Short version is...I pretty much agree. (Sorry, this is LONG AS CRAP, read the rest at your own peril.)
Sidebar before I address the original poster's questions -- Yes, "selling" yourself as an expert witness in consult cases takes a while, as you need enough experience and reputation to be considered as a paid consultant. However, after a few months of fellowship it's quite possible that the court will recognize you as an "expert witness" and allow you to testify as such. In fact, it's highly desirable that you testify as such before you finish fellowship -- just hard to accomplish because the obscenely sluggish judicial system limits the likelihood that one of your cases will go to trial, AND need a forensic pathologist to testify, within a year. (You don't have to be FP certified to be considered an "expert witness" in forensic path.)
1. Competition: The good programs (see below) are very competitive, not uncommonly filling 2-3 years in advance. But, there seem to be more fellowship positions than people filling them overall, so there are opportunities out there. It just may be at a smaller program with less of a reputation. And keep in mind that competitive applicants occasionally get swayed away from forensic path into something more lucrative -- when I was interviewing for fellowships it seemed like a lot of programs had a story of someone backing out a few months before starting. I don't recall any place REQUIRING you do a rotation with them to get a fellowship there, but it made things easier, especially the competitive places.
2. Job market: There are a lot of positions out there, but they are extremely scattered. Having to move to start a job isn't a possibility, it's a strong likelihood. And it's true the governmental financial meltdown has tightened the screws on places which would otherwise be hiring. But when I was looking only a year and a half or so ago it seemed like a lot of smaller offices were advertising. Larger offices with a strong national reputation tend to hire by networking or from internal fellows. Websites like thename.org and aafs.org are common places for offices to advertise, often but not always with salary information -- don't be discouraged by only seeing 4 or 5 postings, as there ALWAYS seems to be at least that many.
3. Starting salary: Pretty variable. Some information is posted in the advertisements for jobs (see #2). When I was starting as a path resident it seemed like the advertisements averaged around $120-130. When I was looking as a fellow it seemed more like ~$140. But it's pretty variable, depending on location (cost of living), the office, and local political goings on. A few offices have been successful in getting their salaries significantly raised, while others are still struggling. The salary bump with certification (AP, then AP/FP) and experience isn't huge, either -- most will probably be lucky to get into the mid $200's base salary at any point in their careers (inflation not considered), unless you make chief. That changes if you develop a good private consult business, however.
4. Reputable programs: I ditto the NYC, New Mexico, Baltimore, and Miami suggestions. New Mexico and Baltimore are just finishing brand new buildings (CT scanners, etc.), though I haven't had a chance to visit the final products yet. Dallas, Richmond, North Carolina, Atlanta.. also seem to do good work with their fellows, but I know much less about them. Some "smaller" programs are very good as well, but I'm sad to say I don't know them well enough to specifically recommend something. Generally I would ask around before agreeing to a fellowship, but if the office does a good number of cases (~1500) with a good number of homicides (in the hundreds would be nice), are accredited, and they give a good vibe then you're probably OK.
5. Programs to avoid: This is a bit of a danger zone, as programs can turn the corner very quickly. A few of the super busy programs are so overwhelmed that their training has probably suffered, but unique self-driven individuals might thrive there. I would be wary about programs that are short by several attendings but are still actively recruiting multiple fellows. And I would be wary about tiny programs only doing a few hundred total cases and fewer than ~50 total homicides -- just because your exposure will be much more limited, even if the attendings are superb and teach you well.
6. Career paths: Well, you really have little choice but to work in some sort of office with regular contracted work at least in the early years. Basically, it's extremely hard to market yourself doing nothing but consult work if you have zero experience. After a few years and developing some contacts, sure -- more money, but also more travel and more contentious cases with angrier lawyers out to make an example out of you. There are certainly differences between medical examiner and coroner systems, but based on my fleeting discussions with people (personally I've only worked in an ME system) the main difference is that as an ME your say is basically final while in a coroner system the coroner can say whatever they want regardless of what you tell them. Some forensic pathologists love the coroner system because the coroner protects them from a lot of the politics and publicity and keeps them from many administrative tasks, so long as they get along with the coroner. Others despise the coroner system because of the loss of control and a sense of over-compromising. But almost all seem to agree the coroner system in general is outdated and inappropriate, which is another topic altogether.
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