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Mr. Keith Shannon does an excellent job of summarizing the theory behind forfeiture laws, but there are baseline cases that have required at the least notice and an opportunity for interested parties to be heard:1. Krimstock v. Kelly United States Court of Appeals, Second Circuit. September 18, 2002 306 F.3d 40 (Individuals whose vehicles where seized by city as instrumentalities of crimes brought action challenging city's post-seizure, pre-judgment retention of the vehicles without a prompt opportunity to challenge probable validity of and justification for that deprivation. The United States District Court for the Southern District of New York, 2000 WL 1702035, granted city's motion to dismiss, and plaintiffs appealed. The Court of Appeals held that due process required that prompt post-seizure, pre-judgment hearing to determine whether city was likely to succeed on merits of forfeiture action.)2. U.S. v. James Daniel Good Real Property Supreme Court of the United States December 13, 1993 510 U.S. 43 1993 WL 505539 (Four years after property owner pled guilty to drug charges under Hawaii law, government filed action seeking forfeiture of owner's home and, pursuant to seizure warrant, seized home. The United States District Court for the District of Hawaii, Harold M. Fong, J., granted summary judgment in favor of government, in proceeding brought by owner challenging seizure, and owner appealed. The Ninth Circuit Court of Appeals, 971 F.2d 1376, affirmed in part, reversed in part, and remanded with instructions. Certiorari was granted. The United States Supreme Court, Justice Kennedy, held that: (1) in absence of exigent circumstances, due process clause requires government to afford notice and meaningful opportunity to be heard before seizing real property subject to civil forfeiture, and (2) courts may not dismiss forfeiture action filed within five-year statute of limitations, for noncompliance with internal timing requirements of procedures involving seizure, summary and judicial forfeiture, and condemnation of property for violation of customs laws, made applicable to drug forfeiture cases. Reversed and remanded.More recent cases have reached not only assets directly involved in commission of the alleged crime, but assets traceable to those assets:3. U.S. v. Bonventre United States Court of Appeals, Second Circuit. June 19, 2013 720 F.3d 126 2013 WL 3023011 (Government sought civil forfeiture of assets owned by criminal defendant, his wife, and his son, alleging that the assets were traceable to the alleged fraud for which defendant was awaiting trial. The United States District Court for the Southern District of New York, Barbara S. Jones, J., 2012 WL 2900487, denied defendant's request for a Monsanto-like hearing regarding his claim of insufficient alternative assets to fund counsel of choice in the criminal case. Criminal defendant appealed. Held: Whatever the full extent of the Sixth Amendment's protection of one's right to retain counsel of his choosing, that protection does not go beyond the individual's right to spend his own money to obtain counsel, and accordingly, neither the Fifth Amendment right to due process nor the Sixth Amendment right to counsel requires Congress to permit a defendant to use assets adjudged to be forfeitable to pay that defendant's legal fees; no violation of the constitutional rights to due process and counsel of choice occurs when, after probable cause that assets are forfeitable is adequately established, the government obtains an order barring a defendant from dissipating his assets prior to trial. The constitutional rights to due process and counsel of choice entitle a presumably innocent criminal defendant to an adversarial, pre-trial Monsanto hearing to address two questions regarding forfeiture of assets that could otherwise be used to retain counsel: (1) whether there is probable cause to believe that the defendant committed the crimes providing a basis for forfeiture, and (2) whether there is probable cause to believe that the assets are properly forfeitable. (My bolding as this is where the justification for forfeiture rests – notice, an opportunity to be heard, and a showing of probable cause for guilt).Note that to maintain a forfeiture, the Government has to make a showing of admissible evidence that a reasonable would think it probable that the defendant is guilty of the accused crime. If courts will not permit an exception to seizures to obtain criminal defense counsel - a right that would otherwise be funded by taxpayers - they are not going to make exceptions for other expenses that are not based in the Constitution.The above case was a reflection of earlier decisions on the same issue, including:4. Caplin & Drysdale, Chartered v. U.S. Supreme Court of the United States June 22, 1989 491 U.S. 617 109 S.Ct. 2646 87-1729 (Narcotics defendant's counsel challenged validity of forfeiture statute to extent that it prevented defendant from paying attorney fees; held, statute, which provided no exception for property