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Strengthening the Medical Examiner-Coroner System Program

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The medicolegal death investigation (MDI) workforce is experiencing a national shortage of practicing board-certified forensic pathologists. Furthermore, there is variability in the practice of death investigation across the United States, resulting in an inconsistent provision of MDI services. This program was initiated in 2017 to help address MDI workforce needs to increase the number of practicing board-certified forensic pathologists, as well as to support medical examiner and coroner (ME/C) offices’ needs to implement and follow quality standards and performance criteria in an effort to provide consistent and equitable application of death investigation services.

The goals of this program are the following:

  1. Increase the supply of qualified forensic pathology practitioners.
  2. Strengthen the quality and consistency of ME/C services.

This program is one of the forensic science programs that moved from the National Institute of Justice to the Bureau of Justice Assistance (BJA) in FY 2020.

Why This Matters

This program helps address the extreme shortage of board-certified forensic pathologists in the United States, as underscored in the 2019 Report to Congress: Needs Assessment of Forensic Laboratories and Medical Examiner/Coroner Offices on strengthening forensic science in the United States. It also provides ME/C offices with the resources to become accredited and maintain that accreditation. Accreditation provides an independent measure of quality assurance by assessing that an office maintains written policies and procedures and adequate staff, equipment, training, and suitable physical facilities to produce a forensically documented, accurate, and credible death investigation product. Further, this program helps to address the increasing workloads experienced at ME/C offices, which have been exacerbated by the opioid epidemic and the COVID-19 pandemic.

Grantee Spotlight: 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.

Program Accomplishments

Fellowship/Purpose Area 1

  • 55 fellowships have been funded by this program.
  • 30 participants have completed fellowship training using program funds.
  • 8,333 deaths were investigated by the program-funded fellows.
  • 8,102 autopsies were performed by the program-funded fellows.

Accreditation/Purpose Area 2

  • 98 individuals have sought certification using program funds.
  • 24 individuals achieved certification using program funds.
  • 11 organizations have achieved accreditation using program funds.

Please note that due to the COVID-19 pandemic, many grantees’ program goals were delayed, especially with respect to accreditation. Also, many awards close prior to achieving accreditation, so that metric goes unreported.

Date Modified: May 25, 2023
Date Created: September 9, 2020