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 a death, disease, or injury. Also, they are typically certified by the American Board of Pathology (ABP) in the forensic pathology subspecialty, a process which can take four to five years after medical school, including the completion of qualifying residency and fellowship programs.
The National Institute of Justice (NIJ)—an organization which has provided more than $42 million to research in pathology—details some of the most pressing responsibilities of forensic pathologists. 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 various 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. Additionally, the American Society for Clinical Pathology (ASCP) reports that with rapidly evolving scientific technologies, there are more than 2,000 laboratory tests available for bodily fluids, and therefore the ongoing training in this field is extensive.
Read on to discover the bright career outlook for forensic pathologists, as well as to learn about salary prospects, specialties, and professional accreditation.
There is ample evidence of opportunities for aspiring forensic pathologists in years to come. Reports from around the country, including juristictions like Arkansas and Arizona, there is a profound shortage of forensic pathologists which is delaying autopsies across the US. The National Association of Medical Examiners (NAME) adds that there are roughly 500,000 deaths annually which are referred to coroners or medical examiners for autopsies, and roughly twice as many forensic pathologists are needed to fill this demand. As it stands, NAME recommends that pathologists perform a maximum of 250 to 350 autopsies annually, but 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 2017) doesn’t report specifically on forensic pathologists, it offers data on two closely related occupations: forensic scientists and doctors. The BLS (2017) projects that there will be an explosion in demand in both of these fields between 2016 and 2026. For forensic science technicians, there’s an anticipated 17 percent increase in job openings, and for physicians and surgeons, it’s 13 percent (BLS 2017). Opportunities in both of these fields are poised to increase much more rapidly than the average growth expected for all occupations over that time period (7 percent).
As with most fields, the forensic pathologist’s salary varies according to experience, location, employer, and specialization. It is 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 a coroner’s or medical examiner’s office. This may be one factor contributing to the current shortage of forensic pathologists.
As mentioned previously, the BLS does not keep data specifically on forensic pathologists. That said, two other sources of data provide salary figures specific to this field. Payscale (2018)—an aggregator of self-reported salaries—found very generous salaries among its 112 responding pathologists, ranging from $73,533 to $307,259. In more detailed terms, Payscale found the following percentiles:
It is important to note here that this data is for all pathologists and is not specific to the forensics specialty. Further, salaries can vary considerably depending on experience, location, and other factors.
By comparison, coroners, an occupation which typically requires at least a bachelor’s degree but not a medical degree, make substantially less money. Here are the salary percentiles among the 48 responding coroners according to Payscale (2018):
Since individuals certified in this profession must be licensed doctors prior to pursuing this specialty of pathology, it is also worth examining physicians’ salaries. In fact, among the 311,320 physicians and surgeons currently employed, the BLS (2017) found an average annual salary of $211,390. This is substantially higher than the average salary across all professions at $37,690.
The top-paying industries for physicians and surgeons were (BLS 2017):
These contrasted with the industries with the highest level of employment for physicians and surgeons:
For physicians and surgeons, the top-paying states were the following (BLS 2017):
These figures contrasted with the top-employing states for this field, a factor which corresponded roughly with regional population size:
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. Following is the most common path that includes those steps for forensic pathologists:
Clearly, the path towards becoming a forensic pathology is neither easy nor brief. High school graduates should expect to spend at least 12 additional years training for this career, including eight years of intense academic study.
To be a forensic pathologist, an individual must earn a medical degree. However, there are ways to participate in the work a forensic pathologist does without pursuing an advanced education. For example, a forensic autopsy technician need not earn advanced degree and will be able to assist with autopsies and death investigations. Additionally, forensic nurses do not require a graduate degree as long as they are able to to pass the NCLEX and earn a nursing license. Forensic nurse death investigators are also able to participate in autopsies and assist with the investigations surrounding suspicious deaths or those with an unknown cause. In both cases, master’s degrees may also be helpful for career advancement, but are not required.
Dr.Judy Melinek, the board-certified forensic pathologist, 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 take 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.”
Some other daily tasks that a forensic pathologist may find themselves doing include:
Due to the often emotionally taxing nature of the work, there are many resources and professional organizations available. 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. Both of these organizations also provide accreditation to offices, laboratories, and institutions.
Although forensic pathology is considered a specialty within the pathology discipline, there are some subspecialties 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 which is typically accomplished through a residency program. For APCP, the training requirement is 36 months (18 months each of AP and CP). For subspecialty certifications such as forensic pathology, the structured training requirement 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 three components: microscopic, written, and practical. 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. For those eligible candidates who do not take the examination, they may be considered “registered” rather than “certified.”
This certification is valid for ten years and can be renewed following the completion of ABP’s Maintenance of Certification (MOC) program, comprising four components: professionalism & professional standing, lifelong learning & assessment, knowledge & skills, and improvement in medical practice.
Additionally, for medicolegal death investigators, the American Board of Medicolegal Death Investigators (ABMDI) provides both 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 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.