– OR –

JUST FIND YOUR ANSWERS BELOW:

These are the questions I hear most often, or find are the source of the most confusion. I hope this is helpful.

  • Defense Base Act (DBA), Military and (JAG), VA Expert Witness, Combat Zone

    I have served as an Expert Witness in military venues and cases involving combat-related facts on numerous occasions.   Increasingly I am called about cases involving private contractors alleging injuries in a military zone (e.g. Defense Base Act aka DBA cases).  Obviously, combat and alleged combat-related injuries, are sometimes psychiatric.

    My experience dates back to 1969-1970 when I was stationed at 5 USA Headquarters as the psychiatric consultant to the Surgeon of 5USA.  One assignment was to consult, and, if necessary, testify as the psychiatry Expert Witness for the Judge Advocate General. In that first case, in 1970, a man went to the Induction Board to be sworn in. He took the oath but couldn’t or wouldn’t step over the line as requested. Was it draft evasion or impaired mental health? In recent years I increasingly find myself asked to opine and testify in cases where private sector employees work in combat zones and suffer injuries in which there is a mental health issue (claim of emotional distress or PTSD caused by alleged employer acts, to name a few). Unprecedented numbers of cases of PTSD and other mental health disorders are being reported by veterans returning from combat in the Middle East.  Most recently, the VA released statistics about increased diagnoses of PTSD, related disorders, and even suicide, among soldiers who have served in Afghanistan.   Proper diagnosis, treatment and prognosis of the such illnesses by a trained physician–psychiatrist–is essential to any assessment.  (My article on PTSD addresses this in greater detail).  I have opined in Defense Base Act cases, and in issues arising out of disputes over VA benefits and insurance liability regarding non-combat employees, to name a few.  As an objective examiner, I am sensitive to issues of both malingering and, contrastly, the individual who is downplaying the severity of their symptoms–not surprising in a personality type hardened from battle.

    I recently received a very kind and gratifying response regarding a VA case:

  • Professional Fees – Rates

    There are several questions potential clients almost always seem to ask the first time they contact my office or send an inquiry from this website:

    • Do you have experience in the area relevant to my case?
    • What are your fees?
    • What is your hourly rate?
    • How much will it cost?

    The last 3 questions are essentially the same.  There’s a very good reason my fee schedule isn’t posted on this website: it is not, in my experience, an indication of the question really being asked: “How much will it cost to have you do what I am seeking, to the level I need it to be done?” Followed closely by “Can you do it efficiently and cost-effectively?” The answer lies completely in the conversation that must take place between us. What do you seek? Do either of us know, prior to a conversation, what is necessary and how long it will take?

    I have been a Forensic Psychiatrist for 40 years, giving me the advantage that whatever lies before me, I have probably done it before, and sometimes many hundreds of times. I am by skill and nature efficient.  My fee schedule, produced out of context, in no way states the cost of my services.

    Am I the right expert for your case? Given my contribution to the litigation, which is always the bottom line, am I worth the expense to your client? Will I accomplish in fewer hours and at a greater level of quality what an alternative expert can, whatever his or her “price.”

    My fee schedule is available on request, of course, but it is my hope that it be a companion to a conversation between us about what brought you to me and what is needed.

  • What is a Forensic Psychiatrist?

    A Forensic Psychiatrist is

    • a licensed physician, Board-Certified in Psychiatry.  Board certification in Forensic Psychiatry requires further experience and training in Forensic Psychiatry.
    • A Forensic Psychiatrist assesses medical and psychiatric history of an individual, reviews relevant records and may conduct a psychiatric examination (IME) and psychological testing, to synthesize and render an opinion used in a legal framework

    Commonly, a forensic psychiatrist performs a psychiatric evaluation within the context of a legal or administrative determination, e.g. civil law, employment (HR) practices, criminal law, and administrative law.  The psychiatrist synthesizes the information obtained to render conclusions which he or she is prepared to defend before the legal venue.  Familiarity with the governing legal questions assists the trained forensic psychiatristto come to a conclusion, issued by report or testimony, although most forensic psychiarists do not have this understanding.  The forensic psychiatric examination (Independent Medical Examination  or IME) is not the same as a clinical psychiatric examination as the law and forensic practices present thressholds and questions which are unique to law and medicine.

