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1.0INTRODUCTION : WORLD RECOGNITION

Brodrick Report:

According to the evidence received the basis of forensic pathologyis the small

amount of work which, although it is carried out on behalf of the coroner, is

particularly the concern of the police. Every police force needs to be able to call

on the services of a specially experienced pathologist to help in the

investigation of murder and other serious crimes against the person. Ideally,

this person should be a pathologist with a sound training in morbid anatomy

who has added to this general knowledge some additional skills, most notably

the ability to detect, and give authoritative testimony about, unusual features

of a dead body and the surrounding circumstances which may well be of

evidential value. He should be able to command the facilities of a well

equipped pathological laboratory, be readily available on call to police and

courts, and be prepared to travel at short notice anywhere in the area which

he serves.

Do the police need the services of a special kind of pathologist who can for the

most part be distinguished from a clinical pathologist in a hospital? Do coroners

need the services of the same kind of pathologist as the police ? Our answer to

both questions is an unequivocal


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2.0DEFINITION : PATHOLOGIST

Pathology is the study and diagnosis of disease. The word pathology is from

Greek , pathos, "feeling, suffering"; and -, -logia, "the study of".

Pathologization, to pathologize, refers to the process of defining a condition or

behavior as pathological, e.g. pathological gambling. Pathologies is synonymous

with diseases. The suffix "path" is used to indicate a disease, e.g. psychopath.

Medical Pathology, Veterinary pathology and Phytopathology are the study of

anatomic, biochemical or microbiological diseases. The related scientific study of

disease processes is called general pathology. Psychopathology is the study of

psychological or mental diseases.

Medical pathology is divided into two main branches, Anatomical pathology

and Clinical pathology. Veterinary pathology is concerned with animal disease,

whereas phytopathology is the study of plant diseases.

Pathologists are biological or medical scientists who study the nature, causes,

and effects of disease in plant and animal life. Pathology is a broad field that

concentrates on the changes in organs, tissues, and cells that are caused by

disease.

Pathologists work in hospitals, medical laboratories, schools, colleges, and

universities. They may teach or do laboratory work or research. They are employed

by government agencies associated with agriculture, public health, law enforcement,

and many other fields. Private companies that make products such as drugs and

insecticides also employ pathologists.

(http://en.wikipedia.org/wiki/Pathology )


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Pathologists concentrate on plant, animal, or human pathology. Although the

areas of study of these pathologists are very different, they are all scientists who

study disease. Pathology has been called the bridge between basic science and

medicine. Pathologists who are concerned with human disease are usually

physicians who have received specialized training in pathology. They are sometimes

called medical pathologists or are classified according to their subspecialty, such as

oral pathology.

Although medical pathologists do not treat patients of their own, they do

laboratory tests to diagnose disease in the patients of other physicians. They

perform tests on body tissues, secretions, and other specimens to see whether a

disease is present and to determine its stage. They evaluate the e xtent of the

disease, estimate the course it is likely to take, and suggest ways to treat the

disease. Surgeons may consult pathologists if they find unexpected problems during

an operation. Pathologists often stand by during surgery to test specimens taken

from a tumor in a patient's body. The patient may remain under anesthesia until the

pathologist can evaluate the specimens. Based on the pathologist's expert advice,

the surgeon is able to complete the operation in the way best suited to the patient's

condition.

Pathologists also do postmortem examinations to determine the cause of

death when the cause is unclear. They can evaluate the extent to which treatmenthad helped a patient. Pathologists' reports help physicians in their care of other

patients with similar conditions. Sometimes pathologists serve as medical examiners

or coroner's consultants. They determine the cause of death in accidents,

poisonings, and suspected murders. Pathologists coordinate and supervise the work

of medical laboratory technologists or technicians who prepare specimens or may

perform the more routine laboratory tests themselves. Pathologists often specialize

in one field, such as hematology (the study of the blood), blood banking,

neuropathology (diseases of the nervous system ), forensic (or legal) pathology,

medical chemistry, medical microbiology, or radioisotopic pathology.


