Forensic Pathology

The challenges are primarily due to limited funding for medical examiners’ or coroners’ offices. Despite the high demand for forensic pathologists, there are not enough to properly service the entire country; finding a job location that aligns with personal preferences can be challenging due to the hyper-specialization of the field and limited office locations with vacancies. However, most forensic pathology positions are tied to government employment at the city, county, or state level, which can provide more employment opportunities.

Typically, forensic pathology requires a one-year fellowship, with some exceptions that require two.

Yes, forensic pathologists can have some on-call time, but it is generally not all that taxing—answering questions about whether a case falls within your jurisdiction or what sort of exam is appropriate and interacting with donor services are the bulk of the on-call issues, and many of those can be managed from anywhere. On rare occasions forensic pathologists may need to attend a death scene after hours, but there are no frozen sections, massive transfusion protocols, or other tasks of that nature.

On average, most forensic pathologists perform 300–400 autopsies per year, but the case volume can vary widely depending on the jurisdiction. Benchmarks set by the National Association of Medical Examiners can help guide potential applicants as to the reasonableness of workloads in a particular location. Ancillary tests, such as histology and toxicology, are run regularly, along with other tests like microbiology, imaging, histology, and vitreous chemistry testing. Immunostains and specialty lab testing may also be ordered depending on the needs of a particular case.

Gathering information on medical history requires interaction with all specialists, and forensic pathology interacts with all types of specialties, including those responsible for the decedent’s medical care. Medical records are routinely reviewed, and on occasion, forensic pathologists will consult with different pathology subspecialties like neuropathology and cardiac pathology, as well as other specialties like forensic odontology, anthropology, and radiology. Forensic pathologists also interact frequently with non-medical professionals, including law enforcement and the legal system.

Yes. The National Association of Medical Examiners (NAME) and the American Academy of Forensic Sciences (AAFS) are the two largest, but there are also numerous organizations present at the state and local level.

Forensic pathology frequently pairs well with neuropathology and cardiac pathology, but different medical examiners may have more comfort with different specialties. Having additional training in pediatrics, radiology, chemistry/toxicology, or any anatomic subspecialty can also be useful. However, it is not necessary to have additional pathology fellowship sub-specialization beyond a forensic pathology fellowship.

Forensic pathologists do not typically interact with patients in the traditional sense. However, forensic pathologists do interact with the families of the deceased and provide clarification regarding autopsy findings. These interactions can be difficult—family members are often in pain—but if you’re honest, kind, and inclined to listen, most of the conversations will be nonconfrontational, even uplifting. One can also encounter people who are initially reasonable but have no idea how to interact with the system and become unreasonable when they feel as though they’re being given the runaround; those conversations can be difficult at times.