One of the most lucrative and in-demand subfields of forensics is pathology. These “death detectives” are licensed physicians with special training to perform autopsies and determine the cause of death, disease, or injury. Also, they’re typically certified by the American Board of Pathology (ABP) in the forensic pathology subspecialty. This process can take four to five years after medical school, including completing qualifying residency and fellowship programs.
The National Institute of Justice (NIJ 2022)—an organization that has provided more than $42 million to research in pathology—details some of the most pressing responsibilities of forensic pathologists.
For example, NIJ reports that these professionals perform rigorous post-mortem examinations to determine the cause of death; consider medical histories of patients; perform complex scientific tests and assessments on subjects; liaise with various legal and medical professionals; construct plausible explanations for multiple types of wounds, marks, or internal injuries; recover evidence from corpses (e.g., bullets); analyze case reports and toxicology tests; and serve as expert witnesses in court.
Forensic pathologists embody traits of doctors and detectives, often working long hours to solve cases and determine where criminal charges may be appropriate. The American Society for Clinical Pathology (ASCP), an organization that certifies laboratory science professionals, has supported this profession for a century through rapidly evolving scientific technologies. There are more than 2,000 laboratory tests available for bodily fluids, and therefore the training and certification options in this field are extensive.
Read on to discover the bright career outlook for forensic pathologists and learn about salary prospects, specialties, and professional accreditation.
There is ample evidence of opportunities for aspiring forensic pathologists in years to come. According to a recent article in the American Bar Association (ABA 2022), there is a profound shortage of forensic pathologists, which is delaying autopsies across the US. The National Association of Medical Examiners (NAME) adds that roughly 500,000 deaths annually are referred to coroners or medical examiners for autopsies, and nearly twice as many forensic pathologists are needed to fill this demand. As it stands, NAME (2022) recommends that pathologists perform a maximum of 250 to 350 autopsies annually. Still, this number is being exceeded as the demand for these services far exceeds the supply of qualified practitioners.
Although the Bureau of Labor Statistics (BLS 2021) doesn’t report specifically on forensic pathologists, it offers data on two closely related occupations: forensic scientists and doctors. The BLS (2021) projects that there will be an explosion in demand in both of these fields between 2020 and 2030. For forensic science technicians, there’s an anticipated 16 percent increase in job openings (BLS 2021), and for physicians and surgeons, it’s 3 percent (BLS 2021). Opportunities in both of these fields are poised to increase much more rapidly than the average growth expected for all occupations (8 percent).
As with most fields, the forensic pathologist’s salary varies according to experience, location, employer, and specialization. However, it’s important to remember that salaries for hospital-based pathologists tend to be higher than those for medicolegal forensic pathologists who work in facilities such as coroners’ or medical examiners’ offices. This may be one factor contributing to the current shortage of forensic pathologists.
As mentioned previously, the Bureau of Labor Statistics (BLS) does not keep data specifically on forensic pathologists. That said, two other data sources provide salary figures specific to this field. Indeed (2022)—a site that collects self-reported salaries from respondents—found an average annual wage of nearly $65,000 among its reporting forensic pathologists. In addition, PayScale (2022)—another aggregator of self-reported salaries—found very generous salaries among its 50 responding pathologists, ranging from $81,000 to $353,000. In more precise terms, PayScale (2022) found the following percentiles:
Not surprisingly, these figures tended to increase with experience. Here are PayScale’s (2022) median annual salaries for forensic pathologists according to different brackets of time on the job:
By comparison, coroners—an occupation that typically requires at least a bachelor’s degree—make substantially less money. Here are the salary percentiles among the 38 responding coroners according to PayScale (2022):
Since individuals certified in this profession must be licensed doctors before pursuing this pathology specialty, it’s worth examining physicians’ salaries. In fact, among the 727,000 physicians and surgeons currently employed, the BLS (2021) found a median annual salary in excess of $208,000. (The BLS does not report salaries above a specific range.) This is substantially higher than the average salary across all professions at $56,310 (BLS May 2021).
The top-paying industries for physicians were (BLS May 2021):
These contrasted with the industries with the highest level of employment for physicians and surgeons:
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According to Dr.Judy Melinek—a board-certified forensic pathologist and writer for the Forensic Pathology Forum—forensic pathologists must graduate from an undergraduate program, complete medical school, undergo at least a three-year residency in pathology, and then enroll in a fellowship program in forensics. She describes a typical day in the life of a forensic pathologist:
“When I get to work, in conjunction with my colleagues, I review the cases that were brought into the office over the previous 24 hours, and I decide which cases I will autopsy. I typically do one or two autopsies a day. After the morning review, I go into the morgue and perform the autopsies. Each one typically takes me 45 minutes to an hour. It takes longer if the case is complex, like a homicide. In the afternoon I type up my autopsy reports, call the families of the deceased and let them know what I found, and that is usually when I am scheduled to testify in court.”
Due to the often emotionally taxing nature of the work, many resources and professional organizations are available. For example, the National Association of Medical Examiners (NAME) offers the Academic Forensic Pathology scholarly journal, professional networking, and an active events calendar. Also, the College of American Pathologists (CAP) provides a calendar of events, job postings, legal advocacy, continuing education (CE) opportunities, and various resources. These organizations also provide accreditation to offices, laboratories, and institutions.
