Medical examiners, a career that once existed far from the public eye, have become much more well-known thanks mainly to their popular culture representations, such as Dr. Saroyan from the television show Bones. By examining the bodies of people who have expired, a medical examiner can uncover the secrets of their death, sometimes with alarming precision.
People interested in this field will find it has many rewarding aspects, from the salary to the exciting work the career offers. A medical examiner may also be a trained forensic pathologist, but not necessarily. It is also essential to distinguish a medical examiner from a coroner, who may or may not have any medical training.
Those in the field perform post-mortem examinations of human bodies. They look into sudden and unexpected deaths, as well as violent incidents to determine the cause and time of death. The forensic medical examiner may look into the deceased’s medical history, examine the crime scene and statements from witnesses, and analyze evidence found on the body, such as gunpowder residue or bodily fluids. Knowing other fields such as DNA, toxicology, and even ballistics is beneficial.
The medical examiner prepares reports, including a death certificate, and often works quite closely with law enforcement on cases. In addition, this specialist may testify in court and present their findings before a judge and jury.
Read on to discover the career outlook, salary, responsibilities, and credentials in this field.
Although data specific to the medical examiner career is not available, a physician’s job outlook is quite good. According to the U.S. Bureau of Labor Statistics (BLS), there will be a growth rate of 3 percent between 2020 and 2030, which is less than the average for all occupations (BLS 2021). However, the demand for physicians remains steady as the field of healthcare expands, and the BLS predicts 22,700 new positions will open up in the coming decade.
Those interested in pursuing the field should look into some of the different professional organizations expressly for medical examiners, such as the National Association of Medical Examiners (NAME). Another professional group that offers certification for forensic medical examiners is the American Board of Medicolegal Death Investigators (ABMDI). Finally, it is also possible to find information from the American Academy of Forensic Sciences (AAFS), which provides support to all manner of scientists working in forensics.
The annual mean wage for a physician in 2020 was more than $208,000 (BLS May 2020), and this figure considers all of the different types of physicians and surgeons. The bottom two wage percentiles are as follows:
Here are the top-paying industries for physicians (BLS May 2020):
Self-reported salary data offers a unique perspective for career-specific salary information for forensic examiners. For instance, PayScale (2021), a site that aggregates self-reported salary data for a myriad of jobs, has collected some details about how forensic pathologists, a similar position, in the U.S. are paid. According to 55 individuals who reported their pay, the median salary for forensic pathologists with forensic toxicology skills is $90,000 per year. Reported salaries range as follows:
Like most positions, salaries for forensic medical examiners depend on the number of years of experience. Here are the self-reported salaries for forensic pathologists with forensic toxicology skills in 2021 according to PayScale:
The best way to determine an accurately predicted salary for the job is to look at the various states and cities hiring medical examiners and then inquire about the specific compensation. Interestingly, the top-paying states for physicians are correlated to locations with a more affordable cost of living which is a rare occurrence. Here are the top-paying states for physicians (BLS May 2020):
To estimate the cost of living, the Missouri Economic Research and Information Center (MERIC) offers an up-to-date index. According to MERIC, in 2021, Alaska is the only state in the top 10 most expensive states to live for physicians and forensic medical examiners.
Becoming a medical examiner takes a substantial amount of work and schooling. They need to have a bachelor’s degree, along with their MD (medical doctor) or DO (doctor of osteopathic medicine). They will need additional residency training in forensic pathology or a forensic pathology fellowship.
Here is one possible path to becoming a medical examiner.
Step 1: Graduate high school or obtain a GED (four years).
Preparation for medical school happens as early as high school. Most bachelor’s degree programs require a high school diploma or GED to be considered for admission. Students should do their best to excel in all coursework, particularly biology, chemistry, and other science classes.
Step 2: Pursue an undergraduate degree (four years).
Future medical examiners will need to excel in their undergraduate education since admissions for medical schools can be highly competitive. Students interested in this career may choose a pre-med track with a major such as biology, chemistry, or a related field. Students who pursue a forensic science degree should ensure that they meet all medical school prerequisites with their undergraduate courses.
Step 3: Complete medical school (four years).
Although it represents just one step on this list, medical school is a massive undertaking. A highly competitive application process means that students should be prepared to submit a thorough accounting of all academic work, letters of recommendation, a statement of purpose, and scores for the Medical College Admission Exam (MCAT).
Once admitted to medical school, students take rigorous courses in topics such as advanced anatomy, physiology, and microbiology and learn proper clinical practice and bedside manner. No matter what their ultimate career goal is, during medical school, students will also complete supervised clinical rotations to apply their skills in specialties such as internal medicine, surgery, obstetrics, pediatrics, and pathology.
It is recommended that any student pursuing the medical examiner career take any available courses in forensics or pathology. For example, autopsy pathology is one common elective in medical school and may also be available among clinical rotations. Doctors who complete medical school are awarded a medical doctor (MD) degree or a doctor of osteopathy (DO), depending on the program.
Step 4: Earn a medical license (timelines vary).
Medical school graduates can earn a medical license upon completing their board exams, also known as the United States Medical Licensing Exam (USMLE). The licensing examination consists of three exams beginning the second year of medical school, with the final exam taking place after one year of residency. Licensing requirements beyond this exam can vary between states, so those pursuing a medical career should be sure to consider where they plan to live and work before becoming licensed.
Step 5: Pursue residency (three years).
After graduation, students begin a full-time residency to start to practice more and more independently as physicians. Medical examiners may choose to complete a residency in the pathology specialty since no residency programs focus entirely on the medical examiner’s career. Instead, applicants should look for residencies that include autopsy and forensic pathology training as part of the program.
