Increasing the Supply of Forensic Pathologists in Los Angeles County

There is a nationwide shortage of trained forensic pathologists in the United States. The National Academy of Sciences found in 2009 that only about 70% of job openings for forensic pathologists are filled annually. The shortfall in pathologists is attributed to manpower shortages and/or insufficient funding.

The Los Angeles County Department of Medical Examiner-Coroner (DMEC) is one of the largest medical examiner’s offices in the United States. Since 1965, the office has had an Accreditation Council for Graduate Medical Education (ACGME)-accredited forensic pathology fellowship program. In the past 30 years the program has trained 60 forensic pathology fellows, most of whom are currently in practice. The office is provisionally accredited by the National Association of Medical Examiners.

Unique features of this fellowship program include a case load of over 10,000 per year drawn from a population of over 10 million; facilities recently upgraded to include a CT scanner; access to a wide variety of board-certified consultants, including odontologists, an anthropologist, and radiologists; in-house toxicology, tool mark, and gunshot residue laboratories; and paid travel to a national forensic conference and to training in forensic anthropology. 

The teaching staff currently consists of 15 board-certified forensic pathologists, as well as consultants in anesthesiology, cardiology, ophthalmologic pathology, pediatrics, psychiatry and psychology, surgery, surgical pathology, hematopathology, toxicology, and infectious disease. Current research initiatives include applications of postmortem computed tomography to advance diagnostics, usefulness of genetic diagnosis at autopsy, and methods of improving contagious disease reporting in a medical examiner’s office.

Local funding for this one-year program provides for one fellow per year. However, the ACGME has approved the office to train up to six fellows per year. Funding has never permitted six fellows; there is thus untapped potential in this fellowship program.

Funding this proposal will allow Los Angeles DMEC to train one additional forensic pathology fellow in 2023-24.