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Medical pathologists frequently teach students in schools and colleges that

train nurses, physicians, medical laboratory technologists, technicians, an d other

health care workers. They sometimes conduct seminars for physicians and interns in

hospitals. They help train law enforcement officers to use scientific methods of

observation when they investigate injuries or deaths. Pathologists also do scientifi c

research into drugs and disease. Laboratories developing new drugs need

pathologists to study their safety. Pathologists use microscopes, radioisotopes, and

other equipment to study the cause of disease. They also use scientific methods and

computerized data as they test theories about disease processes. Cancer,

atherosclerosis, allergies, and birth defects are among the many diseases being

studied by medical pathologists.

Animal pathologists may be veterinarians or zoologists (animal scientists).

Veterinarians specializing in pathology study diseases and disorders in animals.

They often specialize in poultry, livestock, or pets. They also help to improve the

quality of livestock and poultry used for human food. In addition, their work helps to

save human lives since animals can transmit diseases such as rabies and

tuberculosis to human beings. Similar to veterinarians and medical pathologists,

zoologists specializing in pathology may study the effects of disease, parasites, and

insects on the cells, tissues, and organs of animals. Unlike other pathologists,

zoologists are often trained to work with a wide variety of animal species. They may

study hereditary diseases or disorders in fruit flies in order to increase knowledge

about the ways diseases are passed on over a period of many generations. They

may study the development of tumors in mice to get clues about the causes and

development of cancer in human beings. Animal pathologists often use equipment

and methods that are similar to those used by medical pathologists. Zoologists and

veterinarians working in animal pathology are employed by colleges and universities,

centers for veterinary medicine, zoos, and wildlife refuges as well as government

agencies and private industry.

Plant pathologists are botanists (plant scientists) whose special field is

sometimes called phytopathology. Sometimes plant pathologists do basic research

into the nature of disease in living things. For example, they may study the effect of

air pollution on the respiration rate and o n the cells and tissues of plants. This study

may have applications for medical pathologists who are concerned with the role of


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industrial pollution in causing lung cancer or emphysema in human beings. On the

other hand, many plant pathologists do research that directly relates to plant

diseases. They devise ways to control or prevent plant diseases. They help to

develop new types of plants that are disease resistant. Their work is useful in

improving our food, fiber, and lumber supplies and in preserving t he ornamental

plants and trees that make our environment more healthful and attractive. Plant

pathologists use many of the same kinds of laboratory equipment and scientific

methods that medical and animal pathologists use. Plant pathologists teach and do

research in colleges and universities. They work for government agencies and

private firms involved in agriculture, horticulture, forestry, and related fields.

(http://careers.stateuniversity.com/pages/412/Pathologist.html)


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2.1DEFINITION : ANATOMICAL PATHOLOGIST

Anatomic pathology, also known as anatomical pathology, is a branch of the

medical field which involves the examination of anatomical specimens to learn more

about the processes of disease and death. Specialists in this field do everything from

examining biopsy samples taken by surgeons to determine whether or not a growthis cancerous to examining the bodies of murder victims to determine the cause of

death and collect evidence which could be used in investigation and prosecution.

The term pathology translates into the study of suffering, and this medical

discipline is focused on examining the nature, course, and resolution of disease. In

order to become an anatomic pathologist, someone must attend medical school and

complete a residency in general pathology, followed by a focus in anatomic

pathology. The other main area of focus in the field of pathology is clinical pathology,in which samples of body fluids are examined in the laboratory.

There are a number of subspecialties within the anatomic pathology field. For

example, someone could focus on neuropathology, the examination of brain tissue,

or cytopathology, the study of samples of cells. When a doctor takes a Pap smear

from a woman, the examination of the tissue is often performed by a cytopathologist.

Other specialties include molecular pathology, gynecological pathology, endocrine

pathology, dermatopathology, cardiac pathology, osteopathology, and autopsy or

forensic pathology.

The goal of a pathologist is to be able to examine an anatomical sample and

to determine whether the sample is normal or abnormal, and if it is abnormal, to

describe the abnormality. Anatomic pathology can be used in the diagnosis and

treatment of disease, to do everything from confirming that a surgeon removed all of

a tumor to diagnosing a particular form of kidney disease from a biopsy sample.