used to pay attorney fees, did not impermissibly burden defendant's Sixth Amendment right to retain counsel of his choice.)I close with a wonderfully named case that illustrates Mr. Shannon’s discussion:5. U.S. v. Ninety Three Firearms United States Court of Appeals, Sixth Circuit. May 27, 2003 330 F.3d 414 2003 WL 21210444 01-5348 ((1) Government's filing of administrative forfeiture proceeding with respect to 93 firearms and ammunition within 120 days of their seizure tolled statute of limitations requiring that any action or proceeding for forfeiture of firearms be commenced within 120 days of seizure, and thus government's subsequent action for judicial forfeiture of same firearms five years after seizure was timely; although meaning of any action or proceeding was ambiguous, statute expressly incorporated provisions of the Internal Revenue Code, which authorized five-year statute of limitations for judicial forfeiture actions, administrative forfeiture proceedings were favored as more efficient and less burdensome, and requiring both administrative and judicial forfeiture proceedings to be filed within 120-day period after seizure would be unreasonable; (2) owner's due process rights were not violated by five-year delay in filing judicial forfeiture proceeding because, with respect to firearms, a potential claimant has no right to contest seizure or forfeiture of weapons that are intrinsically illegal in character because he would have no property right in such a weapon; (3) District court was not required to dismiss based upon government's failure to serve claimant within 120 days after filing forfeiture complaint; Owner of firearms seized by government during execution of search warrant waived argument on appeal that government's forfeiture action, accrued, for limitations purposes, on date upon which government allegedly knew that he had prior felony conviction and was aware that he possessed firearms illegally, rather than on date of the actual seizure of the firearms, where owner failed to raise argument before the district court; and (4) any error in failing to inform owner of summary judgment requirements was harmless. Due process rights of owner of firearms were not violated by government's five-year delay after seizure of firearms in bringing civil forfeiture proceeding; initial three-year period of delay was justified by pending proceeding for remission and criminal prosecution against defendant, during remaining two years owner did not actively seek return of firearms after his petition for remission was denied, and owner was not prejudiced by delay.)Note: I should mention that, for particularly convoluted reasons, 18 U.S.C. sec. 924, on which forfeiture in this case was based, has been found unconstitutional in whole or some undefined part by numerous courts and not replaced by legislative action, although there have been (so far) no less than 51 proposed pieces of replacement legislation, so this whole issue sometimes goes forward under the only authority around - judicial action. Write your elected representative and complain. It is a ridiculous situation that members of Congress seem too busy to address, even though such things are part of their primary responsibilities.As can be readily seen, forfeiture is conditioned upon compliance with constitutional safeguards and, while admittedly harsh because it takes place prior to conviction and depends upon a fiction, is intended to safeguard the interests of taxpayers by permitting recovery of some or all of the costs of the prosecution from the defendant before the defendant has an opportunity to transfer or dissipate those assets. I used to occasionally be called upon to assert the rights of a secured creditor holding a lien on one or more of the seized assets and never heard a peep from any defendant about getting the property back once it was turned over to the creditor. Perhaps it would only have been re-seized; I never knew.

Q. I don't know whether I should do my specialty training in the U.K. or in USA, I heard that it is quite difficult for IMGs to get into either (even impossible) and that I could rarely get a specialty that I would want?A2A: Below is a very informative road map for attaining a psychiatric residency for an IMG in the US. This is applicable to other specialties.Pursuing training in the United StatesMedical specialisation and training in the UKI have no personal knowledge to offer informed advice regarding specialty training in the US vs UK.Pursuing training in the United StatesAuthors: Adeel MerajPublication date: 29 2010Adeel Meraj gives tips to international medical graduates on getting a psychiatry residencyThe United States has a long tradition of attracting and training quality medical graduates from across the world. Not only does the US training system provide first rate training, it also leads to eligibility for specialist board exams that are well recognised and respected worldwide. Unlike the current position in the United Kingdom, the situation of a training post versus a non-training post does not exist in