What is the Faculty of Forensic & Legal Medicine?
The FFLM was established as a faculty of the Royal College of Physicians in 2005 and is a charity set up to develop and maintain the highest possible standards of competence and professional integrity in forensic and legal medicine.
The specialty covers professionals working in the following related disciplines: forensic medical practitioners (forensic physicians, forensic pathologists, forensic psychiatrists, forensic odontologists); medico and dento-legal advisers; clinicians working in secure and detained settings and medically qualified coroners.
Is the work of FFLM members similar to what we see on CSI and other crime dramas on TV?
No – the different groups of practitioners have different roles.
Forensic practitioners (FPs) (doctors, nurses and paramedics) are independent from the police, and do not investigate cases. The major part of their work is to provide healthcare to people in police custody or to complainants of alleged assault including sexual assault in sexual assault referral centres (SARC).
FPs are there to safeguard the health of those detained in police custody and undertake forensic assessments, including the collection of forensic evidence. They work with the living as opposed to forensic pathologists who work with the dead. FPs are part of a wider team that may include the CID, and scenes-of-crime officers. They may for instance provide initial opinions on the likely cause of injuries to assist investigation.
Medico-and Dento-legal practitioners provide medico-legal support and advice to medical practitioners. They often come from a clinical background and may have had legal training. Dento-legal advisers have a similar role and background, but their focus is on advising and supporting dental professionals.
Medical coroners are judicial appointments and investigate deaths.
How is healthcare provided in the police custody setting?
This varies across the UK depending on the police force. Multi professional teams of doctors, nurses and paramedics work together to care for those detained by the police. Liaising with others in the healthcare team such as the emergency department, liaison and diversion teams, covering mental health and substance use disorders, for example.
Who are the patients of forensic & legal medicine practitioners?
People detained by the police are the biggest group of patients seen by forensic physicians, nurses and paramedics (known collectively as Healthcare Professionals (HCPs)). The police can detain people for a limited time whilst investigating crime.
Recent research has shown that this is an extremely vulnerable group of patients with over representation of substance use disorder and mental health conditions. The detainees may have had no recent contact with primary or secondary healthcare services and treatment for comorbidities, for example, asthma, diabetes, and epilepsy, may not be optimal. This patient population needs well trained and skilled practitioners to care for them. They may be homeless or have other vulnerabilities such be victims of interpersonal violence.
In addition, about 20% of detainees are children (under 18 years), and a rising proportion are over 65 years in age. Safeguarding the well-being of all these patient groups is a key priority for healthcare practitioners.
Complainants of alleged sexual assault, both adults and children, are the other group of patients who are seen and assessed by forensic physicians and nurses; many of these are also very vulnerable.
What type of tasks are undertaken by HCPs in police setting?
Please see The Role of the HCP
How do forensic practitioners become members of the Faculty of Forensic & Legal Medicine?
In fact, anyone with an interest in the field of forensic & legal medicine can become a member as an Associate. There are other categories of membership for those working directly in the field (see below).
Associates – Association with the FFLM is open to those who are not working in the field but are able to demonstrate an interest in forensic or legal medicine.
Affiliates – Affiliation with the FFLM is open to those who:
- are qualified and registered healthcare professional, and are working in Forensic and Legal Medicine, either full-time or part-time; for this purpose, “Forensic and Legal Medicine” covers the core groups that the FFLM was established to cover: forensic physicians, nurses and paramedics working in forensic medicine, medico-legal practitioners, dento-legal practitioners and dentists, and medically-qualified coroners;
- are working as Medical Reviewers in Scotland or as Medical Examiners in the other devolved countries;
- are working as a court-appointed, medically qualified members of a Tribunal;
- are working as clinicians in the secure and detained setting who are currently qualified and registered with their appropriate regulatory body (General Medical Council (GMC), Nursing & Midwifery Council (NMC), General Dental Council (GDC), General Optical Council (GOC), General Pharmaceutical Council (GPhC), and Health and Care Professions Council (HCPC));
- pass the Diploma of Legal Medicine (DLM) at distinction level are eligible to be elected as Affiliates of the FFLM and on successful election, may use the post-nominal AFFLM (DLM);
- are a doctor or nurse advisor working for the DVLA (clinicians who are employed by the DVLA or self-employed clinicians who undertake contracted work for the DVLA).
Nurse Affiliate Membership with the FFLM is open to those who:
- are qualified nurses registered with the Nursing and Midwifery Council or equivalent abroad and are working or intending to work in forensic and legal nursing, either fulltime or part-time
- are working in a field that the Faculty Board determines is allied to forensic and legal nursing. The individual should be registered with an appropriate regulatory body or studying in an allied field.
Paramedic Affiliate Membership with the FFLM is open to those who:
- are qualified paramedics registered with the Healthcare Professions Council or equivalent abroad and are working or intending to work in forensic and legal medicine, either full-time or part-time
- are working in a field that the Faculty Board determines is allied to forensic and legal medicine. The individual should be registered with an appropriate regulatory body or studying in an allied field.
The FFLM is particularly keen to welcome students and Student Affiliate Membership with the FFLM is open to those who:
- are part or full-time students enrolled at an accredited university
- are studying in a field and at an educational institution that the Faculty Board determines are appropriate for the purpose of Student Affiliate Membership.
For doctors, nurses and paramedics working in this field it is important to gain the knowledge and skills to care for the patients seen in the challenging environment of police custody or a sexual assault referral centre.
Medico-legal and Dento-legal practitioners need to be able to apply medical law and ethics principles to a wide range of medico-legal problems. They need to provide clear and accurate advice and guidance and to use oral and written advocacy skills to assist healthcare professionals respond appropriately and constructively when things go wrong in a professional setting.
There are a number of examinations:
Licentiate Membership (LFFLM) (GFM) and (SOM) – Those who successfully complete the Licentiate in Sexual Offence Medicine or General Forensic Medicine and are in good standing with their regulatory body are eligible to apply for Licentiateship.
LFFLM (SOM) (Child) is available for paediatricians experienced in conducting forensic child sexual abuse examinations. Candidates must hold the MRCPCH/FRCPCH, or MFSRH/FFSRH, or MRCOG/FRCOG or MRCGP/FRCGP or another appropriate Royal College or Faculty membership. This route to the LFFLM (c) is available until 31 December 2022.
Membership by Examination (MFFLM) – Those who successfully complete the membership examination in Sexual Offence Medicine, General Forensic Medicine, Medico-Legal Medicine and Dento-Legal Medicine (from October 2021) and are in good standing with their regulatory body are eligible to apply for membership.
Membership (Equivalent Qualification Clause) – Medical Coroners, Forensic Pathologists, Forensic Odontologists and Forensic Psychiatrists can be elected to Membership under an equivalent qualification clause. Forensic psychiatrists and forensic pathologists in the UK need to show evidence of specialist status (on the GMC register).
The Diploma of Legal Medicine is open to those with an interest in forensic & legal medicine. Success in this examination does not lead to membership of the FFLM per se. Candidates (who are doctors and eligible for the membership examination) who pass with distinction are exempt from part 1 of that examination.