One of the more unique specialties within the field of anatomic pathology is

autopsy pathology, which involves the study of deceased individuals to learn how

they died. Autopsies are routinely requested in cases where a death is suspicious, or

when the cause of death is unclear. In forensic pathology, the pathologist studies the

body to learn not only how the person died, but when. This branch of pathology also

focuses on the collection of legal evidence.


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Work in the field of anatomic pathology can be varied and quite rewarding.

Candidates interested in working in this area of medicine need to have excellent

attention to detail, along with great descriptive skills which will allow them to

communicate clearly in pathology results. It can also help to have a high tolerance

for unpleasant sights and strong odors, as these frequently crop up in pathology

laboratories.

(http://www.wisegeek.com/what-is-anatomic-pathology.htm)


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2.2DEFINITION : FORENSIC PATHOLOGIST

Forensic pathology is a branch of the field of pathology which applies the

principles of pathology to the legal profession. Forensic pathologists specialize in

examining bodies and evidence such as body fluids and tissue samples for the

purpose of gathering information which can be used in criminal investigation and

court trials. They are sometimes known as medical examiners, coroners, or simply

pathologists, depending on the region where they work.

Some people think that the term forensics refers to forensic pathology, which

generates considerable confusion when forensic accountants, forensic document

examiners, forensic psychiatrists, and other forensics professionals are discussed.

Forensic actually comes from the Latin forum, and it means pertaining to a trial.

The field of forensics was developed in the 1800s, when people began applying

scientific methods to criminal investigation and legal trials.

The field of pathology in general is focused on the study of disease and its

processes. A specialist in forensic pathology has training in this field, with additional

skills which can be applied to the legal field. For examp le, he or she can examine a

body to determine the cause of death, but the pathologist can also look for other

clues and information, such as defensive marks on the hands which might indicate

that the victim fought back while being attacked.

Forensic pathology can involve the study of bodies, a process known as

autopsy, or analysis of samples taken at crime scenes or from the body. In cases

where a complete body is not available for examination, the forensic pathologist can

gather information from the available materials which can be used in investigation

and eventual prosecution. They can also examine samples of tissue and body fluids

to look for toxins and signs which can provide additional clues into the nature of the

death, such as evidence that someone was suffocated and then submerged to make

the death look like a drowning.


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In addition to being knowledgeable about huma n anatomy and pathology, a

forensic pathologist needs some additional skills. He or she must be able to collect

evidence properly and to maintain the chain of custody, ensuring that the evidence is

not compromised. It may also be necessary for forensic pathologists to testify on the

witness stand in some cases, and in some instances, a specialist in forensic

pathology may be retained by the defense for the purpose of refuting claims made by

the specialist who works for the government or the prosecution.

(http://www.wisegeek.com/what-is-forensic-pathology.htm)


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2.3SUMMARIZING

The doctor that practices both

iscalled

GENERAL PATHOLOGIST

Sub-specialities

*stated only a fewof thesubspecialitiesof anatomical pathology

Pathologyasspecialist

Clinical

Pathologist

Anatomical

Pathologist

Dermatopathology

Molecular Pathologist

Neuropathologist

FORENSIC

PATHOLOGIST


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3.0CLASSIFICATION : FORENSIC PATHOLOGY VS CLINICAL PATHOLOGY

Clinical pathology is a medical specialty that is concerned with the

diagnosis of disease based on the laboratory analysis of bodily fluids such as

blood and urine, and tissues using the tools of chemistry, microbiology,

hematology and molecular pathology. Clinical pathologists work in close

collaboration with medical technologists hospital administrations and referring

physicians to ensure the accuracy and optimal utilization of laboratory testing.

We accept the view that while every forensic pathologist needs to be a

competent morbid anatomist, the reverse statement does not follow: Many morbid

anatomists will never have the inclination to undertake forensic work, i.e. work for the

police or the criminal courts. The nature of the problems most often encountered incriminal investigation is different from that most often encountered in clinical work.