Step 6: Apply for a medical examiner fellowship (one year).
To specialize in the medical examiner career, most doctors choose to do a fellowship. A fellowship is specialty training after a residency. These fellowships mainly take place at government-run medical examiner offices and will give doctors the chance to focus on the specific aspects of the career.
Step 7: Build a professional network (timeline varies).
During every step towards this career, aspiring medical examiners should be building a professional network. This is particularly important in this specialty because many medical examiners must be appointed to office, which is quite different from the hiring process in most other medical specialties. A medical examiner fellowship will be helpful, but it can also be beneficial to attend conferences and other networking events to get in front of those who may be integral to future professional success.
Becoming a medical examiner requires a highly dedicated individual. A high school graduate can expect to spend at least an additional 12 years pursuing education and training in the fields of pathology and forensics to prepare for this career. Because the position is often appointed, there may also be an extended period where a trained medical examiner cannot find employment in the area of their choosing.
Medical examiners must be medical doctors with specific training in conducting death investigations. However, some jobs are available for those who are not interested in pursuing an entire course of medical study. For instance, forensic autopsy technicians can also be employed in a medical examiner’s office, assisting with autopsies and helping to determine a cause of death.
Further, in many jurisdictions, coroners do not need specific medical training. These professionals work alongside medical examiners and pathologists to determine why someone may have died and are responsible for tasks such as completing death certificates. Depending on local or city regulations, coroners may be elected or appointed government officials.
Students may also choose to pursue a master’s degree in a field such as pathology. Earning a master of science (MS) in pathology can help obtain a position in a medical examiner’s office or in a laboratory that tests samples from the medical examiner. A master’s degree could also help obtain a job such as a forensic pathologist assistant. Should someone in that position decide to take the next step towards becoming a medical examiner, that type of experience could be very valuable.
The University of North Texas (UNT) offers a certificate in forensic science that’s available for biology, biochemistry, or chemistry undergraduates. This certificate program is one of 35 forensic science programs accredited by the Forensic Science Education Programs Accreditation Commission (FEPAC).
This certificate is designed for students pursuing careers in crime laboratories or preparing to apply for medical school to become medical examiners. The certificate requires 19 credit hours of forensic science course work which follows the recommendations of the National Institute of Justice. Courses include criminalistics, forensic microscopy, and instrumental analysis and are taught by nationally certified faculty members who have extensive experience in the field.
Upon completing this certificate program, graduates can take the American Board of Criminalistics certification test to prove their knowledge and skills. This certificate can prepare students for medical school admissions or entry-level careers in arson investigation, ballistics or firearm analysis, DNA analysis, and drug and trace analysis.
The Los Angeles County Medical Examiner-Coroner offers a one-year forensic pathology fellowship. Two positions are offered each academic year, and the competitive admissions process requires interviews two years before the fellowship’s start date. To be considered for admission, applicants must be licensed to practice medicine or osteopathy in California by the fellowship start date, be a US citizen or permanent resident who has filed an intent to become a citizen, have completed an ACGME-accredited residency in anatomic pathology or anatomy and clinical pathology or equivalent pathways, and pass a background check as well as submit to fingerprinting and pre-employment psychological and physical examinations.
LA County sees a massive annual case volume of approximately 20,000 deaths each year, offering students a well-rounded experience with various dissection techniques to solve complex homicide cases. Those accepted to the program earn a competitive salary and health, dental disability, life insurance, a retirement savings plan, and vacation, sick, and holiday leave time. Those who meet the application criteria must apply with a letter of inquiry, a curriculum vitae, and a standardized fellowship application from the College of American Pathologists.
Washington University School of Medicine (WUSM) in St. Louis offers medical residencies in pathology with a forensic pathology fellowship for medical license holders seeking experience. Residencies require four years of study and experience, and the forensic pathology option requires one year to complete. The American Board of Pathology certifies the forensic pathology subspecialty. Most of the residents in this program opt for a four-year program that combines anatomic and clinical pathology (AP/CP).
Applications are accepted 18 months before the desired start date. WSUM is nationally accredited by the Liaison Committee on Medical Education (LCME), which the U.S. Department of Education recognizes as the accrediting agency for medical education programs.
Medical examiners are nearly always crouched over a body on television dramas, pointing out wounds and evidence to interested detectives and solving mysteries. While autopsies are a critical part of the medical examiner’s job, in reality, there are many daily tasks and responsibilities that this type of professional will need to be prepared to complete — and not all of them look good on television.
The work of a medical examiner can be pretty gruesome and at times isolating since medical examiner offices typically do not have very many employees. Medical examiners must be comfortable dissecting bodies, removing organs, and dealing with families who experienced a very traumatic and violent death. In addition, they can expect to:
To become a medical examiner, one has to be a licensed doctor (MD or DO) and take a licensing exam regardless of the state where they work. The Federation of State Medical Boards (FSMB) keeps a list of state-specific requirements for initial medical licensure. Medical licensing is done on a state-by-state basis, and requirements vary. All require medical school, passing all four tests of the USMLE, and extensive training (residency).
In addition to licensing, many medical examiners will also want to look into certifications, as they can help improve the chance of finding a job.
The American Board of Medicolegal Death Investigators (ABMDI) offers certification options that may help to bolster a career. Applicants must have a minimum of 640 hours of work in death investigation to be certified by the ABMDI. Medical examiners may also consider earning board certification in forensic pathology from the American Board of Pathology.
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Rachel Drummond is a freelance writer, educator, and yogini from Oregon. She’s taught English to international university students in the United States and Japan for more than a decade and has a master’s degree in education from the University of Oregon. Rachel writes about meditation, yoga, coaching, and more on her blog (Instagram: @racheldrummondyoga).