There are varied paths to becoming a forensic pathologist. However, here is one possible route to joining this high-growth career:
Step 1: Graduate from high school. Students interested in pursuing medical careers should take as many mathematics and sciences courses as possible to prepare for the academic rigor of university sciences classes.
Step 2: Complete an undergraduate program (four years). Students can major in forensic science at this stage, but since forensic pathologists must become licensed physicians before practice, completing a pre-med program may be advisable. Pre-med programs typically involve biology, chemistry, math, and physics coursework.
Step 3: Take the MCAT exam. The Medical College Admission Exam (MCAT) is a prerequisite to enrolling in medical school.
Step 4: Enroll in medical school to obtain a doctoral degree (four years). In medical school, students take classes in advanced anatomy, physiology, medical law, and microbiology, to name a few. They must also complete supervised clinical rotations to apply their newfound abilities in real internal medicine, surgical, obstetrics, and other medical settings.
It is also recommended to take any courses or opportunities related to forensics or pathology at this stage. For example, autopsy pathology is one common elective in medical school and may also be available among clinical rotations. Two possible degrees to achieve at this stage are the doctor of osteopathy (DO) or medical doctor (MD).
Step 5: Pass the United States Medical Licensing Examination (timeline varies). The USMLE is the primary test to become a licensed physician in the US.
Step 6: Complete a residency program accredited by the Accreditation Council for Graduate Medical Education (three to four years). The ACGME provides a continually updated list of programs that can ultimately qualify a person for professional certification. Most of these residencies instruct students in clinical pathology (CP) or anatomic pathology (AP). In particular, AP residencies offer advanced instruction in some of the cornerstones of forensic pathology, such as lab testing and instrumentation.
Common application requirements for these programs include sending an official medical school transcript; a CV; a personal statement; letters of recommendation; and USMLE scores.
For example, the Wake Forest School of Medicine of North Carolina provides an ACGME-accredited autopsy rotation as part of their medical residency program. Performing 1,300 autopsies and postmortem exams annually, rotations in this program include cytopathology, autopsy & forensic pathology, neuropathology, renal pathology, hematopathology, microbiology, lab management, and more. Wake Forest also offers a forensic pathology fellowship.
Step 7: Complete a forensic pathology fellowship (one to two years). In forensic pathology fellowships, these aspiring professionals participate in medicolegal death investigations, garnering advanced skills under the mentorship of a trained professional. These specialized programs may be directed by the Chief Medical Examiner of a city or state office.
The University of Michigan offers an exemplary forensic pathology fellowship. The Department of Pathology at UM allows fellows to work with 11 forensic pathologists, medicolegal death investigators, and clerical staff onsite in large metropolitan facilities. Split over two counties, Wayne and Washtenaw, fellows in this program gain experience investigating homicides and child abuse and courtroom testimony.
Step 8: Apply for certification through the American Board of Pathology (ABP). The ABP offers a range of professional certifications in this field, including CP, AP, and a subspecialty in forensic pathology. The credentialing process involves completing an application and passing a comprehensive exam with written and practical components. Please visit the certification section below for a detailed examination of this step.
Although forensic pathology is considered a specialty within the pathology discipline, some subspecialties are available. For example, molecular pathology technologists work to discover the roots of diseases at a microscopic level, examining genetic material and proposing potential treatments. Furthermore, forensic pathologists may be specially trained in toxicology, trace evidence, firearms & ballistics, DNA analysis, and serology.
Forensic pathologists are advised to get certified by the American Board of Pathology (ABP). To qualify for professional credentialing, students must have the following:
There are anatomical pathology (AP), clinical pathology (CP), mixed (APCP), and subspecialty (e.g., forensic pathology) certifications available. For AP or CP certification, candidates must complete 24 months of structured training typically accomplished through a residency program. For APCP, the training requirement is 36 months (18 months each for AP and CP). The structured training requirement for subspecialty certifications such as forensic pathology is one year. It should be noted that to qualify for subspecialty certification, candidates must have already achieved primary certification (e.g., AP or APCP).
Additionally, candidates must pass a comprehensive examination involving microscopic, written, and practical components. Some of the areas tested include analytical methods, criminalistics, asphyxia, firearm-related injuries, blunt trauma, identification of human remains, obesity, the central nervous system, chronic alcoholism, elder abuse, water-related deaths, and the endocrine system. Those eligible candidates who do not take the examination may be considered “registered” rather than “certified.”
This certification is valid for ten years and can be renewed following the completion of AB Path’s CertLink program, with 30 practice areas of pathology.
Additionally, for medicolegal death investigators, the American Board of Medicolegal Death Investigators (ABMDI) provides both a registry and certification for professionals in this field. For registry, eligible candidates must have at least 640 hours of experience in a coroner or medical examiner’s office; professional references; a completed “Performance Training Guidebook Checklist”; and a passing score on the examination. For certification, candidates must send an employment verification form, including references from a forensic science specialist, a supervisor, and law enforcement; and pass an examination. The ABMDI certification is valid for five years.
Jocelyn Blore is the chief content officer of Sechel Ventures and the co-author of the Women Breaking Barriers series. She graduated summa cum laude from UC Berkeley and traveled the world for five years. She also worked as an addiction specialist for two years in San Francisco. She’s interested in how culture shapes individuals and systems within societies—one of the many themes she writes about in her blog, Blore’s Razor (Instagram: @bloresrazor). She has served as managing editor for several healthcare websites since 2015.