America. In the US, when you are accepted into a programme accredited by the Accreditation Council for Graduate Medical Education there is no distinction between a US graduate and a foreign medical graduate.Pursuing a career in a medical specialty in the US can be a long and challenging path with intense competition, but in view of recent Home Office changes in the UK it is an option worth exploring. I made the move to America for professional and family reasons. After one year of battling the trials and tribulations of entering a residency programme in the US, I decided to write this article for doctors considering a career in psychiatry in the States. Although much has been written on this subject, my article will attempt to outline briefly the steps required to enter a residency programme, with a specific focus on psychiatry.Basic requirementsTo enter a residency programme it is necessary to pass step 1 and step 2 of the United States Medical Licensing Exam (USMLE) and to be certified by the Education Commission for Foreign Medical Graduates (ECFMG, box 1). For certification, ECFMG requires written verification of an applicant’s medical diploma and a transcript certificate, which must be sent directly from the candidate’s medical school to the ECFMG. The name of the medical school and graduation year must also be listed in the International Medical Education Directory, which is a free, web based resource for accurate and up to date information about international medical schools that are recognised by the respective government agencies in the country where the schools are located. USMLE step 1 and step 2 can be taken in any order.Box 1: Minimum eligibility for appointment as a residentGraduate from an accredited medical school in the US or CanadaORGraduate from an acceptable medical school outside the US and holding an unrestricted ECFMG certificateBasic life support certificationHolder of a relevant visaSuccessful outcome of criminal background checksUSMLE step 1This exam is a test of knowledge in the basic sciences covered in the initial years of medical school. Step 1 is a computer based test that includes single questions with one best answer, and it costs around $800 (£510; €600).USMLE step 2This test is divided into clinical knowledge and clinical skills. The clinical knowledge component is a test of knowledge in the clinical sciences covered in the last two years of the medical school curriculum. Its format is the same as USMLE step 1, and it costs around $800. The clinical skills aspect includes clinical encounters with standardised patients and costs $1295.USMLE step 3Although completing step 3 is not a prerequisite, it considerably improves the chances of acceptance into a residency programme. Step 3 is a more advanced form of step 2 and costs around $705.Prometric is a company that administers step 1 and step 2 clinical knowledge in most countries and on various dates. In the UK the exams can be taken in London and Cardiff.USMLE step 2 clinical skills and step 3 are offered only in the US in various cities and on various dates. Citizens of nations that are not in the European Union will need a valid visit visa to travel to the US and take USMLE exams.Visa requirementsUnless you are a US citizen or a permanent resident, you require a non-immigrant visa to work in the US. Non-immigrant visa categories commonly used for residency and fellowship training are the J-1 exchange visitor visa and the H-1B non-immigrant visa (box 2).J-1 exchange visitor visaThis is a temporary non-immigrant visa that allows the visa holder to participate in a residency programme for a maximum of seven years. At the end of their training J-1 physicians are required to return to their home country for at least two years before changing their visa category. This requirement can be waived if the physician works in an underserved area for three years in a so called “J-1 waiver job.” The US Department of State has authorised ECFMG as the sole sponsor for all J-1 exchange visitor visas for clinical training.H-1B non-immigrant visaThis is a temporary non-immigrant visa that allows US employers and training institutions to sponsor foreign workers in specialty occupations. The maximum time allowed is six years, and there are no restrictions to change the visa category. H-1B visas are sponsored directly by the residency training programme.Box 2: Brief outline of visa requirementsJ-1 exchange visitor visaCertification from the Education Commission for Foreign Medical GraduatesUnited States Medical Licensing Exam steps 1 and 2Official residency acceptance letter from a training programmeA statement of need from the ministry of health of the country of most recent residenceForm DS-2019, a certificate of eligibility issued by the Education Commission for Foreign Medical GraduatesH-1B non-immigrant visaPosition must be a specialty occupation (physicians qualify)Training programme must file an immigration petition, and petitioner must work for the petitioning employerTraining programme must pay the prevailing wageTraining programme must file a labour