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Apparently you dont have to be a doctor to be a medical examiner

Socrates25

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    http://www.nytimes.com/2014/02/11/us/heroins-small-town-toll-and-a-mothers-pain.html?hp&_r=0

    http://www.co.saint-croix.wi.us/index.asp?SEC={AD3916EA-C308-47B2-A59A-614FF7B24E0C}

    I know that some counties have coroners who are not medically trained; you can be a high school dropout and still be a coroner.

    But I was always under the impression that medical examiner = pathologist.

    Apparently that is not the case either, as St Croix county has a "medical examiner" who is a former EMT and never went to medical school.

    If the medical examiner is not a physician, then who does the autopsy? Do they ship all their autopsies out to a different county?
     

    dr4n6

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      Correct, one does not need to be a pathologist to serve as a coroner, which is a publicly elected official. While many coroners are indeed physicians, they are not necessarily pathologists they just happened to win the job in a public election. If an autopsy is deemed necessary by a coroner, they will subsequently have the autopsy performed by a pathologist that they typically contract with to do their cases. I don't know what the situation is in Wisconsin-it appears that they are using the terms medical examiner and coroner synonymously. As a forensic pathologist, I have always thought that the coroner system was one that is just an abomination and invites incompetence.
       
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      mlw03

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        Wisconsin is, to my knowledge, the exception to the rule that medical examiners are pathologists. Not sure why they use that title there and do it that way, but it is what it is. Everywhere else, yes, medical examiner generally means pathologist, although some jurisdictions may have "local medical examiners" or some similar term for non-pathologist doctors who will do external examinations in more rural locations. So the local ob-gyn gets some training and can perform an adequate examination and draw specimens for tox testing on someone with overt lethal injury after a motor vehicle accident. Saves time, money, and moves things along faster for the decedent's family. This is especially useful in the West where states are geographically huge and there may only be a single statewide office for performing autopsies (New Mexico and Alaska, for example, only have a single autopsy facility to my knowledge... don't know if they use the local MEs).

        To answer the other question, yes, when this set-up exists, if an autopsy is necessary the body is transported to a facility and the autopsy is done by a forensic pathologist (hopefully). Body transport costs become a significant chunk of many office's budgets.
         
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        LSU-Tech

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          It depends on which state you're in. In some places you do have to be a pathologist or a licensed physician, while in others, you only need to be an elected official. If you want see something controversial, and slightly related, take a look at the 18 year old deputy coroner in Indiana. You only need to pass an examination there. I'm not a fan of this, and I'll just leave it at that.

          http://www.wthr.com/story/6534514/amanda-barnett-indianas-youngest-death-investigator
           

          TMZ2007

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            In North Carolina, there were medically-oriented people (typically EMT/Paramedic/RNs but occasionally MDs) who served as local "medical examiners" and would take call to do death pronouncements and very basic scene investigations for uncomplicated cases, usually people found dead at home with multiple medical problems. The "medical examiner" would then coordinate with the decedent's physician to sign the DC or send the body to the OCME for external exam/autopsy. The "medical examiners" that worked for the OCME were of course all forensic-boarded paths.
             

            LADoc00

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              Im not even sure there is a requirement to be an actually lawful US citizen to be the coroner in California.

              In short: the death investigation process in the US is nothing short of bedlam.
               

              mlw03

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                Im not even sure there is a requirement to be an actually lawful US citizen to be the coroner in California.

                In short: the death investigation process in the US is nothing short of bedlam.

                Not sure I'd say bedlam, but yeah, it's a bit of a mess in some places. The quality of death investigation can vary widely over a few miles if you cross a county or state border. A recommendation came out in 2009ish to phase out coroners and replace entirely with MEs. That's not happening anytime soon.
                 

                dr4n6

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                  A few years ago New Jersey instituted an in state residency requirement for governmental employees that includes forensic pathologists. However the non-boarded certified pathologists that have been in their positions prior to the time that the residency requirement was instituted have been allowed to maintain their out of state residencies. Seems to me like the State of New Jersey apparently places a premium on the residency of their pathologists over the quality of care provided to their citizens by allowing these non-board certified pathologists to maintain their positions.
                   
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