    Since 1994, the American Board of Psychiatry and Neurology (ABPN)  has certified Psychiatrists (through examination) in Forensic Psychiatry.   I became Board‑Certified by the ABPN in Forensic Psychiatry in 1994, the first year the specialty was certified.  I already had been Board‑Certified in (general) Psychiatry for many years.  Presently, in order to be eligible to take the Board examinations in Forensic Psychiatry, the psychiatrist must complete a one‑year fellowship in Forensic Psychiatry at an accredited institution.

    When I completed my residency in psychiatry, there were no forensic psychiatry fellowships; psychiatrists learned by doing, and usually obtained consultation from psychiatrists who were experienced in forensic psychiatry.  I chose first to audit selected law classes at the University of California, Berkeley (Boalt Hall), in a special program arranged for me by Bernard Diamond, M.D., who was then Professor of Law, Professor of Psychiatry, and Chairman of the Department of Criminology at the University of California, Berkeley.  Upon completion of my one year at Boalt Hall, Dr. Diamond continued to mentor me for four more years.

    3% of all Board Certified Psychiatrists also hold Board Certification in Forensic Psychiatry. It is of note that since 1994 only half of all Board Certified Forensic Psychiatrists are still in practice.  Most have obtained this Board Certification in only the past 8-10 years**.    It is a small population and, when you need experience on and off the stand, the pool shrinks further.  For those reasons, an experienced Forensic Psychiatrist makes any case stronger where mental health is at issue in a medical-legal venue.

    * These two Board Certifications are significant because a doctor who is not Board Certified as a Forensic Psychiatrist specifically, may still hold him or herself out as a “Forensic Psychiatrist.”

    ** Per the American Board of Psychiatry and Neurology.

  • What is an Expert Witness?

    An Expert Witness is a person who possesses information due to special education, training or experience who can assist the trier of fact in reaching a verdict. (In our judicial system, a “trier of fact” is generally a judge or jury). The term Expert Witness is generally used in civil litigation or criminal cases, and the names of Expert Witnesses who will testify on behalf of a plaintiff or defendant are disclosed to the opposing party and the Court. Details of this process are best deferred to an attorney.

    See also What is Expert Testimony?

  • Are you a lawyer?

    No. I am not an attorney and do not practice law. I also do not refer individuals to specific attorneys.

  • Do you treat patients? Where on your website can I find out about insurance you accept and what you charge?

    Reasons the Treating Psychotherapist Should Not Be the Expert Witness

    In civil cases where emotional distress is alleged, it often occurs that the plaintiff’s attorney designates the treater as his expert. Usually the argument is that the plaintiff’s own therapist (“the treater”) has spent many more hours with the plaintiff than the defense expert and therefore “knows” the plaintiff better.  The treater often agrees with this reasoning.

    I believe a number of fallacies exist in this conclusion:

    If the patient is conniving, then the therapist is being duped into undertaking a sham therapy.

    If the patient believes the therapist is going to be his Expert Witness, then consciously or unconsciously the patient will withhold information detrimental to his case and over-emphasize facts favorable to it.

    Therapists undertake therapy with the implicit understanding that the relationship is private and privileged under almost all circumstances. This enables the patient to divulge embarrassing or damaging information which he wouldn’t want revealed. After the fact, how can the patient give an informed consent when he doesn’t know what personal information will be divulged.

    Once the therapist is perceived as an advocate, I believe the therapist’s impartiality and non-judgmental attitude is replaced with the perception of approval and advocacy. A therapeutic boundary is crossed. Therapy is damaged. Being an Expert Witness for one’s patient does not further the therapy. The Hippocratic Oath “above all do not harm” is disregarded.

    Setting these reasons to the side, is the assumption true that a comprehensive structured forensic psychiatric exam including a review of all records, relevant depositions, expert reports and psychological testing less reliable than a psychotherapy which is defined by the patient’s transference, unstructured free association, therapeutic process, and non-judgmental therapeutic attitude of the therapist where the therapeutic task is to help the patient understand emotional conflicts and resolve them. It is not far-fetched to imagine the therapist-expert developing opinions during discovery which might be damaging to the therapeutic process. He can’t withdraw because doing so damages the therapy, he shouldn’t lie because that damages his therapeutic impartiality, and he becomes the patient’s advocate in the patient’s mind which also introduces a non-therapeutic parameter into the therapy. The therapist is now a dual agent (dual agency) and cannot serve the single purpose of treating a patient.

