Frequently Asked Questions

Q. OK, so what is pathology?
A. Pathology is the medical specialty concerned with the diagnosis of diseases and injuries by examination of body tissues and fluids, typically in the laboratory setting. There are two main branches of pathology:

Anatomic pathology involves the morphologic evaluation of tissues removed from living or dead individuals, using the unassisted senses (sight, touch, smell) and the microscope. The three main areas of anatomic pathology are autopsy pathology, surgical pathology, and cytopathology. Forensic pathology is concerned almost exclusively with autopsy pathology, or evaluation of the deceased. General pathologists, on the other hand, spend most of their time practicing surgical pathology and cytopathology, in which specimens removed from living patients are examined.

Clinical pathology involves the evaluation of body fluids by laboratory means. The main subcategories of clinical pathology are chemistry, hematology, microbiology, blood banking, toxicology, and immunology. Forensic pathologists are most interested in chemistry and toxicology. Chemistry is concerned with measurement of natural chemicals in the blood, urine, and other body fluids. Toxicology is concerned with the detection and measurement of unnatural chemicals (poisons and drugs).

Q. How many years of schooling and training does it take to become a forensic pathologist?
A. After high school you'll have to undertake:

Q. Wow! Thirteen to fifteen years after high school before you can get a job? To hell with that!
A. It's not as bad as it sounds. Of course you have to pay tuition and living expenses for the eight years of college and med school, but residents and fellows earn a decent living wage (about $26,000/yr to start).

Q. What do forensic pathologists do at work?
A. Forensic pathologists split their time among 1) performing autopsies, 2) acquiring data from investigating officers, and 3) testifying in court. Occasionally they may visit scenes of crimes or accidents.

Q. What personality characteristics are required in a good forensic pathologist?
A. Varying combinations of the following ingredients:

A talent for and interest in science. This should include not only biology, but physics, chemistry, and the social sciences (anthropology and psychology). For the bread-and-butter technical part of your work, you should especially have a good grasp of spatial relationships.

Good communication skills. You will not only be interacting with law officers, but you'll be trying to convince judges and juries that your findings are valid.

Strong stomach. You'll be routinely dealing with dismembered and/or rotting bodies. From a pure visceral standpoint there is no job more disgusting than forensic pathology.

Thick skin. You will be periodically raked over the coals by the local media, who apparently cannot to resist the urge to armchair-quarterback your work. You will also make many enemies among the citizenry. For instance, when you determine that Daddy killed himself, and he wasn't poisoned by that blond bimbo who was only interested in his money, you are going to have some very angry children buzzing around you.

The mind of a detective. You will have to constantly be on guard against being fooled by malefactors smarter and more focused than you. You will have to have some insight into the heart and mind of a criminal.

Q. What should I be studying in high school/college/med school to prepare for a career as a forensic pathologist?
A. In high school, concentrate on traditional core subjects and develop your study skills and self-discipline. Take four years of English, four of science, four of math. Take as many honors-level courses as you can handle, so you can test out of survey-level courses in college. By the time you graduate, you should be able to write clear, polished reports without grammatical errors. If you are shy or uncomfortable speaking in public, you may benefit from getting involved in your high school's debating team or other organized speech activities.

In college, you will have to meet prerequisites to get into med school. These vary from school to school, so get to know your college's premedical adviser early on. In general, you will need two years of chemistry (inorganic and organic), two of biology, one or two of English, and maybe one of physics. You don't have to major in a science to get into med school, and in fact some med schools encourage applicants to have strong backgrounds in the humanities. I can't argue with that, but I do think the current crop of young physicians is somewhat deficient in their grasp of the scientific underpinnings of medical practice. So, I guess what I would say is that if you don't major in a natural science, you should still take more science courses in college than are required by the med schools you are looking to attend.

I think that colleges generally do a better job of teaching biochemistry and psychology than do med schools, so you may wish to consider taking those as electives in college. Medical schools shine in the teaching of anatomy and physiology, so I would stay away from vertebrate anatomy and physiology classes in college. Since medical examiners often deal across cultural lines, you may also wish to enrich your knowledge of various ethnic groups by taking some courses in minority studies. Developing proficiency in a foreign language may come in handy, too.

In med school, concentrate your elective time in basic patient care. Remember that you will be a physician first and foremost. You should do an autopsy pathology rotation early on in your elective bloc, so you will get a leg up on the first day of residency, plus you will learn right away if a career in pathology is right for you. You may even wish to arrange an elective rotation at a large county medical examiner's office. These can usually be arranged, even if you have to travel hundreds of miles to get there.

Q. Where should I go to high school/college? Where should I do my pathology residency/forensic pathology fellowship?
A. You can go to high school anywhere. At any school, rich or poor, public or private, most of the teachers are mediocre, a few are totally incompetent, and a few are wonderful. The bottom line is that you, the student, are ultimately responsible for your education. Even if you are so unfortunate as to be the victim of uniformly abysmal teaching, the information is out there, and it is up to you to get it. Also, if you develop good time management skills in high school, college will not only be easier, but fun, too. The potential for an enjoyable social life in college is great, but you have to come armed with a sense of priorities to succeed both socially and academically on campus.

The choice of college is a little more important. I think the college education is the single most important (but least appreciated) part of one's education. Its value is subtle, though, and it may take decades for its promise to flower.

Medical school is an easy choice: go to the cheapest one you can get into. The quality of education is the same in every U.S. school. You have the same textbooks, the same human bodies with the same diseases, and the same quality of faculty.

The choice of residency is more important. I strongly suggest a program associated with a university, not a private hospital (although you can rotate at private hospitals under the aegis of university-based teaching programs). So much of the value of a residency program depends on the rapport between residents and faculty. This is a hard parameter to measure from a distance, so you should consider doing a med school pathology elective in one or more of the departments you are looking at for residency training. It is usually easy to arrange this, even between schools in different states.

Regarding your forensic pathology fellowship, you will have to go to a big city to get sufficient experience. You will want to look for a program in which the fellow (you) does about 250 autopsies a year. Too many less than that, and you won't get enough experience. Too many more, and you'll be so busy you won't have time to read, study, and do thorough workups on your cases. Of course, you will also want to look for a place that has senior faculty you can respect and have rapport with.

Q. How much money will I make as a forensic pathologist?
A. The range I hear is $60,000 to $180,000, depending on experience, geographical area, and level of responsibility. As a government employee, your fringe benefits (insurance, retirement) should be pretty good. If you are good on the witness stand, you could become one of the corps of elite expert witnesses that fly around the country and command a handsome hourly consultant's fee.

Q. Would I manage other people?
A. Yes. Even at the junior level, you would be expected to show proper management skills in handling dieners, histological technicians, and pathologist's assistants. As a senior person in a large medical examiner's office, you would manage other forensic pathologists.

Q. What are the advantages of being a forensic pathologist?
A. The hours are better than for most other physicians, but this is not a nine-to-five office job by any means. Don't even think about going to med school if you are a clock-watcher.

You have the satisfaction of not only helping to put criminals away, but of comforting grieving families. The job is very challenging, and boredom will not be a problem.

Q. What are the disadvantages of being a forensic pathologist?
A. Some are mentioned above. The pay is not all that great in comparison with that of physicians with similar years of training. Eventually you may become heavily burdened by the continual exposure to the all-too-graphic evidence of man's inhumanity to man.

Q. Where on the Internet can I find out more about forensic pathology
A. For an area that enjoys such popular interest, there is surprisingly little online. However, here's one resource: