The Role Of A Forensic Pathology Doctor
Forensic pathology is a well-known but small pathology specialty. In England and Wales, forensic pathologists assist coroners and police forces to investigate murders and suspicious deaths, while in Scotland these investigations are led by Procurators Fiscal.(1)
Performing autopsies on bodies of people who died in suspicious circumstances (eg, suspected murders, suicide, etc) is a central component of the duties of a forensic pathologist, and these are usually performed under the authority of a Coroner or Procurator Fiscal.(1) As the findings in these autopsies may provide key evidence in criminal cases, a forensic pathologist may be required to attend court.(1) The majority of the doctor’s work concerns suspicious or unexplained deaths; however, they might also be called to assess the injuries of live victims.(1)
A forensic pathologist’s job is normally carried out in mortuaries, hospitals, the courts and sometimes crime scenes and will therefore require regular travel. Most of the work is done independently with the help of Coroner’s officers, police officers, procurators fiscal and mortuary staff.(1) Multiple pathologists may work on the same case, and the workers in the criminal justice system such as barristers and lawyers will often be involved as well.(1)
The number of female trainees in pathology is currently higher compared to that of qualified female pathology consultants and continues to increase, suggesting that more women are joining the pathology workforce.(2)
The future of the specialty will be affected by changes in the coroner system and death certification, as well as demands of the public for less invasive autopsy techniques, which may have a significant impact on the current common practice in forensic pathology and autopsy pathology.(3)
A Typical Day & Workload
The workload in forensic pathology varies day to day. Generally, routine post-mortem examinations will be performed in the morning, usually involving people who have been brought in dead from the community or post-operative deaths.(4) The doctor will examine any histopathological specimens taken from the post-mortems. In the afternoon, the pathologist may be called to court to provide evidence for a criminal case, or to assist a criminal investigation directly at the crime scene.(4) Overall, the working hours are quite regular, usually starting at about 7.30am and finishing around 6-7pm.(5) Besides examinations, lab work, and field work a forensic pathology consultant might also devote some time to teaching at a university or teaching trainees in a hospital, undertake a management or leadership position, and will also need to complete administrative tasks.
Route To Becoming A Forensic Pathologist
To apply for specialty training in forensic pathology trainees are required to have completed a medical degree and the UK foundation training programme or an equivalent qualification and will need to be registered with the GMC.(6) The competition ratio for Histopathology ST1 is 2.09 applicants per post.(7) The training for forensic pathology is divided into 4 stages- stage A, B, C and D. The first two stages are more general and focus on training in histopathology, while stages C and D are specific to forensic pathology.(6, 8) Further specialisation in forensic pathology is possible only after completion of stage B of histopathology training.(6) Full time training takes approximately 5.5 years to complete; this varies between trainees depending on whether the trainee chooses to undertake two out of the three optional training packages, or all three.(6, 8)
Stages A and B will take between 2 to 2.5 years altogether and aim to provide a broad understanding of histopathology and training in laboratory skills such as cutting up specimens, perform screening, write appropriate reports and more.(8) Within the first two stages, the trainees are introduced to all the other histopathology subspecialties paediatric pathology and neuropathology, cytopathology and autopsy pathology.(8)
Stage C is a minimum of 30 months in length and includes 3 months of each, neuropathology and paediatric pathology.(8) This stage aims to develop a sound skill and confidence in complex forensic post-mortem examinations and show working knowledge of the Coroner’s Rules and the role of the Procurator Fiscal in criminal investigations.(8)
Stage D lasts a minimum of 6 months.(8) Trainees will complete stage D only after having completed a total of at least 66 months of training, with additional 3 months training in a specialty relevant to forensic histopathology, eg neuropathology, paediatric pathology and radiology (can be undertaken in either stage C or D).(8) Trainees are also required to complete an expert witness training course approved by Forensic Pathology SAC.(8) During this stage, the trainees develop experience in court and the ability to work independently.
To move forward in the specialty training, trainees need to pass 3 formal written exams. The trainees sit the Histopathology stage A exam at the end of stage A to determine their competency for further training.(8) The next exam is FRCPath Part 1 in Histopathology and is sat at the end of stage B to assess whether trainees are fit for further specialisation.(8) The final exam, FRCPath Part 2 can be taken after completing a minimum of 24 months in stage C.(8)
NHS consultant salaries are the same for all specialties but vary between Scotland (highest), England, Northern Ireland, and Wales (lowest) and increase with service (up to 19 years). In 2020 the salary bands range from £77,779 to £109,849. Salaries can be further enhanced with NHS excellence awards.
A consultant’s salary will also depend on their level of experience and the amount of additional responsibilities they undertake.
As a doctor in training, you will earn a basic salary between £28,243 to £32,691. If you are a doctor starting your specialist training in 2020, the basic salary will increase to £38,693 to £49,036.(9)
Specialty doctors earn a basic salary of £40,037 to £74,661.(9)
For more information on doctor's salaries within the NHS, please feel free to review The Complete Guide to NHS Pay.
Before applying for specialty training in forensic pathology prospective applicants should research the specialty independently. Professional bodies such as GMC and the Royal College of Pathologists are a useful online resource and there is a range of books and podcasts available, such as Handbook of Forensic Pathology by Vincent DiMaio, or the Dead Men Do Tell Tales podcast.
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Related Job Sources With BMJ Careers
The Royal College of Pathologists, Become a forensic pathologist, date accessed Jun 2020 https://www.rcpath.org/discover-pathology/careers-in-pathology/careers-in-medicine/become-a-forensic-pathologist.html
The Royal College of Pathologists, The pathology workforce-latest figures, published 29 Jun 2017, date accessed Jun 2020 https://www.rcpath.org/discover-pathology/news/workforce-report-2017.html
Vanezis P, Forensic medicine: past, present, future pdf, published Dec 2004, date accessed-Jun 2020 https://www.thelancet.com/pdfs/journals/lancet/PIIS0140673604176204.pdf
Health education England NHS, Day in the life of a forensic pathology trainee, pdf, publication date unavailable, date accessed Jun 2020, https://madeinheene.hee.nhs.uk/Portals/39/Forensic%20Pathology/Day%20in%20the%20Life.pdf
NHS Health Careers, Working life (histopathology), date accessed Jun 2020 https://www.healthcareers.nhs.uk/explore-roles/doctors/roles-doctors/pathology/histopathology-doctor/working-life
The Royal College of Pathology, Training in forensic pathology, date accessed Jun 2020 https://www.rcpath.org/discover-pathology/careers-in-pathology/train-to-work-in-pathology/training-in-forensic-pathology.html
Health Education England NHS, Specialty recruitment competition ratios 2019 pdf, publication date unavailable, date accessed Jun 2020, https://specialtytraining.hee.nhs.uk/Portals/1/Competition%20Ratios%202019_1.pdf
The Royal College of Pathology, Curriculum for specialty training in forensic histopathology pdf, published Oct 2012, date accessed Jun 2020, https://www.rcpath.org/uploads/assets/6ed6eee8-d85c-4c49-8ca9f2f9d4ec07df/Forensic-Histopathology-curriculum.pdf
Health careers NHS, Pay for doctors, date accessed Jun 2020, https://www.healthcareers.nhs.uk/explore-roles/doctors/pay-doctors