So are the circumstances in which the two kinds of pathologists are called upon to

work. The Forensic Pathologist may be required in field work literally! There is also

a difference between writing an opinion for a colleague, and giving evidence

based on that opinion orbeing cross-examined on that opinion in the criminal

court. There are pathologists who feel attracted to this par ticular kind of challenge

and also have the ability to cope with it, and there are pathologists who do not feel

this urge and who may not have the right attributes. We conclude that the differencebetween a clinical pathologist and a forensic pathologist i s as much in the nature of

the man as the nature of the work.

Whilst it is certainly true that the difference between a clinical pathologist and

a forensic pathologist is in the nature of the person performing the task as well as the

nature of the work, it is not true to say that forensic pathology can be carried

out only by medical practitioners with a certain type of personality . Instead, this

personal aspect of the difference between clinical and forensic pathologists is

accounted for by training and experience . The forensic pathologist has to be

trained in, and develop an understanding and aptitude for, the legal process of

investigation in conjunction with their knowledge of the scientific process of

investigation. These two approaches to investigating matters are quite distinct and

few medical practitioners have any real understanding of or feel for the legal


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investigative method . It is a knowledge of the role that legal systems play in

society, as well as an understanding of the legal process and legal method, that

distinguish forensic pathologists from their clinical counterparts. Certainly there are

areas of specialist factual knowledge that forensic pathologists are familiar with

that their clinical counterparts are not.

However, simply acquiring factual knowledge on forensic issues will not

provide a clinical pathologist with sufficient skills to undertake forensic work .

A practical result of this difference is that forensic pathology does not sit

comfortably within a professional clinical pathology environment. Indeed, the

service requirements of forensic pathology mean that the service is usually more

efficiently provided by specialist forensic pathologists working together and

providing a broad based regional forensic pathology service for a ran ge of

clients.


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3.1 CLASSIFICATION : FORENSIC PATHOLOGY VS CORONER

In order to examine the role of the forensic pathologist, it is essential to

understand the development of death investigation systems including the role the

coroner plays in such jurisdictions. The office of coroner has its roots in Normantimes where death investigation had associated with it important political and

financial considerations . Coroners were associated with the collection of a number

of fines and taxes that could be levied by the Crown in association with certain types

of deaths. Deodands comprised taxes paid to the Crown that were based on the

financial value of the implement or object that had caused a person's unnatural

death, so that if a person was run over by a cart, the cart or its value was forfeited to

the Crown as a tax and the coroner was responsible for ensuring that the tax was

paid. Similarly the fine of presentment of Englishry was payable by a local

community if the coroner found that a deceased person was not of English blood.

The role of the coroner in criminal matters relat ing to death was limited,

although the coroner had the ability to ensure that potential criminal matters

were brought within the criminal justice system . Their main function in relation to

crime was to keep a check on the sheriff and to ensure that revenue s such as

fines reached the King . With regard to the prevention of deaths, the coroner had

little or no direct function, although some early coroners made attempts to

highlight hazards in the community and to reduce their impact.

Over time, the coroner's role diminished and the office became an onerous

one with the coroner having to pay many of the fees associated with the work out of

his own pocket. Early coroners were not necessarily medically or legally trained, and

many of the early coroners appointments were essentially political rather than

professional.

Today the approach of coroners in Australia differs from that of coroners

in England and Wales . Much of the function of the office of coroners in Australia is

focused on prevention , with the coroner empowered to make broad

recommendations surrounding the issues of public health and safety and judicial

administration. Such an approach gives the coroner a dynamic function in


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contributing to the welfare of the community. In this modern framework the rol e of the

full-time forensic pathologist has been revitalized. The forensic pathologist is not

involved only with the investigation of suspicious deaths that may have a criminal

connotation. Instead, the forensic pathologists role has been widened to includ e a

wide range of natural and unintentional deaths, investigation of which, can lead to

improvements in the health and safety of the community. In conjunction with the

coroner, the forensic pathologist is a watchdog who maintains a constant

surveillance on potential fatal hazards in our society and ensures that preventable

deaths are recognized and the issues surrounding them addressed.


