Forensics fellowship
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Some related threads (not all of them, but a few on a very quick search):
http://forums.studentdoctor.net/showthread.php?t=785171&highlight=forensic+fellowship
http://forums.studentdoctor.net/showthread.php?t=751725
http://forums.studentdoctor.net/showthread.php?t=721311
As a forensic fellow it's -possible- to make in the $100k range; I believe FREIDA maintains salary information, though it may be outdated, and the pathology resident wiki (http://pathinfo.wikia.com/wiki/Forensic_Pathology_Fellowship_Directory) links to fellowship websites, where available, which may have more up-to-date information. The "catch" is that such salaries are typically at large, busy places which really need someone to help with the workload, in areas with a high cost of living, and some may not be accredited fellowships. But that doesn't mean all of those places aren't good to train at -- for example, Miami-Dade's website indicates the current stipend is $95,590, and they have a good reputation as a good training program. I thought New York was up in that range too, and they also have a good training reputation, unfortunately I can find no reference for their fellow salary right now. Most programs offer salaries more in line with any other 5th year resident in that region.
Busy reputable programs include but are certainly not limited to Baltimore (settling into a big new facility), Miami, New York, New Mexico (also recently in a new facility), and Dallas. There are a number of smaller programs which also have a good reputation, but you aren't likely to see as many wild cases...nor have to deal with the same problems. Personally, I think a preferred program is one that takes more than 1 fellow per year, does on the order of 2000+ autopsies per year including on the order of 100+ homicides, is NAME accredited (www.thename.org), and, obviously, the fellowship is ACGME accredited. I'm sure there are very good programs that don't meet those gross number generalizations, but it's one frame of reference; I would be less concerned with numbers than quality of training and types of cases they do get, in that I believe you really need to see a lot of homicides/suspicious deaths, including children/infants, while in training.
The other part of the question was about the job market. In my observation it's one of the better markets in pathology right now in terms of jobs being available (a common advertising place is also www.thename.org, though as with many other pathology jobs not all openings are widely advertised) vs level of competition. Nevertheless, some governments have implemented hiring freezes or budget cuts with the recent economic problems. And with every change in job in forensic path you are essentially guaranteed to have to move, as ME offices typically cover very large areas. On the other hand, many positions are working directly for county or state government, and typically provide solid benefits. The average starting salary for an AP boarded, FP eligible finishing fellow seems to be in the range of $140-150k, give or take, but ranges down to just under $100k up to around $200k depending on location, whether the office is private, etc. Add FP boarding and you generally add on the order of $3-5k, give or take. The downside is that there may not be a whole lot of room for salary improvement; you may get a little bump for years of experience, becoming deputy chief, or chief, but we're still generally talking about $250k or less -- not taking into account private consults (not everyone does much of this, nor ever earns enough of a reputation to do much of this), or working for a private company contracting ME services...where it can be better, but still limited by the budgets of governments you're contracting with.
http://forums.studentdoctor.net/showthread.php?t=785171&highlight=forensic+fellowship
http://forums.studentdoctor.net/showthread.php?t=751725
http://forums.studentdoctor.net/showthread.php?t=721311
As a forensic fellow it's -possible- to make in the $100k range; I believe FREIDA maintains salary information, though it may be outdated, and the pathology resident wiki (http://pathinfo.wikia.com/wiki/Forensic_Pathology_Fellowship_Directory) links to fellowship websites, where available, which may have more up-to-date information. The "catch" is that such salaries are typically at large, busy places which really need someone to help with the workload, in areas with a high cost of living, and some may not be accredited fellowships. But that doesn't mean all of those places aren't good to train at -- for example, Miami-Dade's website indicates the current stipend is $95,590, and they have a good reputation as a good training program. I thought New York was up in that range too, and they also have a good training reputation, unfortunately I can find no reference for their fellow salary right now. Most programs offer salaries more in line with any other 5th year resident in that region.