condition application with Department of LaborUnited States Medical Licensing Exam steps 1, 2, and 3Practical tips for getting a visaMost programmes prefer J-1 visas to H-1B visas, which leave processing and filing work to the candidate and the ECFMG.Aim for H-1B visa sponsoring programmes so that you can change your status to permanent resident later and have the freedom to moonlight (locum) during residency and fellowship.Discuss your desire to get H-1B with the programme at the time of interview or when an offer is made—you can offer to bear some of the expenses related to filling the visa petition. There are certain expenses that cannot be deferred to the candidate.Be prepared for legal paperwork and fees; consider hiring a hospital recommended attorney.There will be lots of paperwork until everything is complete. Consider opening an account with a good courier company to speed up the process and possibly receive a discount.Immigration petitions can take weeks to months. Start the process as early as possible.It’s not too difficult to get a J-1 waiver job in a primary care specialty.Application and the matching processResidency application is made online via the website of the electronic residency application service. There is no limit to the number of programmes to which one can apply. Applicants can begin working on their online application on 1 July and submit their application to the Accreditation Council for Graduate Medical Education’s accredited programmes from 1 September. Applying to programmes has associated costs that can be expensive if you are planning to apply to lots of programmes (figure ).Once the application data is available online, programme coordinators begin downloading the application and deciding which candidates to interview. Selection of candidates takes place in March each year. Some programmes offer positions to outstanding candidates before the matching process to get the best of the best, and this process is called pre-match. US allopathic medical graduates have to go through the match (more than 90% of American medical graduates are from allopathic schools). After the match takes place, unfilled or unmatched applicants have another opportunity, known as the post-match scramble, when unfilled vacancies are posted on the electronic residency application service’s website and unmatched applicants can contact the programme to apply for available positions.Pearls of wisdom for application and matchingPrepare well in advance, and complete exams as soon as possible.Apply early. There is a large pool of applicants and some programmes stop downloading applications when they get the required number of applications.Exam scores are important, but most psychiatry programmes also look for other characteristics in the curriculum vitae and personal statement (box 3).Choose authors carefully for a letter of recommendation. In the US, recommendations are weighted heavily and are considered an important part of the application. If an applicant is able to obtain a recommendation from a psychiatrist practising in the US, he or she will have an advantage.Plan interview dates carefully to avoid travelling back and forth because air travel, hotels, and transportation can be expensive.Applicants who have been out of medical school for more than five years or who have low USMLE scores should consider accepting pre-match offers.Box 3: Qualities needed in a prospective candidateAptitude for psychiatry, which can be in the form of previous training, research, or any voluntary workEmotional intelligenceLinguistic skills and ability to communicate in EnglishInterpersonal skills and being a team playerSome familiarity with the local culture, medical politics, and healthcare reformsExperience in UK, USA, Australia, or New Zealand is desirablePsychiatry training in the United StatesNow a good time to apply for a career in psychiatry in the US (box 4) because there are training opportunities available only in America. A number of programmes now offer combined residency training in internal medicine and psychiatry; neurology and psychiatry; and family medicine and psychiatry. These combined programmes last five years and lead to board eligibility in both specialties.Box 4: Facts and figures (total numbers)Psychiatry Match 2010Psychiatry programmes—185Positions offered—1091Applicants—2068US seniors (4th year medical students)—741Matches—1075US seniors matched—670Positions filled—98.5%Positions filled by US seniors—61.4%Most programmes participate in the matching process and accept applications only through the electronic residency application service. Psychiatry training lasts for four years including the internship year (box 5).Box 5: Things to look for in a training programmeAccreditation status from the Accreditation Council for Graduate Medical EducationBalance between inpatient and outpatient workResearch opportunitiesFellowship opportunitiesNumber of training spotsUniversity programmeLocationProgramme willing to sponsor H-1B visaApproachability and friendliness of programme director and programme coordinatorThe