The 2023 Forensic Pathology Match Program Update

Of the 46 U.S. accredited forensic pathology fellowship programs (78 total positions), 40 programs participated in the National Association of Medical Examiners (NAME) National Resident Matching Program (NRMP), offering a total of 70 positions. The match was held on May 3, 2023, for positions starting in July 2024. There were 47 match applicants, and all but two applicants matched (i.e., 95.7 percent applicants matched). In total, 50 percent of the forensic pathology programs in the match filled, and 64 percent of the forensic pathologist (FP) positions filled. The application numbers are similar to recent years if one considers that a handful of positions this year were available outside of the match. The data indicates there is not a shortage of FP fellowship positions but rather a shortage of applicants. NAME conducted a survey of the fellow applicants (55 percent response rate) and found that four of five residents matched with their first choice; 88 percent were “definitely” satisfied with their match outcome. The next FP match date is scheduled for May 1, 2024, for July 2025 positions. 

For more information on the NAME NRMP, visit the NAME webpage.

New York Office of the Chief Medical Examiner (NYC OCME)

NYC OCME serves a population of approximately 8.5 million people in an area of 300 square miles that encompasses the city’s five boroughs. The office has more than 30 full-time forensic pathologists and has trained an average of 4 forensic pathology fellows every year for more than 30 years. A recent grant award from the BJA Strengthening the ME/C Program has allowed the NYC OCME to accommodate up to 6 forensic pathology fellows each year. 

The NYC OCME’s reputation within the forensic pathology community as a consistently strong training program enables it to draw applicants from around the country and the world. Locally, the NYC OCME partners with 7 regional medical schools and more than 10 regional pathology residency programs to educate a large pool of future doctors and pathologists about the unique intersection of science and medicine in forensic pathology. A limited number of summer internships hosted by the NYC OCME encourages college students to consider careers in the forensic sciences, and some of these interns even return as forensic pathology fellows years later after completing college, medical school, and a pathology residency.

Forensic pathology fellows perform more than 200 autopsies of various complexity, attend daily conferences with senior medical examiners to discuss cases with a strong emphasis on the principles behind the practice of forensic pathology, teach students and residents, and gain experience testifying in grand juries and criminal trials. Over the last 30 years, the NYC OCME’s forensic pathology training program has successfully graduated more than 100 forensic pathologists, most of whom have continued to practice forensic pathology full-time in and beyond New York City.

Kittitas County Coroner's Office

The portable X-ray machine funded under this award has truly been an asset to the office and their investigations. In the past, cases requiring X-rays had to be transported to a local hospital for imaging, at considerable expense to their office. As a result, the coroner's office was very selective when it came to scheduling cases for imaging.

Since they received the portable X-ray machine, they have enhanced their investigation to support their forensic pathologists by providing X-rays on any case in which it appears that X-rays would be advantageous to have. In several cases, their pathologist has been able to certify cause and manner of death by reviewing scene photos and X-rays, thereby avoiding a costly autopsy that would have been required in the absence of the images. In a recent gunshot death, they were able to locate projectiles in an area they did not expect them to be found based upon their initial review of the wounds. This saved a considerable amount of time at autopsy.

Overall, having access to their own dedicated X-ray machine has enabled the coroner's office to perform better investigations with more accurate results while, at the same time, saving the county thousands of dollars in autopsy fees and hospital X-ray fees. The convenience of being able to obtain images at their facility without having to transport back and forth to the hospital is a great advantage as well.

Montgomery County Coroner’s Office, Ohio

The performance of autopsies by a fellow reduced the overall caseload average for the full-time forensic pathologists, helping to keep them below 325 annual autopsies and preserving critical criteria that must be met for NAME accreditation. The fellowship was an affordable and cost-effective approach to solving concerns regarding record autopsy numbers, as well as bolstering forensic pathology in the future, by providing two well-trained forensic pathologists to an understaffed field.

Milwaukee County Medical Examiner’s Office, Wisconsin

With the hiring of a fellow, the office was able to increase the number of autopsies performed by 6 percent when compared with the 12 months prior, which allowed the office to offer support to surrounding jurisdictions in need of forensic autopsy services. During this timeframe, the Milwaukee County Medical Examiner’s Office was able to provide autopsy support to 14 other jurisdictions, which is an increase of more than 100 percent from years prior.

Montgomery County, Texas

Thanks to the grant funds, the county was able to make the necessary improvements to a facility, increase storage capabilities with the purchase of a high-density mobile shelving unit, and send two death investigators to medicolegal death investigation training who subsequently achieved certification. The marked increase in caseload, internal staffing challenges, and continued changes in the death investigation process affected the county’s ability to complete all the goals within the timeframe; however, it is still on task to complete them.

Broward County, Florida

The fellow started promptly on July 1, 2018, and successfully completed all phases of the program. She completed over 200 autopsies, attended training from NAME and the American Academy of Forensic Sciences, and presented a well-received poster concerning a very rare cause of sudden death. In the spring, she attended courses on forensic anthropology, forensic botany, and forensic entomology. Over the course of the year, she consulted with and learned forensic toxicology from an in-house laboratory and board-certified PhD toxicologist. With the opioid epidemic, this was a lot to undertake and master, and she became well versed in the properties, analysis, and interpretation of hundreds of prescription and nonprescription drugs. She received more than 30 hours of training from the staff pathologist, as well as hands-on training while doing cases. She was eventually hired as a staff forensic pathologist.