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4.0PATHWAY TO BECOME FORENSIC PATHOLOGIST

You need advanced training to become a pathologist. As an undergraduate,

you should major in premedical studies, a biological science, chemistry, or a related

field. It generally takes fouryears to earn a bachelor's degree and another one or

two years to obtain a master's degree.

Medical pathologists usually go to medical school for four years after they

graduate from college. They receive the degree of doctor of medicine (M.D.). In

some cases they spend six years in medical school and earn a doctoral deg ree

in pathology in addition to their medical degree.

After medical school, pathologists spend about four more years in ahospital as a resident in pathology . If they choose, they may also take additional

training in one of the subspecialties in medical p athology.

Medical pathologists need to be licensed by their state to practice

medicine and must also be certified by the American Board ofPathology .

Medical pathologists are likely to spend a total of at least twelve years in

training before they are fully qualified in their profession. Pathologists must spend

time reading and studying throughout their careers in order to keep up with newdevelopments in their field.

(http://careers.stateuniversity.com/pages/412/Pathologist.html )


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5.0ROLES AS FORENSIC PATHOLOGIST

5.1 MEDICAL PRACTITIONER

Most forensic pathologists do not take part in clinical medical practice

involving the diagnosis of illness and disease or the provision of surgical and

medical treatment. They are none the less medical practitioners, committed to

the maintenance of good health within the community . The forensic pathologist

retains the basic medical skills in clinical diagnosis and therapeutics. In providing an

autopsy service for the coroner and other individuals involved in the heal th and

justice systems, the forensic pathologist is involved in analysis of clinical,

diagnostic and therapeutic issues as well as broad public health issues

including occupational health and safety. The media, the lay community and indeeda number of medical and legal professionals tend to view the forensic pathologist as

being concerned only with criminal justice aspects of death investigation. In reality,

deaths involving a suspicion of criminal activity represent a small percentage

of the work of the forensic pathologist . Whilst the forensic pathologist remains a

watchdog on the lookout for criminality during death investigations , most of

their work involves deaths associated with natural disease and unintentional

traumatic injury. These deaths have important considerations for public health

policy and health service planning as well as for community health and safety.


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5.2 PUBLIC HEALTH

The forensic pathologist in the course of everyday work identifies natural

disease processes within all age groups and all sections of the community. In order

to completely identify all aspects of natural disease in an autopsy , the investigation

has to be thorough and complete . In many cases, the identification of a cause of

death at autopsy is straightforward. However, in order to identify and recognize all

the natural disease processes that are present and to assess their relevance both for

the death and the ante-mortem symptoms, a thorough autopsy examination is

required. In those legal systems where the forensic autopsy simply provides a

cause of death, the quality of information obtained from autopsies may be limited.

However, the coronial system in the more modern jurisdictions has a responsibility to

find not only the cause of death, but also the circumstances of the death, andany factors that contributed to it , including those associated with the operation of

the health and legal systems. The autopsies performed within these jurisdictions

provide much more information. In reality, no cause of death can be satisfactorily

ascertained at autopsy without ensuring that the autopsy investigation has

been thorough enough to exclude potentially significant but rare natural

diseases. In autopsies where the death is the result of an unnatura l process, in

particular deaths from intentional injuries such as homicides, it is essential to

accurately assess, document - and in some circumstances to exclude - the influenceof natural disease processes. In criminal cases, the forensic pathologist is often

asked to assess the degree to which a pre-existing disease might have contributed

to the traumatic death.


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5.3 SPEACIALIST PATHOLOGIST

Most forensic pathologists are qualified clinical pathologists , and indeed their

work calls upon the basic scientific knowledge of pathology as well as the skills and

knowledge associated with each of the major branches of clinical pathology. As we

have seen, forensic case work can involve recognition and understanding of

the principles of haematology, microbiolo gy, chemical pathology,

immunology, and anatomical pathology or histopathology . In this regard,

forensic pathology can be seen as an applied area of clinical pathology which has

its focus on the delivery of primary information to the legal system regarding the

medical issues surrounding the causation and the circumstances of a death.