Accreditation Council for Graduate Medical Education is a regulatory body that sets standards for residency programmes all across the US. The American Board of Psychiatry and Neurology is equivalent to the British Royal College of Psychiatrists and sets standards and competences to be achieved during training. During year one (internship), four months are typically spent in medicine and two months in neurology. The remainder of the first and second years are divided between inpatient and outpatient psychiatry and rotations in various subspecialties.During the third year, trainees spend all of their time in outpatient clinics, and the final year consists mainly of elective rotations and administrative work. Some trainees choose to extend their training; this is called a fellowship year, but it is not a mandatory requirement for working as a psychiatrist. Most applicants apply for the fellowships during their third year of residency (box 6).Box 6: Fellowships available to psychiatristsTraditional fellowshipsChild and adolescent psychiatryAddiction psychiatryForensic psychiatryPsychosomatic medicine (previously called consultation and liaison)Geriatric psychiatryNon-traditional fellowshipsSleep medicinePain medicineAdministrative psychiatryPublic psychiatryCommunity psychiatryNeuropsychiatryPsychopharmacologyTypical interview dayUnlike in the UK, interview day for psychiatry consists of a full day when trainees not only meet with the faculty and the programme director for formal interviews, but also spend time with the residents, attend didactic teaching sessions, and get a tour of the training facility. Most training programmes organise a dinner the night before interview with their residents, which allows the candidate to learn about the programme in an informal setting.A typical day in the life of a first year psychiatry resident in an inpatient psychiatry serviceStart pre-rounds at 8 amEvaluate admissions from previous night and prepare for presentation to the attending physicianSupervise medical students assigned to serviceStart rounds at 10 am with the team attending, and interview each patientCarry out orders and write progress notesEvaluate new admissions admitted from clinic, emergency room, or transfersAfternoon clinic once a week in second yearAt least two hours supervision with attending every weekTuesday half day lectures and case conferencesGrand rounds on FridayFurther informationAccreditation Council for Graduate Medical Education—[Link]American Board of Psychiatry and Neurology— [Link]Educational Commission for Foreign Graduates— [Link]Electronic Residency Application Service for residency applicants— [Link]National Resident Matching Program— [Link]United States Medical Licensing Examination— [Link]US Citizenship and Immigration Services— [Link]Thanks to Barry Liskow and Jon Hossain for their help.Competing interests: None declared.Adeel Meraj resident physician Department of Psychiatry and Behavioral Sciences, University of Kansas Medical Center, Kansas City, KS 66160, [email protected] this as BMJ Careers ; doi:Medical specialisation and training in the UKMedical specialisation and training in UK require General Medical Council (GMC) medical licence. The basic requirement is to have at least first medical diploma valid in UK.The GMC Medical Licence is necessary for all doctors in the UK regardless of whether they are working in the National Health Service (NHS) or independent sector, on a full or part time, permanent or locum basis, either they are British or International Medical Graduates (IMGs).It also applies to all levels of registration, whether provisional, full or on the specialist or general practitioner (GP).Registration to General Medical Council in UKThere are four routes to GMC registration:Professional and Linguistic Assessments Board test (PLAB);Sponsorship through a recognised body such as the RCP;Acceptable Postgraduate qualification;Certification of eligibility for specialist registration (CESR);Specialization and training in UKMedical Specialization and Training in UK starts after getting 5 or 6 year diploma of Medicine at medical school and then undertake a two year foundation training program (Foundation Program), which exposes prospective specialists to a range of specialties and placements designed to meet the requirements of the UK nationally approved Foundation curriculum.The length of medical specialization training (including General Practice –GP- training) in UK varies depending on the speciality. As example, in generally, GP training takes 3 years to complete, although more generally, specialty training will last at least 5 years.For Medical specialisation in UK, training consists of 2 years core training and 3 or more years advanced training, leading to Certificate of Completion of Training (CCT) in the chosen specialty and to the eligibility to enter the General Medical Council’s (GMC) specialist or GP register.Specialization and training in UK are undertaken in National Health Service (NHS) employment and so the trainer specialist is paid during the training period.