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Advice for a potential Forensic Pathologist

Discussion in 'Pathology' started by Kamoto, Sep 6, 2016.

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  1. Kamoto

    Kamoto

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    Sep 6, 2016
    Hi All,

    First post, so I'm hoping that the few Forensic Pathologists here can help with some guidance.

    I'm a freshman at the University of Florida majoring in Biology. Chose a great mid level school to maximize my GPA chances, so hopefully that works out. Prior to starting at Florida, I was an intern with the Contra Costa County Coroners office. I took notes, weighed organs and observed about fifteen autopsies over the summer. I didn't throw up, I came back each day, and found the work amazing even with the overwhelming smell at times. The hardest autopsies were the decomposed bodies with four days being the longest brought in. I have yet to see children, or horribly deformed bodies, although I did observe an autopsy where someone burned to death in a fuel tanker fire. The Dr. I interned for has asked me back during breaks and summer vacation. I'm hoping this work experience covers a few of the must haves in the medical school admissions process. The Dr. also volunteered to help me with a research project of my choosing.

    Do pathologists generally score on the high end of the MCAT exam? Is there a specific goal I should have in mind for the MCAT? What else can I do to prepare for this career? It is good to have a respected Dr. as my mentor, but I'd also like some other opinions. CA resident which makes things tough for medical school acceptance. Thanks in advance for any replies.

    Kindly
     
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  3. PrettyLadyDoc24

    PrettyLadyDoc24 2+ Year Member

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    Mar 25, 2014
    Kamoto,

    I'm so glad you're thinking about Pathology and Forensics as a career. I'm a pathology resident and I actually just completed a rotation at the state medical examiner's office. It seems like a very cool career path and I commend you on your shadowing and experiences thusfar.

    To answer your question, your MCAT score exists to get you into medical school, but the USMLE exams have a greater bearing on your application for pathology residency. So my advice is to study hard and matriculate to medical school, then you can plan your attack for the USMLE, especially Step 1. When you say CA, are you talking about California or Canada, btw?

    As a college student, keep your focus on getting into a medical school. Pathology is made up of MD, DO, and IMG physicians but competition varies. However, Forensics is a specialty that needs physicians. The US gets about 42 newly minted Forensic Pathologists every year, which is not enough to keep up with demands.

    Having a mentor is good but if you're looking for more info and want to talk further, please PM me.

    Best,
    PLD24
     
    Autopsy101 likes this.
  4. mlw03

    mlw03 Senior Member 10+ Year Member

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    Send me a PM. I'm one of a few practicing FPs who post on here regularly. I also happen to be a UF alumnus. I'll keep it fairly short here. MCAT is a way to get into med school - no one cares about your MCAT score when you apply for residency. I also wouldn't waste time doing 'forensic' courses - you'll learn that stuff in due time if you stick with this route. Try to be well-rounded, and definitely work on your writing. I cannot emphasize how important strong writing skills are as any type of pathologist, but especially forensic path. Complex cases' written opinions are where you really earn your money, and conveying probability, likelihood, and other non black/white issues is hard. Social science and economics is useful too, as it helps you gain a better understanding of society. If you're not comfortable with it already, get comfortable with public speaking. Court testimony is an essential part of forensic path work.

    The numbers from PLD are spot on - high 30s to low 40s per year is how many people sit for the FP ABP exam each year, and that generally is not keeping up with the retirement rate. Plus, you occasionally have people like me who get poached to a foreign country. A competent FP will have no problems finding work somewhere, but do recognize that you have to have geographic flexibility.
     
  5. nr-xxx

    nr-xxx Banned Banned

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    I do not wish to give my name. I am a board certified forensic pathologist who trained at a university program and worked for many years at a prestigious office. I was let go do to a personality problem with the director. I would say think twice about forensic. to me the work is more interesting but here are the drawbacks 1) it is the old adage there are 2 types of medical examiners a) those in trouble, and b) those that have yet to get into trouble. the fields lends itself to a major problem occurring in your career. even if a 'good guy" you will move about 5 times in your career. 2) the old adage "the bad money drives out the good." it appears that there are only a handful of big name people in the field. they dominate the field, the positions and the consults. they do not want to relinquish this to newcomers. they will politically try to get rid of someone if they think it detracts from them. 3) once you have a 'bad case" or serious trouble that is it for your career--it is over. look at the late Dr Edland, ME at Rochester ,NY when they had the Attica riots, he did the cases at age 36 and his life was over with . he died a broken man at age 56 - never say this could not happen to you. it could. so I tell people do not consider forensic pathology I would rather have you go into another branch of pathology like hematopathology or one of the anatomic fellowships like Derm, GI or GU your career and life will be better. really the field of pathology will be automated out of existence and my guess is that it will be done with in about 20 years. go into internal medicine(IM) and do a fellowship. under CLIA you can still run a lab with Internal medicine boards. forensic is usually for those that do not have all the pieces of paper . they usually are considered "the bastard at the family reunion" types. in the field of academic pathology they are not considered in high regard. in my own life , so called colleagues never lifted a finger to help in an hour of need. even with a high demand in the field politically you may be ostracized and forced to leave the country to try to do the forensic work in Canada or New Zealand. also you may get sued like Dr Sptiz for a defamation of character lawsuit by Brother of Jon Benet Ramsey for $150 million. so think twice before doing forensic. it is a field that sooner or later may leave you crying or with a life changing event that spells disaster. I do not want you to be another Dr Edland a tragic ending to a man that stood up for what was the truth and was hounded BY POLICE for that . he died a broken man . don't let that happen to you
     
    dr4n6 likes this.
  6. mlw03

    mlw03 Senior Member 10+ Year Member

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    I do not agree with most of this. There are plenty of normal, content, well-adjusted forensic pathologists all over the US and Canada. Who are not in any type of trouble. Of all varying ages, many of whom stay in 1 position their entire career. I know just such a man - his office is right next to mine. I can think of plenty others off the top of my head. I personally could not care less if the poster becomes an FP or not, but I do not want misinformation being disseminated, and the below is misinformation in my experience.

     
  7. mikesheree

    mikesheree 7+ Year Member

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    Over the years, mlw03 has given generally excellent advice as regards the field of FP.
    And, I concur with his current comments. Listen to him.
    I am aware of the disasters that have befallen a number of FP's over the past decades.
    Most of those folks occupied CME positions or some other type of "boss" in an admin as well as a professional medical position and were politically beholden/appointed etc. They often did not have any civil servant or union-type protection. Often, a big case was involved. Often, the FP never met a news camera he did not like, and got in trouble because (s)he DID NOT THINK CAREFULLY before opening their mouth.
    Often, an oversized ego with a desire to be a "name" FP is part of the toxic brew.
    Be humble, affable, available and know your trade COLD, be"zen-like" and you
    should have no more problem than a prudent and capable hospital lab medical
    director.

    People in every field, everyday, everywhere are "let go" due to personality problems
    with the boss.
     
    Last edited: Oct 27, 2016
    mlw03 and Autopsy101 like this.
  8. nr-xxx

    nr-xxx Banned Banned

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    Unless someone has actually practiced as a forensic pathologist or an ME in an y capacity then they are not in any position to comment recently the NAME ( national association . of medical examiners ) have developed a "courage award" in honor of Dr Edland so these events really did happen. Any one who wants to be an ME shoulder be realistic and not listen to a TV show ( like Quincy) and assume that it is realistic. it is not, I gather someone is from Canada and look no further than the case of David Smith in Ontario, Evan Matashes or Anne Suavegeau ion Saskatchewan all of which have multimillion dollar lawsuits or even criminal charges. As I said think twice before embarking on a career in the field. less hectic and more remuneration is in Heme , Derm,GI or GU far too many "duck into forensic" because they can not do something else. sad but true
     
    dr4n6 likes this.
  9. jupiterianvibe

    jupiterianvibe

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    Forensic pathology is not a particularly attractive choice professionally or financially, in my opinion.
     
  10. mlw03

    mlw03 Senior Member 10+ Year Member

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    While there are nuggets of semi-truth in here, there is plenty that is false. I know way more than I can or will post here, but even by simply looking up info that is in the media, one would see some of the mistakes. For starters, both Drs. Matsches and Sauvageau worked in Alberta, not Saskatchewan. Sure, lots of wheat farming in both provinces, but no, not the same place. What happened in Ontario (look up 'Goudge Inquiry') in fact involved a PEDIATRIC, not forensic, pathologist doing potentially suspicious pediatric autopsies. Anyone practicing FP in Canada is well aware of what happened, and Ontario has developed a system to ensure that forensic pathologists are doing the autopsies in suspicious deaths, as is the case in every province and territory in Canada.

    I repeat what I said before - I could care less what the original poster does, but I don't like misinformation being disseminated. Forensic pathology is a solid career choice for someone who likes and learns the material, and can handle the more unique aspects of the field (such as testifying and seeing the horrific things humans can do to other humans). These disparaging comments about FP are not coming from someone who is actively practicing FPs. I am. I'll give my name to those who ask and will stand by my comments (not that it's a challenge to figure out who I am). Whatever problems nr-xxx had/has, they certainly are not representative of the near 600 practicing FPs across the US and Canada.

    All that said, I do agree that FP is not like Quincy or CSI or Crossing Jordan. That part of the post is something I'll agree with.
     
  11. mikesheree

    mikesheree 7+ Year Member

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    I have practiced as an ME, never got into trouble, and I second my prior post.

    Seems he's one of those (self-described) folks who "duck into forensic" because he cannot
    do something else and has failed "even" at that. Sad but true.
     
    Last edited: Nov 1, 2016
  12. HmanPath

    HmanPath 2+ Year Member

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    People who choose FP, I assume do so knowing that the money is less than PP. Also, all of the practicing FPs I have met thus far are socially functional and seem to enjoy their jobs. To endeavor into this field and not realize the political nature of the work would be foolish. I, for one, am excited for the challenging and interesting work ahead!
     
    Autopsy101 likes this.
  13. WEBB PINKERTON

    WEBB PINKERTON 5+ Year Member

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    Pretty sure "nr-xxx" is the same guy using the "knightmare 3000" username here. Not hard to figure out who he is. For someone trying to stay anonymous , you haven't done a very good job.

    I wish he would tell us about working in Miami during the cocaine cowboy days. Bet he has some interesting stories.
     
    Last edited: Nov 2, 2016
  14. Kamoto

    Kamoto

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    Sep 6, 2016
    Some great replies. Thanks for the spirited discussion. First semester of school has gone reasonably well. I'll end up with a 3.76 GPA. Looking forward to returning home next week and starting up the internship. Help me out with "Automated out of existence". Robotics will see to that, or something else I'm not thinking of?
     
  15. pianoguy05

    pianoguy05 Slide Oracle 7+ Year Member

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    MCAT doesn't matter after you enter med school. Do the best you can to enter medical school.

    Once in med school, keep an open mind. Don't be so held-fast to pathology that you miss your calling in something else. If Path is where you want to be, you'll get there.

    In residency, again, keep options open. Plenty of jobs/need for FP if that's what you like, but we do so much more in pathology...FP is almost, I feel, a box that can't be unchecked (i.e. once you go down that road, I would think it would be hard to find a job in another area of pathology/medicine).

    Finally, best advice I can give you: Take as much humanities/arts as you can as an undergrad. You'll miss it after 10+ years of training in medicine. Enjoy undergrad for what it is. Medicine requires that you lose your 20's to long standardized exams and nights in a hospital...if that's what you're willing to sacrifice then proceed. But you don't get your 20's back. You might have a slightly better 30's and 40's, but you don't get your 20's back. So think about that before you commit to anything.
     
  16. Future.miss.doctor

    Future.miss.doctor 2+ Year Member

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    I am an incoming OM1, and just like the OP, I'm also extremely interested in becoming a forensic pathologist/medical examiner. I noticed that multiple times someone has commented about the "political nature" of the work. I was wondering if someone could comment on that.
     
  17. KCShaw

    KCShaw Chief Resident 7+ Year Member

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    I'll second pretty much everything mikesheree, mlw03, and pianoguy05 have said. As you get closer to finishing undergrad and applying to med schools, it would be worthwhile to revisit this. It is my general feeling that if you tell the med school admissions folks you are 100% sold-out on forensic path, you are probably not helping yourself. Mostly they don't seem to "love" anyone 100% sold-out on anything, but I suspect they think those who can talk of nothing but forensics have watched too much TV or whatever. You can tell the truth, but be realistic and understand there is more to medicine and it's possible you may find yourself doing something else. Most of them, I think, lean towards folks who seem mature and realistic rather than simply puppy-dog passionate -- while I wouldn't overthink it, I wouldn't go in blind either.

    RE: Political nature
    Well, IMO, by its nature it's more political than other specialties/subspecialties per se, but to an extent it's also only as political as you make it. If you decide to play the politics game, then yeah, at some point along the way the likelihood of being burned is higher. But let's look at the basics. First, your money as an FP comes from taxpayers, by way of a county/counties or sometimes state. Essentially everyone holding the purse strings is a politician, or so enveloped in politics that the distinction is irrelevant. There will also be other government agencies and media outlets wanting things, and again one has to play nice. As a *chief* you will have to deal with them. Occasionally a chief will be stuck between a rock and a hard place, lacking funds to do their job, and they either have to get into a public spat or resign, neither of which looks good on the surface, but those in the FP field generally know the difference between someone who wasn't doing their job/doing a poor job and someone who just wasn't getting the resources they deserved. Generally if one wants their face in the news they will get it there, but the media is fickle and will turn in a heartbeat; this seems to mainly happen to those *seeking* it, though often with the flawed expectation that they can handle any controversy. There can also be individual cases which can turn ugly, whether through fault of the FP or not, and these can be more problematic. Much of the time those issues still end up falling on the chief in some way. However it's been my experience that, most of the time, unless the pathologist *tries* to make it a big deal, it usually remains locally isolated; those who take the position that they are right no matter what, holler it to the moon and back, and screw everyone else tend to do worse than those who are willing to say hey, this is my opinion, here's why, make of it what you will -- or are willing to quickly own up to a mistake.

    However as an *associate*/deputy/anything other than a chief, I think one would have to work fairly hard to crash and burn "politically." Any individual case can potentially turn bad, but usually they don't and usually even if they do it is not job or career ending. Some FP's who have been through the ringer, terminated, bad public reputation, etc., have still found FP jobs elsewhere -- partly because there simply aren't enough of us, and partly because often it's "one bad case" or a situation where someone wasn't managing their duties well (severe backlogs, taking on absurd numbers of cases, etc.).

    But, yes, at the end of the day you are beholden to the taxpayers -- and their government representatives -- by a much more direct line than other docs, even if the field also spends a lot of time trying to remain "independent" from undue political influence.
     
  18. pre med 2014

    pre med 2014 SDN Gold Donor Gold Donor Classifieds Approved 5+ Year Member

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    That is unless you are a private FP, and your salary does not come from taxpayers...
     
  19. Future.miss.doctor

    Future.miss.doctor 2+ Year Member

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    Thank you so much for your thorough responses. I will seek shadowing/volunteer/research opportunities at the local ME to get further exposure to the field.

    The majority though are government employees
     
  20. KCShaw

    KCShaw Chief Resident 7+ Year Member

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    Yes..and no.

    If by "private FP" you mean someone who does nothing but private consulting -- with families, attorneys, etc., and zero work as an official ME per se -- then that's only accurate when you have not been hired by, say, the prosecution or some other government entity. But of course even if you are only getting paid by a family to do a "private" autopsy, whether a second autopsy of an ME case or one which had not been an ME case, it's still more than possible to end up as the focus of political attention, depending on the case...such as how the family and/or their other representatives choose to spin what you do, and how much you are stepping on the toes of local law enforcement, state attorneys, physicians, etc.

    However FP's who do nothing but that are a tiny percentage of our population, and for all practical purposes one must work as a "regular" ME for years prior to earning enough of a reputation that people will hire/pay you enough for you to actually make a living doing nothing but "private" work. There are a few companies who do "private" autopsies or otherwise cater to the notion of such "private" work and I suppose it's possible to work with some of them fresh out of training, but that's also a relatively tiny number of people, many who I do not think are FP's, and the work load typically is very spread out -- no idea what they pay but I suppose there may be some standing contracts with, say, a hospital system. Volume (high or low) could be an issue.

    It's more common for a group/FP to do both -- contract with counties/coroners to be their referral FP's, and *also* do private autopsies/consulting work. This "semi-private" setting still means one gets most of their money directly from the counties -> taxpayers, but one can internally manage how to spend it, which is good for some things. Personally I lean towards that business model, although it also carries its own business risks. At any rate -- many/most offices still seem to be the state/regional/county system, managed at least partly or indirectly by government appointees, hires, or elected personnel (sometimes it's just the HR department, sometimes director of operations, facilities, etc. etc.) rather than being directly hired by the local "chief", where even if they contract with surrounding coroner counties for referrals, the contracts may be with the *county* the FP works for, rather than with the FP or their own private company.

    I should probably take a moment to note that the coroner system (as opposed to the ME system) twists the scenario a bit. Sometimes the "coroner" is for all practical purposes a "chief ME." But sometimes the coroner is an elected layperson who subsequently hires/contracts someone to do their autopsies, then can choose to either accept what the pathologist tells them, or they can choose to put whatever they want on the death certificate. As one might imagine, this also can cause some political turmoil. Much of the time they just take on the management role of a chief, including running the political side of the game, and the political involvement of the "associate/deputy/whatever non-chief FP" is more or less comparable to the ME system. It's a trade off.
     

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