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Medical examiner

January 01, 1970

Not to be confused with coroner.

The medical examiner is an appointed official in some American jurisdictions[1] that investigates deaths that occur under unusual or suspicious circumstances, to perform post-mortem examinations, and in some jurisdictions to initiate inquests. They are necessarily trained in pathology.[2][3]

Hawaiian medical examiner van

In the US, there are two death investigation systems: first, the coroner system based on English law; and second, the medical examiner system, which evolved from the coroner system during the latter half of the 19th century. The type of system varies across jurisdictions, with over 2,000 separate jurisdictions for investigating unnatural deaths. In 2002, 22 states had a medical examiner system, 11 states had a coroner system, and 18 states had a mixed system. Since the 1940s, the medical examiner system has gradually replaced the coroner system and serves about 48% of the US population.[4][5]

The coroner is not necessarily a medical doctor. They may be a lawyer or a layperson. In the 19th century, the public became dissatisfied with lay coroners and demanded that the coroner be replaced by a physician. In 1918, New York City introduced the office of the Chief Medical Examiner and appointed physicians experienced in the field of pathology. In 1959, the medical subspecialty of forensic pathology was formally certified.[6]

The types of death reportable to the system are determined by federal, state, or local laws. Commonly, these include violent, suspicious, sudden, and unexpected deaths, death when no physician or practitioner was present or treating the decedent, inmates in public institutions, those in custody of law enforcement, deaths during or immediately following therapeutic or diagnostic procedures or deaths due to neglect.

Duties edit

A medical examiner's duties vary by location, but typically include:

  • investigating human organs like the stomach, liver, and brain
  • determining cause of death
  • examining the condition of the body[3]
  • studying tissue, organs, cells, and bodily fluids[3]
  • issuing death certificates
  • maintaining death records
  • responding to deaths in mass disasters
  • working closely with law enforcement[7]
  • identifying unknown dead
  • performing other functions depending on local law.

In some jurisdictions, a coroner performs these and other duties. It is common for a medical examiner to visit crime scenes or to testify in court.[7] Medical examiners specialize in forensic knowledge and rely on this during their work.[3] In addition to studying cadavers, they are also trained in toxicology, DNA technology and forensic serology (blood analysis).[7] Pulling from each area of knowledge, a medical examiner is an expert in determining a cause of death.[3] This information can help law enforcement solve cases and is crucial to their ability to track criminals in the event of a homicide or other related events.[3]

Within the United States, there is a mixture of coroner and medical examiner systems, and in some states, dual systems. The requirements to hold office vary widely between jurisdictions.

Qualifications edit

United Kingdom edit

In England and Wales, a new statutory Medical Examiner system based in NHS Acute Trusts commenced in 2019 and is expected to be fully operational several years later. A medical examiner is always a medical doctor, whereas a coroner is a judicial officer.[8]

Pilot studies in Sheffield and seven other areas, which involved medical examiners looking at more than 27,000 deaths since 2008, found 25% of hospital death certificates were inaccurate and 20% of causes of death were wrong. Suzy Lishman, president of the Royal College of Pathologists, said it was crucial there was "independent scrutiny of causes of death".[9]

United States edit

Qualifications for medical examiners in the US vary from jurisdiction to jurisdiction. In Wisconsin, for example, some counties do not require individuals to have any special educational or medical training to hold this office.[10] In most jurisdictions, a medical examiner is required to have a medical degree, although in many there is no requirement for specialized training in pathology. Other jurisdictions have stricter requirements, including additional education in pathology, law, and forensic pathology. Medical examiners are typically appointed officers.[1]

Education edit

In the United States, medical examiners require extensive training in order to become experts in their field.[7] After high school, the additional schooling may take 11–18 years.[7] They must attend a college or university to earn a bachelor's degree sufficient for admission to medical school.[3] Biology is usually the most common.[11] A medical degree (MD or DO) is often required to become a medical examiner.[12][11] To enter medical school, the MCAT (Medical College Admissions Test) is usually required [3] after which medical school is another four years with the first two dedicated to academics and the rest of the two used to gain clinical experience.[11]

To become experts in pathology, specifically, additional training is required after medical school. The first step is to complete pathological forensic training.[12] This usually consists of anatomic and clinical pathology training which takes anywhere from four to five years to complete.[3] After this, the physician may complete an anatomic pathology residency or a fellowship.[11] Before practicing as a medical examiner, the physician must also become board certified through the American Board of Pathology.[12][13]

Career edit

The general job outlook for medical examiners in the United States is considered to be excellent.[7] Remuneration varies by location, but it is estimated to average between $105,000 and $500,000.[7]

Shortage edit

In the United States, there are fewer than 500 board-certified forensic pathologists, but the National Commission on Forensic Science estimates the country needs 1,100–1,200 to perform the needed number of autopsies. The shortage is attributed to the nature of the work and the higher pay in other medical specialties. It has caused long delays in some states and resulted in fewer investigations and less thorough investigations in some cases.[14]

