There's basically two broad philosophies in FP (my designations, admitedly over-simplified):
1. Classic: The approach here is largely grounded in criminalistics and the forensic pathologist's/coroner's task is to investigate suspicious deaths to gather evidence for law enforcement agencies. Here the FP/C functions primarily like a detective and the most important part of thier training has to do with that and not with medicine. Sometimes, with coroners, these people come from law enforcement backgrounds and move into forensics by dint of interest and taking some night courses in anatomy, ect. The "interesting cases" these guys talk about at the water cooler are the bizzare accidents and weird/extreme homicides. The maxim here is that to be a good FP/C you need to be a good criminalist. So medical training is not that important.
2. Nuevo (or Accademic): The approach here is grounded in medicine and the FP's (these guys eschew coroners) task is to perform a medical assessment to determine cause and manner of death. This assessment deliberately and circumspectly goes beyond the immediate medical situation to incorporate broader elements of the circumstances in which a death occured. Here the FP functions like a physician who has specialized in pathology and subspecialized in forensic pathology. Their primary task is to arrive at a diagnosis. The "interesting cases" these guys talk about are the unique undiagnosed medical conditions which initially presented as sudden death. The maxim here is that to be a good forensic pathologist you have to be a good pathologist. So, obviously, good medical training is essential.
The center of gravity in FP is shifting (and really has for some time) towards Nuevo. However, the primary public perception -- and it seems also that of many people in the medical and even pathology fields-- is still firmly ensconced in Classic.
It's probably obvious I'm a Nuevo FP, so it's no surprize that I whole-heartedly disagree that FP should be disassciated from pathology or a full pathology residency. I rather think the two should be wedded more closely, as, for example, molecular/genetic diagnostic techniques can be developed to diagnose things like electrically unstable hearts, which can cause sudden fatal arrhythmias. That's just one example. Overall, forensic pathologists really need to be fully competent in applying firm biomedical-scientific principles to what they do, as well as be aware of new developments in medicine and pathology that could impact both the public, whom they serve, and their day to day work.
Long story short:
- You could definitely get an FP fellowship with AP-only, for now.
- The extra year notwithstanding, AP/CP can ONLY help you.
- If you can possibly stand it, Clinical Internship/AP/CP will only help you the more.
