Most doctors in training who think they might want to be forensic pathologists never follow through.
About one-third of all doctors who complete forensic training never become board certified in the specialty. Some practice anyway Ė at least part time; some donít.
The United States would need more than twice the number of currently practicing forensic pathologists to do the number of autopsies the National Association of Medical Examiners recommends, and we arenít even training enough to match the retirement rate.
Forensic pathologists discussing these grim statistics on the Internet believe bad experiences in the courtroom are partially to blame.
One mentioned a pathology resident he had mentored. For part of a summer, the young doctor, who thought he wanted to be a medical examiner, shadowed my colleague. He watched and assisted with autopsies, went to death scenes and read forensic literature.
He seemed to enjoy the experience until my colleague took him to court to observe his testimony in a murder trial.
My colleague found the direct and cross-examinations routine. The resident did not.
It would be awful to be publically questioned and humiliated like that, the resident said. He would never tolerate such an abusive, adversarial confrontation.
He dropped his pursuit of forensic pathology and became a general surgeon.
I donít doubt that resident made a good decision. Feeling as he did, he would never have made it as a medical examiner. Iím a little surprised that a doctor at that advanced stage of training would be freaked out by one apparently routine court experience, but I recognize that the judicial process can be intimidating.
My mentor, Dr. Charles Hirsch, chief medical examiner of New York City, tells his students the first time he testified, he was so terrified that when asked where he went to medical school, he couldnít remember.
I donít recall I ever was that frightened, but I do remember that my voice sounded squeaky the first few times I took the stand.
I also know forensic pathologistsí testimony is being challenged more and more. Earlier in my career, it was unusual for a defense expert to be hired to dispute the conclusions of the autopsy pathologist. No more. Battles of the experts have become commonplace. Lawyers and the public know how controversial determinations in custody deaths, child abuse and shaken baby cases have become. And even when the defense doesnít bring in another expert, cross-examinations can be brutal.
In some ways, thatís a good thing. For years, we were too complacent about some of these issues and too cocksure about how much we thought we knew and could prove.
Quite a few people who continue to testify with reasonable certainty about issues that are by no means certain are getting the hubris knocked right out of them in court.
On the other hand, we badly need more qualified people. If court testimony becomes so unpleasant that the experience scares people out of the field, thatís not good at all.
firstname.lastname@example.org Dr. Carol J. Huser, a forensic pathologist, has served as La Plata County coroner since January 2003.