series offers fellows the opportunity to participate in a mock trial as an expert to assist them in their actual testimony and observe others in mock trials conducted throughout the year. Tours of state hospitals, community mental health programs, correctional sites, and court-related sites are available during the year. Classes at Michigan Law-University of Michigan and completion of a scholarly project are part of the program. Fellows can study in the CFP library and have access to the vast library resources of the University of Michigan.

Key faculty involved in the program include:

Matthew Grover, M.D.

Dr. Grover is the Program Director of the Forensic Psychiatry Fellowship and supervises fellows at the Center for Forensic Psychiatry and the University of Michigan. He is Clinical Assistant Professor of Psychiatry in the Program in Psychiatry, Law, and Ethics at the University of Michigan Medical School.

Debra A. Pinals, M.D.

Dr. Pinals is the Director of the Program in Psychiatry, Law, and Ethics and Clinical Professor of Psychiatry at the University of Michigan Medical School. She also serves as the Medical Director of Behavioral Health and Forensic Programs for the Michigan Department of Health and Human Services (MDHHS). She participates in the fellowship as senior faculty supervising fellows and other trainees in her roles at MDHHS and the University of Michigan.

Diane Heisel, M.D.

Dr. Heisel serves as the State Hospital Administration Director of Training and Research at the Center for Forensic Psychiatry. She supervises fellows at the Center for Forensic Psychiatry.

Kimberly Kulp-Osterland, M.D.

Dr. Kulp-Osterland serves as the Director of Psychiatry at the Center for Forensic Psychiatry. She participates in the teaching and supervision of fellows.

Candyce Shields, Ph.D.

Dr. Shields is the Assistant Director of Evaluation Services at the Center for Forensic Psychiatry. She is a leading national figure in education in forensic psychology. She serves as a fellowship supervisor on the Evaluation Unit.

Ernest Poortinga, M.D.

Dr. Poortinga serves as a fellowship supervisor on the Evaluation Unit and on the inpatient units at the Center for Forensic Psychiatry.

Lisa Anacker, M.D.

Dr. Anacker serves as a fellowship supervisor on the Evaluation Unit and on the inpatient units at the Center for Forensic Psychiatry.

Martha Smith, Ph.D.

Dr. Smith is the Assistant Director of Evaluation Services at the Center for Forensic Psychiatry. She serves as a fellowship supervisor on the Evaluation Unit.

Jay Witherell, Ph.D.

Dr. Witherell is the Director of Evaluation Services at the Center for Forensic Psychiatry. He serves as a fellowship supervisor on the Evaluation Unit.

Margo Schlanger, J.D.

Professor Schlanger is the Wade H. and Dores M. McCree Collegiate Professor of Law at the University of Michigan Law School. She teaches the fellows as part of a monthly seminar series.

Samuel Bagenstos, J.D.

Professor Bagenstos is the Frank G. Millard Professor of Law at the University of Michigan Law School. He teaches the fellows as part of a monthly seminar series.

Elissa Benedek, M.D.

Dr. Benedek is an Adjunct Clinical Professor of Psychiatry at the University of Michigan Medical School and teaches the fellows as part of monthly case seminar series, which is based upon her career in child and adolescent forensic psychiatry.

Clinical Rotations

Fellows receive clinical training on the inpatient treatment units at CFP, the outpatient Evaluation Unit at CFP, and the Forensic Evaluation Service at Michigan Medicine. Additional time is spent in Lansing participating in work in administrative and consultative forensic psychiatry. Since the start of the SARS-CoV-2 pandemic, video teleconferencing has been used to complete some forensic evaluations, consultative work, and administrative work. Tours of correctional facilities, including local jails and state prisons are also available.

Center for Forensic Psychiatry  Outpatient Evaluation Unit

In order to obtain certification as Consulting Forensic Examiners under Michigan law, fellows observe competency to stand trial and criminal responsibility evaluations in the outpatient unit. They then conduct at least ten supervised competency evaluations and ten criminal responsibility evaluations. These evaluations are supervised by both psychiatrists and psychologists who are Consulting Forensic Examiners, with three staff members participating at the beginning of the process and then again at the end to evaluate the fellows progress. Fellows observe court testimony, participate in a mock trial, and provide testimony when required in cases they have examined. Other forensic issues arising in the evaluation unit include competency to waive Miranda rights and competency to be sentenced.

