Medical examiner

Medical examiner van

A medical examiner is a person trained in medicine or a medical organization that investigates deaths and injuries that occur under unusual or suspicious circumstances, to perform post-mortem examinations, and in some jurisdictions to initiate inquests.[1] Medical examiners, coroners and forensic pathologists are often thought to be the same, but they are different professions.[2] Coroners have a completely different role as well as having differing responsibilities.[2] In some parts of the United States, unlike a medical examiner or forensic pathologist, coroners are elected officials and may not require the extensive medical training that the former must go through.[2]

Job roles

A medical examiner's duties may vary depending on location. The medical examiners’ job is usually extensive and has a lot that goes into it. Typically, a medical examiner's duties may include:

  • investigating human organs like the stomach, liver, brain,
  • determining cause of death,
  • examining the condition of the body[2]
  • studying tissue, organs, cells, and bodily fluids[2]
  • issuing death certificates,
  • maintaining death records,
  • responding to deaths in mass disasters,
  • working closely with law enforcement[3]
  • identifying unknown dead, or
  • performing other functions depending on local law.

In some jurisdictions, a coroner performs these and other duties. It’s not uncommon for a medical examiner to visit crime scenes or to testify in court.[3] This takes a certain amount of confidence in which the medical examiner has to rely on their expertise to make a true testimony and accurately testify the facts of their findings.[3] Medical examiners specialize in forensic knowledge and rely on this during their work.[2] In addition to studying cadavers, they are also trained in toxicology, DNA technology and forensic serology (blood analysis).[3] Pulling from each area of knowledge, a medical examiner can accurately determine a cause of death.[2] This information can help law enforcement crack a case and is crucial to their ability to track criminals in the event of a homicide or other related events.[2]

Within the United States, there is a mixture of coroner and medical examiner systems, and in some states, dual systems. The requirements to hold office vary widely between jurisdictions.

Qualifications

United Kingdom

In the UK, formal medical training is required for medical examiners. Many employers also request training in pathology while others do not. In the UK, a medical examiner is always a medically trained professional, whereas a coroner is a judicial officer.

Pilot studies in Sheffield and seven other areas, which involved medical examiners looking at more than 27,000 deaths since 2008, found 25% of hospital death certificates were inaccurate and 20% of causes of death were wrong. Suzy Lishman, president of the Royal College of Pathologists, said it was crucial there was "independent scrutiny of causes of death".[4]

United States

Qualifications for medical examiners in the US vary from jurisdiction to jurisdiction. In Wisconsin, for example, some counties do not require individuals to have any special educational or medical training to hold this office.[5] In most jurisdictions, a medical examiner is required to have a medical degree, although in many this need not be in pathology. Other jurisdictions have stricter requirements, including additional education in pathology, law, and forensic pathology. Medical examiners are typically appointed officers.[6]

Education

In the United States, the road to becoming a medical examiner is a long and hard one. They require a lot of extensive training in order to become experts in their field.[3] After high school, the additional schooling may take 11–18 years.[3] They must attend a college or university to receive a bachelor’s degree in the sciences.[2] Biology is usually the most common.[7] On average, it takes four years to complete a bachelor’s degree.[7] A medical degree (Doctor of Medicine, MD) is required to become a medical examiner.[8][7] To prepare for medical school, the MCAT (Medical College Admissions Test) must be taken and passed.[2] Medical school is another four years with the first two dedicated to academics and the rest of the two used to gain clinical experience.[7]

Additional training is required after medical school. The first step is to complete pathological forensic training.[8] This usually consists of anatomic and clinical pathology training which takes anywhere from four to five years to complete.[2] After this, an anatomic pathology residency and/or a fellowship in forensic pathology should be completed.[7] Before practicing, they must also become certified through the American Board of Pathology;[8] this certificate is good for life.[9]

Job outlook

The general job outlook for medical examiners in the United States is considered to be excellent.[3] Salary varies greatly by state and location, but it is estimated to average between and a year.[3]

Literature

Television

Medical examiners are common characters in many crime shows, especially American shows. The following characters are well known medical examiners:

CSI franchise

Law & Order franchise

NCIS franchise

  • Dr. Donald "Ducky" Mallard in NCIS, is the chief medical examiner for NCIS Major Case Response Team.
  • Dr. James "Jimmy" Palmer in NCIS, is the assistant medical examiner for NCIS Major Case Response Team.
  • Dr. Loretta Wade in NCIS: New Orleans is the Medical Examiner of Jefferson Parish.

References

  1. ↑ "Coroner vs. medical examiner". Visible Proofs. Retrieved 12 October 2014.
  2. 1 2 3 4 5 6 7 8 9 10 11 "Forensic Medical Examiner Jobs in Forensic Criminal Investigations". www.crimesceneinvestigatoredu.org. Retrieved 2018-03-30.
  3. 1 2 3 4 5 6 7 8 "Forensic Pathologist | explorehealthcareers.org". explorehealthcareers.org. Retrieved 2018-03-30.
  4. ↑ "Medical examiners help expose patient safety risks". Health Service Journal. 12 February 2015. Retrieved 10 March 2015.
  5. ↑ Coroners and Medical Examiners: A Comparison of Options Offered by Both Systems in Wisconsin Jenifer Keach, Rock (WI) County Coroner, April 6, 2010
  6. ↑ National Academy of Sciences, Strengthening Forensic Science in the United States: A Path Forward, (2009), pp 241–253.
  7. 1 2 3 4 5 "How to Become a Medical Examiner in 5 Steps". Retrieved 2018-03-30.
  8. 1 2 3 "Medical Examiner - Forensic Science Careers". Forensic Science Careers. Retrieved 2018-03-30.
  9. ↑ "Becoming a Medical Examiner: Salary Info & Job Description". learningpath.org. Retrieved 2018-03-30.
  10. ↑ The real 'Kay Scarpetta' retires - updated 6:37 p.m. ET 1 January 2008 (By Lisa Billings / AP) - TODAY: Books – MSNBC.com

Further reading

  • Judy Melinek, MD; T. J. Mitchell (2015). Working Stiff: Two Years, 262 Bodies, and the Making of a Medical Examiner. New York: Scribner. ISBN 978-1476727264.
  • Valdes, Robert. "What Is the Difference Between a Medical Examiner and a Coroner?". HowStuffWorks. Retrieved 21 June 2018.
  • "Public Health Law Program: Coroner/Medical Examiner Laws, by State". Centers for Disease Control. Retrieved 21 June 2018. See also the links at the bottom of the linked article.
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