Busy reputable programs include but are certainly not limited to Baltimore (settling into a big new facility), Miami, New York, New Mexico (also recently in a new facility), and Dallas. There are a number of smaller programs which also have a good reputation, but you aren't likely to see as many wild cases...nor have to deal with the same problems. Personally, I think a preferred program is one that takes more than 1 fellow per year, does on the order of 2000+ autopsies per year including on the order of 100+ homicides, is NAME accredited (www.thename.org), and, obviously, the fellowship is ACGME accredited. I'm sure there are very good programs that don't meet those gross number generalizations, but it's one frame of reference; I would be less concerned with numbers than quality of training and types of cases they do get, in that I believe you really need to see a lot of homicides/suspicious deaths, including children/infants, while in training.
The other part of the question was about the job market. In my observation it's one of the better markets in pathology right now in terms of jobs being available (a common advertising place is also www.thename.org, though as with many other pathology jobs not all openings are widely advertised) vs level of competition. Nevertheless, some governments have implemented hiring freezes or budget cuts with the recent economic problems. And with every change in job in forensic path you are essentially guaranteed to have to move, as ME offices typically cover very large areas. On the other hand, many positions are working directly for county or state government, and typically provide solid benefits. The average starting salary for an AP boarded, FP eligible finishing fellow seems to be in the range of $140-150k, give or take, but ranges down to just under $100k up to around $200k depending on location, whether the office is private, etc. Add FP boarding and you generally add on the order of $3-5k, give or take. The downside is that there may not be a whole lot of room for salary improvement; you may get a little bump for years of experience, becoming deputy chief, or chief, but we're still generally talking about $250k or less -- not taking into account private consults (not everyone does much of this, nor ever earns enough of a reputation to do much of this), or working for a private company contracting ME services...where it can be better, but still limited by the budgets of governments you're contracting with.
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i will confirm that the NYC salary is north of 100k, but why does that matter? Sure it's an awesome perk (plus an almost necessity to live in this city! NY i love you but you're damn expensive). if you are THAT concerned about money... FORENSICS IS NOT FOR YOU😀
Why not go to the best fellowship you can? after all, isn't it all about the training/connections you'll make? i generally hear NYC, Miami, New Mexico, maybe Baltimore as the top, though i'm sure one of the Texas programs is good too, i just don't know either way.
ACGME accreditation is a must. NAME accreditation isn't. We're not NAME accredited, though we easily could be. keep an eye out for the programs that have you do north of 250 to 300 autopsies. you won't have time to fully work-up your cases. make sure fellow training is a priority for the office and that you're just not cheap (PGY-5 level) labor. the point about having >1 fellow is a good one. you don't want to be on call EVERY weekend (i know one poor fellow who is). Balance is very important. plus, i actually like my spouse/cats/having a life.
and start early! our spots for 2012-2013) are already all gone.
Why not go to the best fellowship you can? after all, isn't it all about the training/connections you'll make? i generally hear NYC, Miami, New Mexico, maybe Baltimore as the top, though i'm sure one of the Texas programs is good too, i just don't know either way.
ACGME accreditation is a must. NAME accreditation isn't. We're not NAME accredited, though we easily could be. keep an eye out for the programs that have you do north of 250 to 300 autopsies. you won't have time to fully work-up your cases. make sure fellow training is a priority for the office and that you're just not cheap (PGY-5 level) labor. the point about having >1 fellow is a good one. you don't want to be on call EVERY weekend (i know one poor fellow who is). Balance is very important. plus, i actually like my spouse/cats/having a life.
and start early! our spots for 2012-2013) are already all gone.
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also re: Texas
I just had the opportunity to meet a forensic neuropathologist from Harris County (Houston) who was lecturing at a Neuropath conf. He seemed very enthusiastic about training and mentioned that that the office is looking to start a FP+NP (3 yr) combined fellowship, which is cool. i don't know much else about the office but definitely worth a look.
