Medical dominance has pervaded forensic mental health practice as well as the provision of mental health treatment, but challenges are currently being mounted against such medical dominance, particularly from psychologists. Educational background and demonstrated competence should be relied on in assessing whether nonmedical mental health professionals should receive some of the prerogatives traditionally reserved for physicians. An examination of the medical education received by psychiatrists does not reveal that they have any special expertise in forensic mental health. Based on educational background, nonmedical mental health professionals appear to approach forensic mental health practice with an equal sparsity of education in this specialty. In examining medical and nonmedical professionals' demonstrated competence in forensic mental health, available empirical information casts strong doubt on the propriety of medical dominance in forensic mental health. The thoroughness and quality of reports by nonphysician mental health professionals are at least equal to those of psychiatrists, and there is substantial evidence of consistency between the judgments of medical and nonmedical mental health professionals on legal matters. Diagnoses by nonmedical health professionals are as accurate or more accurate than medical mental health professionals. These findings indicate the desirability of changing existing legal barriers to encourage participation in forensic issues by nonphysician mental health professionals. A total of 128 footnotes are listed. (Author summary modified)