Where was the shooter standing when he fired the fatal shot? This is a matter for forensic experts. Where was the shooter standing when he fired the non-fatal shot? Well, according to William Smock, this is also a matter for forensic experts although this has long not been the case.Dr Smock, the first clinical forensic physician in the US, was on the Island last week training local medical and public service personnel on forensics in cases where there is injury but not death.“Most people think of the dead when they think of forensics forensic pathologists, but clinical forensic medicine is the application of forensic medicine to living patients,” said Dr Smock.The Bermuda Police Service does have a forensic department but expanding that knowledge to others involved in public safety may be helpful in ensuring justice, according to Dr Smock.Since May 2009 there have been 14 fatal shootings in Bermuda four so far this year but there have also been 45 cases where victims survived being shot. Recognising that forensic expertise in solving crimes is now not just something we watch on TV the Bermuda Hospitals Board brought Dr Smock to the Island to lecture and train on the forensics of gunshot wounds.Here as part of the board’s Continuing Medical Education programme, he trained nurses, emergency department physicians, hospitalists, anesthetists, police officers and emergency medical technicians.His training with each group was specific to the stage at which they come in contact with a gunshot victim. His lecture with anesthetists for example, focused on what goes on in the operating room. He explained how adding new protocols in operating procedures could safeguard the integrity of evidence.The real importance of forensic knowledge in medical cases related to gunshot wounds is that it helps ensure justice is carried out, according to Dr Smock.In an interview with Body & Soul’s Cathy Stovell, he said that medical expertise and forensics are not the same.“There are physicians who are rendering forensic opinions without any forensic training. So the opinions that they are rendering are not based on good forensic science,” he said.This can result in an innocent person going to jail, according to Dr Smock. He actually conducted two studies which illustrate his point, one in 1993 and in 1997.“We took 100 patients that came to the A&E (emergency department) and we looked at the opinions rendered by the emergency physicians and the trauma surgeons,” he said.“Those 100 patients who died went on to the medical examiner for autopsy. We then compared the opinions of the physicians against the medical examiner’s opinion which is the gold standard.“What we found is that in cases where there are only two wounds, entrance and exit, the physicians were only correct 27 percent of the time. And when there were more than two wounds that percentage dropped further.”Dr Smock said the finding was scary when you look at the weight of persuasion a physician’s opinion holds in a court case.“Because you are a physician a jury tends to believe you but if you are rendering opinions, in the case of gunshot wound, on the size of the wound, not the physical characteristics, this will be flawed. We always want justice to be served and we want it to be based on good science,” he added.