NYC has the 1 yr FP and 1 yr forensic Neuro/Cards fellowship (which i am now doing next year, WOOT!). it is ACGME accredited but you'd need to find a place to do a clinical year to sit for the NP boards (since it requires 2 yrs of training).
I just had the opportunity to meet a forensic neuropathologist from Harris County (Houston) who was lecturing at a Neuropath conf. He seemed very enthusiastic about training and mentioned that that the office is looking to start a FP+NP (3 yr) combined fellowship, which is cool. i don't know much else about the office but definitely worth a look.
NYC has the 1 yr FP and 1 yr forensic Neuro/Cards fellowship (which i am now doing next year, WOOT!). it is ACGME accredited but you'd need to find a place to do a clinical year to sit for the NP boards (since it requires 2 yrs of training).
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With lots of respect to the NYC program (it has had a top notch reputation as a training program for forever, and I -love- the idea of their cards/neuro year), I continue to scratch my head about their NAME accreditation status (that's an office accreditation, not a training program accreditation). Agreeing that I suspect that they -could- pass isn't the same as doing so, and I simply hold some curiosity as to why it hasn't happened. But I still have no reservations recommending it as a training program, based on reputation and what I've heard of its graduates. My opinion, however, is that in general NAME accreditation is still an important factor, and if a program's office doesn't have it, ask them why and draw your own conclusions.
I've heard over the last several years that the Harris County office has really been building itself up, being active and involved, etc.; I don't know anyone who's been through the program though.
The numbers issue was definitely worth bringing up.. Technically a fellow "can't" do more than 300 autopsies/yr or the program risks its ACGME status. Frankly, having hit that number about on the head as a fellow, I wouldn't generally recommend a fellow doing that many, unless it's an attempt to build on efficiency late in the year, knowing that some offices may need you work that hard in your first "real" job. You need to learn how to handle a case well first and foremost. Efficiency improves with pressure, yes, but also with experience. And it's simply a worse problem to get in the habit of being behind while also not being able to work up your cases fully, learn important but rarely performed (especially when everyone's in a hurry) autopsy techniques, do relevant reading/literature searches, go to scenes, at LEAST observe testimony a few times, etc. etc.
I also definitely agree with starting early. As with many fellowships, FP can fill early -- especially the top programs, but also the smaller ones that only have 1 position available. You're competing with a small group but for a small number of positions.
FWIW, don't make the fellow salary your deciding factor. For only one year when training should be the most important thing to focus on, salary is not worth ending up somewhere that otherwise isn't a good fit for you. You can start talking yourself into concessions for salary when you look for a "real" job, if you really want to.
I've heard over the last several years that the Harris County office has really been building itself up, being active and involved, etc.; I don't know anyone who's been through the program though.
The numbers issue was definitely worth bringing up.. Technically a fellow "can't" do more than 300 autopsies/yr or the program risks its ACGME status. Frankly, having hit that number about on the head as a fellow, I wouldn't generally recommend a fellow doing that many, unless it's an attempt to build on efficiency late in the year, knowing that some offices may need you work that hard in your first "real" job. You need to learn how to handle a case well first and foremost. Efficiency improves with pressure, yes, but also with experience. And it's simply a worse problem to get in the habit of being behind while also not being able to work up your cases fully, learn important but rarely performed (especially when everyone's in a hurry) autopsy techniques, do relevant reading/literature searches, go to scenes, at LEAST observe testimony a few times, etc. etc.
I also definitely agree with starting early. As with many fellowships, FP can fill early -- especially the top programs, but also the smaller ones that only have 1 position available. You're competing with a small group but for a small number of positions.
FWIW, don't make the fellow salary your deciding factor. For only one year when training should be the most important thing to focus on, salary is not worth ending up somewhere that otherwise isn't a good fit for you. You can start talking yourself into concessions for salary when you look for a "real" job, if you really want to.
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Just to add my 2 cents..(I'm an infrequent poster)...
The additional duty of testifying is a rare but unique quality of a fellowship program. Not simply viewing other ME's testify, but having the opportunity as a fellow to testify for preliminary and/or jury trials is a bonus!!!