Center for Forensic Psychiatry – Inpatient Units and Clinical Consultation

Most inpatients at CFP have been found Not Guilty by Reason of Insanity (NGRI) or incompetent to stand trial (IST). Fellows function both as treating psychiatrists for their own patients and as forensic examiners for the patients of other clinicians. They receive ongoing supervision in the management of forensic patients with emphasis on clinical problems such as suicide, malingering, amnesia, self-injurious behavior, violence, psychosis, substance abuse, and antisocial behavior. Fellows prepare psychiatric reports and provide testimony related to clinical certificates for continued, involuntary hospitalization. Other important forensic issues encountered on inpatient units include the right to treatment, the right to refuse treatment, informed consent, and confidentiality/privilege. Typical case loads of 4-6 patients are carefully monitored to provide exposure to a variety of diagnostic groups, legal issues, and offenses. 

Additionally, CFP oversees the community access points for individuals found Not Guilty by Reason of Insanity (NGRI) throughout Michigan. Many of the individuals are hospitalized at CFP; others are at one of three regional state hospitals for adults (Caro Center, Kalamazoo Psychiatric Hospital, and Walter Reuther Psychiatric Hospital) or in the community. Interviews of these individuals are at times required, including assessments for readiness for step-down to regional state hospitals or direct community placement. Fellows routinely participate in these interviews with senior forensic psychiatrists, including the Departmental Designee who is assigned to review specific release decisions for individuals whose NGRI finding was related to these more serious offenses.

Program in Psychiatry, Law, and Ethics, Michigan Medicine —Forensic Evaluation Service

The Forensic Evaluation Service within the Program of Psychiatry, Law, and Ethics at Michigan Medicine serves as the venue for this rotation. Fellows consult to other psychiatrists on issues related to the legal regulation of psychiatric practice, such as civil commitment, confidentiality, refusal of treatment, emergency treatment, decision-making competence, guardianship and conservatorship, etc. Cases have also included federal criminal cases, asylum and immigration cases, as well as evaluation of high-risk professionals such as pilots. They gain experience in psychiatric aspects of civil litigation such as malpractice, disability, sexual harassment, psychic injury related to trauma, child custody, and in administrative and public policy aspects of forensic psychiatry.

The rotation includes several major components. First, fellows attend a monthly conference including psychiatry residents and faculty from the forensic psychiatry program of the University of Michigan Department of Psychiatry.  At the conference, cases and questions pertaining to the law/psychiatry interface are presented for consultation and educational purposes. Fellows and psychiatry residents also participate in the presentations. Second, fellows meet regularly with University of Michigan Law School faculty to discuss matters relating to the legal regulation of psychiatry, with particular reference to active issues such as litigation, prison reform and policy issues across systems of care. Third, fellows observe and assist experienced forensic psychiatrists in private practice and in settings related to civil controversies. Fourth, fellows can work with senior faculty who participate in high level behavioral threat assessments when consultation is requested from a variety of systems.

Didactic Program

Mastery of forensic psychiatry requires immersion in a knowledge base and a style of thinking that are foreign to most clinicians. Didactics are therefore given a high priority, and protected time is offered for fellows to attend these trainings.

Clinical Aspects of Forensic Psychiatry (Core Curriculum I)

Dr. Matthew Grover oversees the main didactic program for the forensic psychiatry fellowship. The program is fortunate to have a robust faculty group with training and experience in the practice of forensic psychiatry. These faculty participate in much of the teaching. Faculty lead discussions on all aspects of forensic psychiatry, emphasizing a practitioner’s perspective. The traditional subject matter of law and psychiatry is covered, including an overview of many of the topics addressed in the complementary landmark case seminar Core Curriculum II course (see below). The course’s emphasis is less on the material facts related to the landmark cases and more on their practical application. Clinical topics covered include:

  • Conducting forensic assessments and writing forensic reports
  • Serving as an expert witness
  • Risk assessment in forensic and civil populations
  • Consideration of malingering in the forensic assessment
  • Evaluation of special populations (sexual offenders, psychopathy)
  • Assessment and treatment of criminal justice-involved populations
  • Applicability of psychological testing in the forensic assessment 
  • Forensic issues within child and adolescent psychiatry (e.g. juvenile justice, child welfare, child custody)

Landmark Cases and Legal Aspects of Forensic Psychiatry (Core Curriculum II)

Debra A. Pinals, M.D., reviews major legal systems and principles of law critical for the practice of forensic psychiatry through the primary fellowship Landmark Case Seminar. The Landmark Cases of forensic psychiatry provide source material for the study of the underpinnings of criminal and civil law, including criminal responsibility, pre-and post-adjudication disposition of defendants, criminal procedure, evidence, personal injury/malpractice, patient and prisoner rights, family law, disability law, and expert testimony as practiced in federal and state courts. The cases presented also provide a thorough introduction to legal principles that enable the forensic resident to understand the legal literature and appreciate the significance of developing case law. Dr. Pinals also emphasizes how these legal cases inform medical knowledge, practice-based learning and contribute to public policy and the legal regulation of psychiatric practice and systems of care. 

To buttress this training core curriculum, faculty from the University of Michigan Law School serve as invited participants in select landmark case lectures pertaining to areas of expertise. Fellows also meet regularly with key law school faculty to assist in their understanding of law and its interface with psychiatry.

Michigan Law-University of Michigan

During the year trainees attend the “Law and Psychiatry at Criminal, Civil and Public Policy Crossroads” Course taught by Dr. Pinals at the University of Michigan Law School in the Winter semester. In addition, trainees meet regularly with select faculty of the law school during the year for individual instruction in an open forum type discussion.

Continuing Medical Education Psychiatry Seminar(Friday Conference)

Visiting speakers, CFP Staff, and University of Michigan faculty present selected topics in general and forensic psychiatry, varying from year to year, but emphasizing newly developing knowledge and treatments.  Topics for major CME conferences in recent years have included intellectual and developmental disabilities in forensic psychiatry, geriatric and older adults and the law, correctional mental health practices, and jail diversion.

Living in Ann Arbor

Located 45 miles west of downtown Detroit, Ann Arbor is a city of around 110,000 residents with a great mix of city sophistication and small-town charm that appeals to students, professionals, singles, and families. This progressive, diverse, and culturally rich city attracts visitors and residents from all over the world.

To learn more about the life in and around Ann Arbor, we encourage you to review the Go Blue Guide!

Program Requirements and How to Apply

Residents are required to be graduates of an accredited psychiatric residency training program and eligible for licensure in the State of Michigan.

We are accepting applications for the 2021-2022 academic year. We will be accepting applications for the 2022-2023 academic year starting in January 2021, and e-mail submission of applications to Dr. Grover is preferred. Interviews for the 2022-2023 academic year will be starting in April 2021. Due to the SARS-CoV-2 pandemic, we will be completing interviews by video teleconference. We encourage applicants from diverse backgrounds and prior fellowship training experiences to apply. Application requirements include:

  1. Completion of the application form
  2. Photo
  3. Official copy of medical school transcript and dean’s letter
  4. Three letters of reference, one of which must be from your current program director or, if you have completed training within the past five years, the director of the program from which you graduated most recently
  5. Copy of USMLE/COMLEX scores
  6. Copy of current medical license(s)
  7. Copy of the ECFMG certificate (if applicable)
  8. Copy of Medical School Diploma
  9. At least one additional writing sample (e.g., de-identified forensic report or psychiatric evaluation, published manuscript of which you are the first author)
  10. Personal statement of one single-spaced page or less that explains your interest and/or experience in forensic psychiatry
  11. Curriculum Vitae

 

For more information, please contact:

Matthew Grover, M.D.
Director, Forensic Psychiatry Fellowship Program, University of Michigan
c/o Center for Forensic Psychiatry P.O. Box 2060 Ann Arbor, MI 48106