5.4 DEATH SCENE EXAMINER

The forensic pathologists work extends beyond the routine performance of

autopsies and the presentation of the results to the coroner and the courts. The case

investigation for a forensic pathologist is initiated by a death; the investigation

process includes analysis of information relating to the deceased person prior to their

death, together with examination and analysis of the scene and environment in

which they died or were found dead .

In allegedly suspicious deaths, the death scene is examined by a team of

individuals that comprises police officers, forensic scientists, forensic

pathologists and other specialist examiners such as forensic anthropologists

(for investigation of skeletal remains). A variety of other individuals are also involved

in the examination of a scene of a suspicious death including photographers and

video cameramen.

In most cases after a dead body is found in suspicious circumstances, the forensic

pathologist is called to the scene not only to examine the body and provide i nitial

information to the investigators, but also to study the environment in which the

body lies. The investigation of the environment of the death helps the pathologist

in coming to conclusions regarding the subsequent macroscopic and


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microscopic autopsy findings. In many cases, by virtue of training and long

experience in attending at death scenes associated with crimes, the forensic

pathologist can contribute directly to the crime scene examination and provide

initial advice in areas of forensic science, including forensic biology and

ballistics. The inclusion of specialist forensic scientists from a wide variety of

disciplines within the death scene investigation team is important, and the forensic

pathologist may well have a part to play in help ing to determine the

appropriate specialists that may be required.

5.5 DEAD BODY EXAMINER

The media and most of the lay public recognize the forensic pathologist as a dead

body examiner. As we have just seen, the pathologist performs a preliminary

examination of a body at the death scene (or the place in which the body is found).

The formal examination of a dead body occurs of course during the process of the

autopsy. But the autopsy is more than an external examination of the body

followed by dissection and an internal examination . The process of an autopsy

covers a wide range of activities, and can include radiology and fluoroscopy

as well as endoscopic techniques for examining the interior of the body without

formal dissection.

The scope of examination of a body at the scene of death depends on the

circumstances, but in most cases, some initial information can be gathered from the

position of the body, the presence or absence of any rigor mortis or post-mortem

hypostatic lividity (discoloration of the skin), and the temperature of the body. A body

that is fully clothed or otherwise wrapped and partly concealed, may be difficult to

examine adequately at the scene, and no definitive conclusions regarding the nature

of the death should be made until the body has been examined fully at autopsy and

the necessary follow up tests have been completed.


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5.6 FORENSIC SOCIOLOGIST

It may seem strange to consider forensic sociology in the list of roles carried out

by forensic pathologists. In practice however, forensic pathology has to do with

issues of human behaviour in settings which involve violen ce and death . There

is no doubt that forensic pathologists acquire considerable expertise in certain

areas of criminology and in respect of certain community social settings .

Knowledge of police culture, prison culture, drug culture and other particular

subcultures is a feature of the professional experience of forensic pathologists. The

very nature of their work with regard to the investigation of suspicious and non -

suspicious deaths involves them with many of these subcultures. A variety of

sociological issues cause enormous community concern. Many of these areassociated with the work of forensic pathologists: deaths in custody, violence

associated with control agency response, deaths associated with failures of health

professionals including health and social services, suicide and the influence of

mental health on crime and social

5.7 MEDICAL DETECTIVE

Forensic pathologists, more than all other specialists in medical practice, are

medical detectives . Acting as a co-investigator for a coroner or the pol ice,

forensic pathologists play a far wider role than just providing an autopsy report. They

are often involved in all phases of a death investigation and form part of the

detective team which analyses the circumstances of a death . This role of

medical detective is often glorified in the media, and in such productions the

forensic pathologist is often elevated to the key player in the investigation .

This is certainly not the case in practice. Despite the media portrayal of the fore nsic

pathologist as a high-profile medical sleuth, the reality is that the forensic pathologist

participates on an equal basis with all other specialist investigators in the team

investigating the death.