The additional duty of testifying is a rare but unique quality of a fellowship program. Not simply viewing other ME's testify, but having the opportunity as a fellow to testify for preliminary and/or jury trials is a bonus!!!
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Absolutely agree! -- Getting experience testifying is one of the more difficult, but more important, parts of training. Most programs will do their best to get you to testify on something before you finish, but judiciary lag times (for your own cases) or antsy prosecutors (if you try to testify on a case that isn't yours) may prevent it. They should all have some kind of contingency though, whether it's mock testimony or whatever, in addition to observing the real thing a few times. It can change your whole perspective in how you mentally approach your cases and write your reports in the future.
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BCME? Where exactly do you mean? Broward County/Tampa? Bexar County/San Antonio? Baltimore, which was already mentioned? Somewhere else..?
Generally one can get a good feel for how a program runs, and whether they would get good training as a fellow, after doing a rotation there. But ideally, do a rotation or even a few days at least observing at another office too -- it's extremely easy to fall into a routine of normalcy at one place and not realize how much better or worse certain things may be elsewhere. I think this is particularly true when one is first learning about a certain subspecialty and has no other frame of reference.
Generally one can get a good feel for how a program runs, and whether they would get good training as a fellow, after doing a rotation there. But ideally, do a rotation or even a few days at least observing at another office too -- it's extremely easy to fall into a routine of normalcy at one place and not realize how much better or worse certain things may be elsewhere. I think this is particularly true when one is first learning about a certain subspecialty and has no other frame of reference.
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Nothing but good things to say about Dr. Cina. Looks like they have "only" 1 fellow, and according to the 2009 annual workload report available on fameonline.org handled almost 1300 autopsies and a little under 90 homicides. Statistically nothing to sneeze at, but probably no district in Florida would regularly reach all of the numbers I suggested in a previous post except for Miami-Dade (frankly I doubt all that many in the country would, and some probably have more of a reputation as a work house than a teaching center). I don't see that they're NAME accredited. But, again, nothing but good things about Dr. Cina -- seems to be a straight shooter, and is active in the field including as current president of the Florida Association of Medical Examiners (www.fameonline.org).
Anyone who has rotated at a place really has the best chance to see how a given office conducts itself, and is in the best position to make an educated judgement regarding whether it would suit them for fellowship -- IF they have seen, in some way whether interview or whatnot, a couple of other places. I would encourage anyone going into the field to try to at least visit both a huge place and a non-huge place for comparison, but you can get excellent all around education, if a little less personal experience with certain things, at the smaller/non-huge offices.
Anyone who has rotated at a place really has the best chance to see how a given office conducts itself, and is in the best position to make an educated judgement regarding whether it would suit them for fellowship -- IF they have seen, in some way whether interview or whatnot, a couple of other places. I would encourage anyone going into the field to try to at least visit both a huge place and a non-huge place for comparison, but you can get excellent all around education, if a little less personal experience with certain things, at the smaller/non-huge offices.
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I am nowhere near FP as a career, but out of sheer curiosity what is the hiring process like? Do you get the full cavity background check?
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Depends. There seemed to be more of a background check to get a state license (fingerprints, etc.) than to get the job per se. My medical license alone took ~5 months. Some states have a reputation for having an arduous process to go through for a medical license -- Florida, Texas, California being among them, though I can't vouch for how much of a cavity search they all do vs whether it's mostly just paperwork. Beyond that it didn't seem to be much more of a process than any other job, except that my references (program director, etc.) were actually called; had to do a drug screen and sign a few things allowing a background check I believe. Not like some jobs, where someone in a black SUV will show up at your 14th cousin's ex-girlfriend's workplace to ask about your character.
I don't know how representative my experience really was, but I haven't heard much different from others. I would probably expect at least agreeing to a background check, and a few phone calls to previous employers.
I don't know how representative my experience really was, but I haven't heard much different from others. I would probably expect at least agreeing to a background check, and a few phone calls to previous employers.
