What You Need to Know About Forensic Pathology

Forensic pathology is a subspecialty of pathology that investigates non-natural or suspicious deaths, often referred to as reportable deaths. Forensic pathology focuses on determining the cause of death via postmortem examinations or autopsies.

A reportable death is any death that occurs unexpectedly such as when a person has not been under medical care for heart, lung, or other diseases. Reportable deaths may include:

• Deaths suspected of stemming from violence, suicide, or drug/alcohol intoxication
• Death of a person in custody of law enforcement or a ward of the state
• Unexpected deaths or deaths due to work
• Maternal deaths during or post pregnancy
• Death of an infant or child without established pre-existing medical conditions
• Deaths suspected to be the result of infectious or contagious diseases
• Deaths attributable to environmental exposures.

Forensic pathologists are physicians who investigate these unexpected, suspicious, and unnatural deaths, typically by performing autopsies. Their work involves both medical and legal matters including testifying in court. Forensic pathologists require a fellowship in forensic pathology after training and certification in anatomic/clinical pathology.

Most forensic pathologists are governmental employees in the medical examiner’s or coroner’s offices at the county and state levels. However, some forensic pathologists also provide consultation services to attorneys, families, and others. Depending on medical examiner or coroner office policies, forensic pathologists in such settings typically perform forensic (medicolegal) autopsies to determine the cause of death, the identity of the decedent, document injuries and/or disease, collect evidence, and assist in the determination of the manner of death.

Yes, forensic pathologists are physicians trained in traditional medicine and the forensic sciences. With their training, they have gained a working knowledge of toxicology, trace evidence, wound ballistics, DNA technology, and forensic serology.

While medical examiners and forensic pathologists are sometimes the same person, there is a difference. Forensic pathology is the medical specialty while medical examiner or coroner’s physician generally is the job title of the forensic pathologist when they work in that capacity for a government agency. Many coroners are not physicians and so they usually will retain a forensic pathologist to perform the autopsies.

Fewer medical students are entering the field of pathology, which leads to fewer pathology residents going into forensic pathology. An average of 37 new forensic pathologists have been certified per year over the last 10 years; however, surveys of newly trained forensic pathologists indicate that only 21 full-time forensic pathologists remain in the field per year, a number too small to replace those leaving due to death, retirement, or burnout.

If you are scientifically curious, enthusiastic about public health, and are civic-minded, forensic pathology may be a good career choice for you. Since many forensic pathologists work for the government, there is a public health and safety undercurrent to their work. It goes without saying that inquisitiveness is a great characteristic to possess, as the work of forensic pathology goes deep beyond the surface level and requires the ability to think outside of the box. If you are intrigued by this field, medical students may spend a day or more at their local medical examiner/coroner office to see what it is like. Lastly, the practice of forensic pathology can be rewarding if one can help bring peace to a grieving family.