    Psychotherapy does not involve weighing all of the clinical facts and rendering a medical-legal opinion with a reasonable medical probability. It doesn’t involve being an impartial evaluator who has no vested interest in the outcome of the case. Psychotherapy isn’t about assuming a skeptical mind set in order to weigh the plaintiff’s statements with other facts and reconcile the conflicted information within the context of the lawsuit. Undertaking a real, impartial forensic psychiatry evaluation is not therapeutic. The content of therapy is part of the basis of an expert opinion but there is much more to the evaluative process which is beyond the scope of therapy. Once the therapist crosses the line to expert, he can’t go back. The bell cannot be unrung.

    This article has previously appeared on the TASA (Technical Advisory Group for Attorneys) website and HGExperts.com as “When Therapists Aren’t Experts.”

  • Have you ever been an Expert Witness for JAG?

    Yes, on numerous occasions. My experience dates back to 1969-1970 when I was stationed at 5 USA Headquarters as the psychiatric consultant to the Surgeon of 5USA. One assignment was to consult, and, if necessary, testify as the psychiatry Expert Witness for the Judge Advocate General.

  • What do you mean by Jurisdictions? Besides, Civil cases, how about Federal Circuit Court, Appeals Court? Military Court? Criminal Cases?

    A “Jurisdiction” is the court where a legal dispute is resolved; e.g., Superior Court. In my work with the U.S. Attorney’s Office, and private law firms for plaintiff and defense, I have testified in cases in Federal District Court and the Court of Appeals. I have served as an Expert Witness in Civil and Criminal cases from the County Superior Court level to the State Supreme Court. I have consulted in cases for JAG as well as individuals in MilitaryCourt. I refer you, as well, to the bio on the home page of this site in which I describe a brief history of my military background as a psychiatrist in forensic settings. Regarding criminal cases, elsewhere on this site is the Case Study Homicide and Murderers on that topic, including my experience with over 100 murder trials and a memorable encounter with “Trailside Killer” David Carpenter. I have also testified in many administrative hearings, such as the Federal EEOC and the California Workers’ Compensation Appeals Board.

  • Do you charge for travel time?

    My charges for travel time vary according to circumstances. My major consideration is the flexibility I am allowed in setting up my trip and conducting the exam. For example, if I am able to fly to the east coast on a “red eye,” conduct my exam, or testify, leave there that day and return on the “red eye” at the end of the day, my use of time is optimized and my travel time charges reflect that. Another favorable scenario is flying to a location on a Friday, conducting my exam on a Saturday and returning on Sunday. In each of these instances, I am away from my office and patients a relatively small amount of time. In principle, the least amount of time I lose from my usual professional practice, the more flexible I can be when charging for travel time. My hourly rate for travel time is less than my usual rate for services.

  • Where in North America have you been an Expert Witness?

    While I maintain offices in the San Francisco area, I routinely conduct IMEsand act as an Expert Witness, including giving testimony, in other States as well as Canada and occasionally farther afield. In only the past few years, my testimony has been called in cases, or to travel for the purpose of conducting an IME, to make a partial list, in Washington, D.C., Nevada, West Virginia, Minnesota, Washington State, New Jersey, Texas, Oregon, Florida and Ohio, as well as Canada and Great Britain. For a number of years I held an Alaska medical license in light of my very busy forensic practice there. I am currently working on cases in States which expand on this list. Therefore, I have chosen to include the terms “nationwide” and “North America On-Site Consultation” to clarify that my forensic psychiatric practice reaches far beyond the location of my office and has throughout my career.

  • What’s the difference between the work you do for “employers” and “law firms ”. Why do you mention both on your website?

    My psychiatric career includes working with plaintiff and defense attorneys to help them to conduct IMEs and/or testify as an Expert Witness.  I also work with employers and insurers to conduct long term disability evaluations, Fitness for Duty and/or Threat Assessments (sometimes called Risk of Violence Assessments) of employees in the workplace.