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Interesting. I guess I assumed that because your work has overlap with both law enforcement and the justice system that you would get the black SUV treatment.
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I've only known that to happen when people were trying to get a federal job/contract and needed a certain level of security clearance (Pentagon, working on or around certain military equipment, etc.). I guess they're the only ones who can afford gas for an SUV these days, much less all that window tinting..
And, of course, every employer is different.
And, of course, every employer is different.
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From what I saw it is like 9-4 at worst.
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Depends a lot on where you work and how you work.
A private contractor working for a coroner or multiple coroners may be on call but not get called very often after hours (most calls are "is this our case?"; a few may be "please come to this scene" but those kinds of calls vary by jurisdiction/local culture) since the coroner typically handles those calls, so they may work normal hours (normal = roughly 8-5) or less depending on the autopsy load.
Working at a busy urban office may mean a lot of calls overnight when on-call, but being on-call is split among many pathologists -- as are weekends. So a couple of days every week, or a week every month or two, may be very busy while the rest of the time is pretty much normal working hours.
Working at a small rural office may mean being on-call a lot and having to work a lot of weekends, but one probably isn't actually called very often. Of course, if a cluster of cases come in at once then it can be very hectic and one could work long days...but other days one could probably drift in late and leave early, depending on how the office is set up.
Personally, I take call and handle weekends on a pretty even split with 2 other FP's. On my days I'm in around 0800 and out around 1700, and occasionally have to field calls in the middle of the night or uncommonly go to scenes. If I'm not "on", then during the week there's generally enough paperwork, follow-up, depositions, court, etc. that I'm still typically in the office or otherwise doing work-related stuff by at least 0900 to 1630, but the caseload is generally such that I don't have to hang around to help with overload, and long lunches, errands, leaving early, etc. can usually be managed.
For the most part only weekends and after-hours call can cramp your style, but generally neither of those are regularly overwhelming at any reasonably staffed office. Indeed, some places are not even open on the weekends or both days of the weekend, leaving you with just call -- and having a good stable of investigators handling such things can trim that down too.
A private contractor working for a coroner or multiple coroners may be on call but not get called very often after hours (most calls are "is this our case?"; a few may be "please come to this scene" but those kinds of calls vary by jurisdiction/local culture) since the coroner typically handles those calls, so they may work normal hours (normal = roughly 8-5) or less depending on the autopsy load.
Working at a busy urban office may mean a lot of calls overnight when on-call, but being on-call is split among many pathologists -- as are weekends. So a couple of days every week, or a week every month or two, may be very busy while the rest of the time is pretty much normal working hours.
Working at a small rural office may mean being on-call a lot and having to work a lot of weekends, but one probably isn't actually called very often. Of course, if a cluster of cases come in at once then it can be very hectic and one could work long days...but other days one could probably drift in late and leave early, depending on how the office is set up.
Personally, I take call and handle weekends on a pretty even split with 2 other FP's. On my days I'm in around 0800 and out around 1700, and occasionally have to field calls in the middle of the night or uncommonly go to scenes. If I'm not "on", then during the week there's generally enough paperwork, follow-up, depositions, court, etc. that I'm still typically in the office or otherwise doing work-related stuff by at least 0900 to 1630, but the caseload is generally such that I don't have to hang around to help with overload, and long lunches, errands, leaving early, etc. can usually be managed.
For the most part only weekends and after-hours call can cramp your style, but generally neither of those are regularly overwhelming at any reasonably staffed office. Indeed, some places are not even open on the weekends or both days of the weekend, leaving you with just call -- and having a good stable of investigators handling such things can trim that down too.
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KCShaw: Thanks very much for plugging the wiki!
Regarding Dr. Cina, he seems like a very nice guy. He is currently campaigning to run for Board of Governors for the CAP.
Regarding Dr. Cina, he seems like a very nice guy. He is currently campaigning to run for Board of Governors for the CAP.
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