See also edit

References edit

  1. ^ a b Strengthening Forensic Science in the United States: A Path Forward (PDF). Washington DC: National Academies Press. 2009. pp. 241–253.
  2. ^ "Coroner vs. medical examiner". Visible Proofs. Retrieved 12 October 2014.
  3. ^ a b c d e f g h i "Forensic Medical Examiner Jobs in Forensic Criminal Investigations". www.crimesceneinvestigatoredu.org. 8 October 2013. Retrieved 2018-03-30.
  4. ^ Jason Payne-James, ed. (2005), "Death Investigation Systems/United States of America", Encyclopedia of Forensic and Legal Medicine
  5. ^ Randy Hanzlick; Debra Combs (1998), "Medical Examiner and Coroner Systems", JAMA, 279 (11): 870–874, doi:10.1001/jama.279.11.870, PMID 9516003
  6. ^ "Overview of the Medicolegal Death Investigation System in the United States". Medicolegal Death Investigation System: Workshop Summary. Institute of Medicine. 2003.
  7. ^ a b c d e f g "Forensic Pathologist | explorehealthcareers.org". explorehealthcareers.org. Retrieved 2018-03-30.
  8. ^ "National Medical Examiners Report 2022" (PDF).
  9. ^ "Medical examiners help expose patient safety risks". Health Service Journal. 12 February 2015. Retrieved 10 March 2015.
  10. ^ Coroners and Medical Examiners: A Comparison of Options Offered by Both Systems in Wisconsin Jenifer Keach, Rock (WI) County Coroner, April 6, 2010
  11. ^ a b c d "How to Become a Medical Examiner in 5 Steps". Retrieved 2018-03-30.
  12. ^ a b c "Medical Examiner – Forensic Science Careers". Forensic Science Careers. Retrieved 2018-03-30.
  13. ^ "Becoming a Medical Examiner: Salary Info & Job Description". learningpath.org. Retrieved 2018-03-30.
  14. ^ "Families suffer due to medical examiner shortage". 7 Dec 2015.

Further reading edit

  • Judy Melinek; T. J. Mitchell (2015). Working Stiff: Two Years, 262 Bodies, and the Making of a Medical Examiner. New York: Scribner. ISBN 978-1-4767-2726-4.
  • Valdes, Robert. "What Is the Difference Between a Medical Examiner and a Coroner?". HowStuffWorks. Retrieved 21 June 2018.
  • "Public Health Law Program: Coroner/Medical Examiner Laws, by State". Centers for Disease Control. Retrieved 21 June 2018. See also the links at the bottom of the linked article.