    I have chosen to include the terms “nationwide” and “North America On-Site Consultation” because I have worked in many states and jurisdictions, as well as throughout California, and I maintain offices in the San Francisco area.  For many years, in addition to my California medical license, I held a medical license in Alaska because I had so many cases there.  In only the past few years I have been retained by attorneys and employers with cases in Great Britain, Nevada, West Virginia, Minnesota, Canada, New Jersey, Texas, Washington, Oregon, Nevada, Florida, Washington, D.C. and Ohio, to make a partial list.

  • How much do you charge?

    Do you have experience in the area relevant to my case? What are your fees? What is your hourly rate? How much will it cost?

    The last 3 questions are essentially the same.  There’s a very good reason my fee schedule isn’t posted on this website: it is not, in my experience, an indication of the question really being asked: “How much will it cost to have you do what I am seeking, to the level I need it to be done?” Followed closely by “Can you do it efficiently and cost-effectively?” The answer lies completely in the conversation that must take place between us. What do you seek? Do either of us know, prior to a conversation, what is necessary and how long it will take?

    I have been a Forensic Psychiatrist for 40 years, giving me the advantage that whatever lies before me, I have probably done it before, and sometimes many hundreds of times. I am by skill and nature efficient.  My fee schedule, produced out of context, in no way states the cost of my services.

    Am I the right expert for your case? Given my contribution to the litigation, which is always the bottom line, am I worth the expense to your client? Will I accomplish in fewer hours and at a greater level of quality what an alternative expert can, whatever his or her “price.”

    My fee schedule is available on request, of course, but it is my hope that it be a companion to a conversation between us about what brought you to me and what is needed.

  • How many cases have you won?

    Doctors do not “win” cases, but their testimony can provide useful impartial medical evidence to assist the triers of fact (e.g. judge and/or jury) to understand psychiatric processes which a lay person is not expected to know. After many trials, jurors have said my testimony enabled them to understand the mental issues in the case.

  • Do you have a Rule 26 Disclosure that I may review?

    Yes. Contact my office via phone (415) 461 4845, or e-mail: rafflemd@rafflemd.com.

  • Do you give testimony as an Expert Witness for private people or just law firms?

    My policy is to consult for attorneys as a psychiatric Expert Witness. I do not consult for individuals who are representing themselves (i.e., pro se).

  • What is a “Fitness for Duty”? Is a “Threat Assessment” different?

    A Threat Assessment is not a Fitness for Duty exam because the focus of each is different. A Fitness for Duty (FFD) exam is a medical examination to determine if an employee is “fit” to do his or her job (duty). The employee’s job description defines the duties and responsibilities. A psychiatric FFD assesses the presence of a psychiatric condition which may make the employee unable to do his or her job. When an employer believes a potential risk of violence in the workplace exists or has a reasonable concern an employee may pose a danger to himself or others, a Threat Assessment is necessary. If an employer believes an employee is creating a hostile work environment, then concurrent Threat Assessment and Fitness for Duty exams may be necessary, depending on the circumstances.

    See also in Practice Areas: Fitness for Duty and Threat Assessment
    and in Articles: When the Workplace Turns Hostile

  • What is Expert Testimony?

    I believe this question is best answered by the definition and scope of expert testimony in the Federal Rules of Evidence, Article VII – Opinions and Expert Testimony:

    Rule 701 – Opinion Testimony by Lay Witnesses

    If a witness is not testifying as an expert, testimony in the form of an opinion is limited to one that is:
    (a) rationally based on the witness’s perception;
    (b) helpful to clearly understanding the witness’s testimony or to determining a fact in issue; and
    (c) not based on scientific, technical, or other specialized knowledge within the scope of

    Rule 702.

    Rule 702 – Testimony by Expert Witnesses

    A witness who is qualified as an expert by knowledge, skill, experience, training, or education may testify in the form of an opinion or otherwise if:

    (a) the expert’s scientific, technical, or other specialized knowledge will help the trier of fact to understand the evidence or to determine a fact in issue;
    (b) the testimony is based on sufficient facts or data;
    (c) the testimony is the product of reliable principles and methods; and

    (d) the expert has reliably applied the principles and methods to the facts of the case.

