There has been considerable resistance to the recognition of clinical forensic medicine as a specialty in the UK. In the past, when forensic medicine was taught in the medical schools, its clinical aspects were negligible; even the interpretation of wounds, such as it was, was conducted on cadavers. If the whole of forensic medicine was regarded as a superfluous luxury in the medical curriculum, what hope was there for its apparently minuscule clinical component? Nevertheless, the need by society for clinical skills at the medico-legal interface has exerted considerable pressure for change. It was inevitable that doctors called by police to examine and report on injuries caused by criminal activity would lead the way and form a nucleus of clinical forensic practitioners. As legislation developed, their skills had to include the assessment of intoxication by drink or drugs, particularly in relation to traffic offences, and the examination of victims of sexual perpetrators and other serious crime. As concern for the care of persons in custody increased, attention had to be focused on medical fitness to be detained and increasingly fitness to be interviewed. Apart from the general skills possessed by the average primary care physician, this required speciality knowledge of the effects of the custodial situation on healthcare, in particular in the short-term to distinguish it from long-term custody in prison. An understanding of mental illness and mental health law became very necessary, initially as more acute psychiatric sick were taken to police stations as a ‘place of safety’, as a result of increased use of community care. One of the main driving forces for change has been the increasing realisation by the media and the public that not only must justice be done, but that it must be seen to be done. Public scrutiny is intense. Deaths in police custody and disclosures of miscarriages of justice associated with dubious medical and scientific evidence
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