January 01, 1970
medical, examiner, confused, with, coroner, medical, examiner, appointed, official, some, american, jurisdictions, that, investigates, deaths, that, occur, under, unusual, suspicious, circumstances, perform, post, mortem, examinations, some, jurisdictions, ini. Not to be confused with coroner The medical examiner is an appointed official in some American jurisdictions 1 that investigates deaths that occur under unusual or suspicious circumstances to perform post mortem examinations and in some jurisdictions to initiate inquests They are necessarily trained in pathology 2 3 Hawaiian medical examiner van In the US there are two death investigation systems first the coroner system based on English law and second the medical examiner system which evolved from the coroner system during the latter half of the 19th century The type of system varies across jurisdictions with over 2 000 separate jurisdictions for investigating unnatural deaths In 2002 22 states had a medical examiner system 11 states had a coroner system and 18 states had a mixed system Since the 1940s the medical examiner system has gradually replaced the coroner system and serves about 48 of the US population 4 5 The coroner is not necessarily a medical doctor They may be a lawyer or a layperson In the 19th century the public became dissatisfied with lay coroners and demanded that the coroner be replaced by a physician In 1918 New York City introduced the office of the Chief Medical Examiner and appointed physicians experienced in the field of pathology In 1959 the medical subspecialty of forensic pathology was formally certified 6 The types of death reportable to the system are determined by federal state or local laws Commonly these include violent suspicious sudden and unexpected deaths death when no physician or practitioner was present or treating the decedent inmates in public institutions those in custody of law enforcement deaths during or immediately following therapeutic or diagnostic procedures or deaths due to neglect Contents 1 Duties 2 Qualifications 2 1 United Kingdom 2 2 United States 3 Education 4 Career 5 Shortage 6 See also 7 References 8 Further readingDuties editA medical examiner s duties vary by location but typically include investigating human organs like the stomach liver and brain determining cause of death examining the condition of the body 3 studying tissue organs cells and bodily fluids 3 issuing death certificates maintaining death records responding to deaths in mass disasters working closely with law enforcement 7 identifying unknown dead performing other functions depending on local law In some jurisdictions a coroner performs these and other duties It is common for a medical examiner to visit crime scenes or to testify in court 7 Medical examiners specialize in forensic knowledge and rely on this during their work 3 In addition to studying cadavers they are also trained in toxicology DNA technology and forensic serology blood analysis 7 Pulling from each area of knowledge a medical examiner is an expert in determining a cause of death 3 This information can help law enforcement solve cases and is crucial to their ability to track criminals in the event of a homicide or other related events 3 Within the United States there is a mixture of coroner and medical examiner systems and in some states dual systems The requirements to hold office vary widely between jurisdictions Qualifications editUnited Kingdom edit In England and Wales a new statutory Medical Examiner system based in NHS Acute Trusts commenced in 2019 and is expected to be fully operational several years later A medical examiner is always a medical doctor whereas a coroner is a judicial officer 8 Pilot studies in Sheffield and seven other areas which involved medical examiners looking at more than 27 000 deaths since 2008 found 25 of hospital death certificates were inaccurate and 20 of causes of death were wrong Suzy Lishman president of the Royal College of Pathologists said it was crucial there was independent scrutiny of causes of death 9 United States edit Qualifications for medical examiners in the US vary from jurisdiction to jurisdiction In Wisconsin for example some counties do not require individuals to have any special educational or medical training to hold this office 10 In most jurisdictions a medical examiner is required to have a medical degree although in many there is no requirement for specialized training in pathology Other jurisdictions have stricter requirements including additional education in pathology law and forensic pathology Medical examiners are typically appointed officers 1 Education editIn the United States medical examiners require extensive training in order to become experts in their field 7 After high school the additional schooling may take 11 18 years 7 They must attend a college or university to earn a bachelor s degree sufficient for admission to medical school 3 Biology is usually the most common 11 A medical degree MD or DO is often required to become a medical examiner 12 11 To enter medical school the MCAT Medical College Admissions Test is usually required 3 after which medical school is another four years with the first two dedicated to academics and the rest of the two used to gain clinical experience 11 To become experts in pathology specifically additional training is required after medical school The first step is to complete pathological forensic training 12 This usually consists of anatomic and clinical pathology training which takes anywhere from four to five years to complete 3 After this the physician may complete an anatomic pathology residency or a fellowship 11 Before practicing as a medical examiner the physician must also become board certified through the American Board of Pathology 12 13 Career editThe general job outlook for medical examiners in the United States is considered to be excellent 7 Remuneration varies by location but it is estimated to average between 105 000 and 500 000 7 Shortage editIn the United States there are fewer than 500 board certified forensic pathologists but the National Commission on Forensic Science estimates the country needs 1 100 1 200 to perform the needed number of autopsies The shortage is attributed to the nature of the work and the higher pay in other medical specialties It has caused long delays in some states and resulted in fewer investigations and less thorough investigations in some cases 14 See also editList of fictional medical examinersReferences edit a b Strengthening Forensic Science in the United States A Path Forward PDF Washington DC National Academies Press 2009 pp 241 253 Coroner vs medical examiner Visible Proofs Retrieved 12 October 2014 a b c d e f g h i Forensic Medical Examiner Jobs in Forensic Criminal Investigations www crimesceneinvestigatoredu org 8 October 2013 Retrieved 2018 03 30 Jason Payne James ed 2005 Death Investigation Systems United States of America Encyclopedia of Forensic and Legal Medicine Randy Hanzlick Debra Combs 1998 Medical Examiner and Coroner Systems JAMA 279 11 870 874 doi 10 1001 jama 279 11 870 PMID 9516003 Overview of the Medicolegal Death Investigation System in the United States Medicolegal Death Investigation System Workshop Summary Institute of Medicine 2003 a b c d e f g Forensic Pathologist explorehealthcareers org explorehealthcareers org Retrieved 2018 03 30 National Medical Examiners Report 2022 PDF Medical examiners help expose patient safety risks Health Service Journal 12 February 2015 Retrieved 10 March 2015 Coroners and Medical Examiners A Comparison of Options Offered by Both Systems in Wisconsin Jenifer Keach Rock WI County Coroner April 6 2010 a b c d How to Become a Medical Examiner in 5 Steps Retrieved 2018 03 30 a b c Medical Examiner Forensic Science Careers Forensic Science Careers Retrieved 2018 03 30 Becoming a Medical Examiner Salary Info amp Job Description learningpath org Retrieved 2018 03 30 Families suffer due to medical examiner shortage 7 Dec 2015 Further reading editJudy Melinek T J Mitchell 2015 Working Stiff Two Years 262 Bodies and the Making of a Medical Examiner New York Scribner ISBN 978 1 4767 2726 4 Valdes Robert What Is the Difference Between a Medical Examiner and a Coroner HowStuffWorks Retrieved 21 June 2018 Public Health Law Program Coroner Medical Examiner Laws by State Centers for Disease Control Retrieved 21 June 2018 See also the links at the bottom of the linked article Retrieved from https en wikipedia org w index php title Medical examiner amp oldid 1219973351, wikipedia, wiki, book, books, library,

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