    Rule 703 – Bases of an Expert

    An expert may base an opinion on facts or data in the case that the expert has been made aware of or personally observed. If experts in the particular field would reasonably rely on those kinds of facts or data in forming an opinion on the subject, they need not be admissible for the opinion to be admitted. But if the facts or data would otherwise be inadmissible, the proponent of the opinion may disclose them to the jury only if their probative value in helping the jury evaluate the opinion substantially outweighs their prejudicial effect.

    Rule 704 – Opinion on an Ultimate Issue

    (a) In General — Not Automatically Objectionable. An opinion is not objectionable just because it embraces an ultimate issue.

    (b) Exception. In a criminal case, an Expert Witness must not state an opinion about whether the defendant did or did not have a mental state or condition that constitutes an element of the crime charged or of a defense. Those matters are for the trier of fact alone.

    Rule 705 – Disclosing the Facts or Data Underlying an Expert

    Unless the court orders otherwise, an expert may state an opinion — and give the reasons for it — without first testifying to the underlying facts or data. But the expert may be required to disclose those facts or data on cross-examination.

    Rule 706 – Court-Appointed Expert Witnesses

    (a) Appointment Process. On a party’s motion or on its own, the court may order the parties to show cause why Expert Witnesses should not be appointed and may ask the parties to submit nominations. The court may appoint any expert that the parties agree on and any of its own choosing. But the court may only appoint someone who consents to act.

    (b) Expert’s Role. The court must inform the expert of the expert’s duties. The court may do so in writing and have a copy filed with the clerk or may do so orally at a conference in which the parties have an opportunity to participate. The expert:

    (1) must advise the parties of any findings the expert makes;
    (2) may be deposed by any party;
    (3) may be called to testify by the court or any party; and
    (4) may be cross-examined by any party, including the party that called the expert.

    (c) Compensation. The expert is entitled to a reasonable compensation, as set by the court.

    The compensation is payable as follows:

    (1) in a criminal case or in a civil case involving just compensation under the Fifth Amendment, from any funds that are provided by law; and
    (2) in any other civil case, by the parties in the proportion and at the time that the court direct — and the compensation is then charged like other costs.

    (d) Disclosing the Appointment to the Jury. The court may authorize disclosure to the jury that the court appointed the expert.

    (e) Parties’ Choice of Their Own Experts. This rule does not limit a party in calling its own experts.”

  • What is a Forensic Psychiatrist? When do I need a forensic psychiatrist?

    A Forensic Psychiatrist is a medical doctor who is a psychiatrist. When a psychiatrist performs a psychiatric evaluation within the context of a legal framework (IME), e.g., criminal law, civil law, or administrative law, and the psychiatrist is prepared to defend his opinions before the relevant venue, then the psychiatrist is functioning as a forensic psychiatrist. A forensic psychiatrist is a useful Expert Witness in any case where emotional distressis claimed, a common feature of many personal injury cases, for example, civil torts or cases where punitive damages are considered. Emotional or neurological damage may drive residual damage and an expert must be involved to assess and explain a forensic finding to a jury. It is expected the forensic psychiatrist is familiar with the governing legal questions and has addressed them during his forensic psychiatric examination.

    Since 1994, the American Board of Psychiatry and Neurology (ABPN) has certified Psychiatrists (through examination) in Forensic Psychiatry. Presently, in order to be eligible to take the Board examinations in Forensic Psychiatry, the psychiatrist must complete a one‑year fellowship in Forensic Psychiatry at an accredited institution. When I completed my residency in psychiatry, there were no forensic psychiatry fellowships; psychiatrists learned by doing, and usually obtained consultation from psychiatrists who were experienced in forensic psychiatry. I chose first to audit selected law classes at the University of California, Berkeley, in a special program arranged for me by Bernard Diamond, M.D., who was then Professor of Law, Professor of Psychiatry, and Chairman of the Department of Criminology at the University of California, Berkeley. Upon completion of my one year at Boalt Hall, Dr. Diamond continued to mentor me for four more years.

    I became Board‑Certified by the ABPN in Forensic Psychiatry in 1994, which was the first year the Board exam was given. I already had been Board‑Certified in (general) Psychiatry for many years.

  • What is a Psychiatric Evaluation, Mental Evaluation, or IME? How are they different?

    A Psychiatric Evaluation, Psychiatric Assessment, Independent Medical Evaluation (IME) or Mental Evaluation mean the same thing: a psychiatrist evaluates the psychiatric condition of an individual in the past and/or present in order to answer specific questions. Elements of the evaluation vary from case to case, depending on the questions. Psychiatrists use skill, experience, and sometimes diagnostic studies (such as psychological tests). Whenever possible, I spend time one-on-one with the person I am examining, obtaining a relevant history. I may review records, psychological test results, and question collateral informants. Only then do I synthesize all of this information to arrive at a diagnosis and conclusions. The result is my medical opinion, reached with no less than a reasonable medical probability (i.e. “more likely than not”).

  • What is Post-Traumatic Stress Disorder (PTSD)?

    Post-Traumatic Stress Disorder (PTSD) is a psychiatric condition understood to be an anxiety disorder arising as a result of an emotionally overwhelming experience usually accompanied by a symptom complex which, for example, might include nightmares that recapitulate the traumatic event, and recurrent intrusive thoughts about the event. In a forensic psychiatrypractice, PTSD is a common diagnosis. PTSD is often erroneously diagnosed by a treating doctor merely because an individual has been exposed to a situation that might cause PTSD. Whereas one individual may experience a debilitating PTSD which lingers for many years, another person exposed to the same trauma may not. The event does not define the PTSD. Further, when there is no PTSD, there may be the presence of another emotional response to a traumatic event. Any psychiatric condition must be accurately diagnosed in order for there to be effective treatment.

    Not all emotional traumas cause PTSD. Symptom syndromes which may arise from a traumatic emotional experience are:

    • emotional distress
    • emotional numbing
    • phobias
    • avoidance (e.g. walking across the street to avoid a reminder of the traumatic event)
    • depression
    • paranoia
    • avoidant behavior
    • nightmares
    • obsessive thinking
    • “I can’t stop thinking about it”
    • irritability
    • change in personality
  • What is the difference between a Psychiatrist and a Psychologist?

    I have explained the training of a psychiatrist in the FAQ “What is a Psychiatrist?” A psychologist has not attended medical school and does not possess medical expertise. Psychology is the study of mental (emotional) behavior. A psychologist is a person skilled in understanding mental (vs. physical) phenomenon. In California, a psychologist is a non-medical practitioner of the mental healing arts who is licensed by the state to perform those arts.

    In order to be eligible to sit for the licensing examination in psychology, the candidate must have completed a Ph.D., Ed.D., or Psy.D. in psychology and been supervised for 3000 post-doctoral clinical hours by a California licensed psychologist, of which 1500 hours may be supervised by a Board-Certified Psychiatrist.

    The curriculum for the study of psychology may emphasize administering psychological testing, scoring and interpreting test results, as well as course work and supervised treatment of patients (usually both inpatients and outpatients). Psychodynamics are taught as well as other theoretical models of psychopathology and therapy. Competence in neurology is not required, nor is psychopharmacology inasmuch as psychologists are not licensed to prescribe medications. Psychologists generally are not expected to diagnose medical conditions which are causing mental illness because of the scope of their training, nor the effects of drug interactions on behavior.

    The Ph.D. requires a research dissertation. After the completion of the Ph.D. some psychologists obtain additional training in neuropsychology which involves the diagnoses of brain dysfunction using neuropsychological tests and the use of neurocognitive rehabilitation therapy in patients who have brain damage.

  • What is a Psychiatrist? What Qualifies a Psychiatrist to practice Forensic Psychiatry?

    Psychiatry is a subspecialty of medicine.

    In order to become a physician, a doctor must complete a four year education in medicine which includes the basic sciences of anatomy, physiology, pharmacology, biochemistry, microbiology, histology, psychiatry, pathology, and the clinical sciences which include, but are not limited to, general and specialty surgery, subspecialty medical clinics in internal medicine, opthalmology, psychiatry, obstetrics, orthopedics, pediatrics, cardiology, pulmonology, gastroenterology, urology, dermatology, pathology (clinical pathological conference), neurology, ENT, obstetrics and gynecology.

    After completing the curriculum, the doctor must pass a competency examination in each state he wishes to practice in order to be licensed a physician and surgeon or, alternatively, pass a nationwide examination administered by the National Board of Medical Examiners which is accepted by almost all states.

    A psychiatrist must first complete all of the medical educational and licensing requirements of a physician and surgeon before he or she can begin four (4) or more years of study to become a psychiatrist. Forensic psychiatry subspecialization requires an additional fellowship year and then successfully passing the Board examination.

    The American Board of Psychiatry and Neurology (ABPN) is the subspecialty board entity overseen by the Board of Medical Specialties which itself is governed by the American Medical Association. In order for a medical doctor to become a psychiatrist, he or she must complete a four-year residency in Psychiatry at a training facility which is approved by the APBN. The course of study includes lectures and readings in psychopathology, lectures and readings in neurology, lectures and readings in psychotherapy, instruction in the use and interpretation of psychological tests, continuous case seminars, attendance at psychiatry grand rounds, bedside teaching, community consultation, forensic psychiatry consultation, psychopharmacology and, usually, a research project.

    Upon satisfactory completion of an approved psychiatry residency, and with fulfillment of Board practice requirements, the psychiatrist may, at his or her own election, sit for the Board examination. The examination is both oral and written, and tests competence in psychiatry and neurology. It is not necessary to take the Board exam to hold one’s self out as a psychiatrist, child psychiatrist or, for that matter, forensic psychiatrist. However, doctors who identify themselves as “Board Certified by the American Board of Psychiatry and Neurology” can only do so if they have passed the Board Exams and received full Certification from the ABPN. Certification in the Subspecialty of Forensic Psychiatry by the ABPN requires still further training and examination. (If interested, see, also, the FAQ “What is a Forensic Psychiatrist?”)

    In 1994, the American Board of Psychiatry and Neurology designated Forensic Psychiatry as a psychiatric subspecialty. Psychiatrists who spent at least 50% of their practice as a forensic psychiatrist during the preceding five years were eligible to sit for the board exam as were psychiatrists who had completed a fellowship in forensic psychiatry. By 1994, I had practiced forensic psychiatrist as 50% of my practice for 22 years and completed a one year program at the University of California, Berkeley, School of Law (Boalt Hall) taking law courses relevant to the practice of forensic psychiatry (1971‑1972).

    I am Board Certified in both Psychiatry and Forensic Psychiatry. In 1994, I was one of the first Psychiatrists qualified to be, as it was called then, a Board Certified Psychiatrist with Added Qualification in Forensic Psychiatry. The American Board of Psychiatry and Neurology now designates this subspecialty Board Certification simply Forensic Psychiatry.

  • What is a Neuropsychiatrist?

    A neuropsychiatrist is a psychiatrist who diagnoses and treats mental disorders attributed to identifiable physical causation; for example, a Traumatic Brain Injury (TBI). (See TBIs and Other Dementias in this website). The training of a psychiatrist includes specific training in neurology, just as the training of a neurologist includes training in psychiatry.

    When I was taking my specialty boards before the American Board of Psychiatry and Neurology to become Board-certified in Psychiatry, I was required to pass written and oral exams in both psychiatry and neurology. These included separate oral exams by three different panels of specialists in psychiatry and neurology.

    Additional suggested reading:

    YudofskyS.C., & Hales E.H. (2002). “Neuropsychiatry and the Future of Psychiatry and Neurology.” American Journal of Psychiatry, 159(8), 12611264

    Berrios G.E., Marková I.S. (2002) “The Concept of Neuropsychiatry. A Historical Overview.” Journal of Psychosomatic Research 53 : 629638

    Price, B.H., Adams, R.D., & Coyle, J.T. (2000). “Neurology and Psychiatry: Closing the Great Divide.” Neurology, 54(1), 814

    Martin, J.B. (2002). “The Integration of Neurology, Psychiatry, and Neuroscience in the 21st Century.” American Journal of Psychiatry, 159(5), 695704

    Kendler, K.S. (2005). “Toward a Philosophical Structure for Psychiatry.” American Journal of Psychiatry, 162, 433440