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6.0SKILLS NEEDED TO BE FORENSIC PATHOLOGIST

6.1 CLINICAL SKILLS

Forensic pathologists are first and foremost medical practitioners . They have

undergone a full undergraduate training course , offive to seven years which has

included both pre-clinical and clinical studies . All forensic pathologists have spent

at least one yearand, in some cases, several years working in clinical medicine

within a hospital setting. Some will have spent a considerable time working in

other clinical specialty areas within a hospital or, in some cases, in general practice

and their knowledge in these clinical areas may be considerable. However it should

not be assumed that because of such experience they are currently experts in

clinical medicine or that they have kept their clinical medical s kills up to date .

The rapidity of developments in clinical forensic medicine and therapeutics makes it

is difficult for practitioners who are not actively engaged in clinical medicine to

maintain clinical medical skills. With the rapid increase in clinical sub-specialties,

any forensic pathologists knowledge of clinical medical practice will be

necessarily limited in most cases to general principles only .


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6.2 FORENSIC PATHOLOGY SKILLS

Some of the basic knowledge in certain important field, whi ch should a forensic

pathologist well-aware are:

1. Neuropathology

2. Cytopathology

3. Haematology

4. Microbiology

5. Immunology

6. Toxicology

6.3 LEGAL SKILLS

The areas of knowledge that distinguishes forensic pathologists from their clinical

colleagues, is their understanding of legal process, medical law, court

procedures and their rules of evidence . Whilst doctors who engage in civil injuries

work are also familiar with court processes, the remainder of the medical profession

has little contact with the legal system and consequently has little knowledge of the

legal principles involved in civil and criminal cases. Many forensic pathologists have

gained their knowledge of the legal system through long experience of

working with it. Most forensic pathologists agree that a sound knowledge of the

legal principles that underlie their forensic work is of value in improving the

quality of service they provide for the legal system . In general, the legal

profession also is more comfortable dealing with those medical practi tioners who are

familiar with, and regularly participate in, the legal process.


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6.4 SCIENTIFIC SKILLS

When assessing the skills of the forensic pathologist, it is important to remember

that, as doctors with a general background and training in medici ne, their early

training both at secondary and tertiary level has been based on the sciences .

All medical students study science either before or at the time of entering a medical

course and in many medical schools the first year of undergraduate medical t eaching

often includes further study of physics, chemistry, mathematics and biological

science although these are naturally oriented towards the needs of medical

practitioners. The remainder of undergraduate pre -clinical and clinical training relies

upon the knowledge of scientific principles, and such basic scientific

knowledge is further developed and reinforced during a medical course.

For the pathologist and forensic pathologist, many of these areas of general

scientific knowledge take on special meaning and relevance to professional forensic

pathology practice. General principles of physics apply to ballistics, and

chemistry and biology have particular relevance to toxicology and chemical

pathology. Principles of mathematics including the use of statistics apply

across the board. Forensic medical practitioners should remember that they have

specialist knowledge in many sciences but that the extent of their knowledge variesbetween different scientific areas. In the same way, it is important for lawyers to

recognize that medical practitioners have a basic general scientific background

which will, on occasions, enable them to give opinion evidence as experts in certain

scientific areas.


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6.5 COMMUNICATION SKILLS

As discussed earlier, skill in medico-legal communications is a particular

attribute of forensic pathologists. Such skill does not arise solely from experience

in forensic pathology or formal training in witness techniques . The reason that

doctors often make good witnesses is that communication with patients in a

medical consultation lies at the heart of the practice of medicine . Through their

undergraduate training and addi tional years of postgraduate training, doctors

develop and rely upon communication skills . The term bedside manner is used

by lay people to describe a doctors performance as a communicator. Regardless

of the nature or type of medical consultation, a variety of communication skills are

employed. Doctors are familiar with techniques to overcome barriers tocommunication. They are aware of the deliberate use of silence,

confrontational, and summarizing techniques . When one examines these skills, it

becomes clear that many of the communication skills involved in medical

consultations are similar to the skills of barristers examining or cross -examining

witnesses in court. In practical terms, individuals in a jury are very similar to the

patient in a medical consultation. Their range of medical knowledge, intellectual

ability, scientific background, attention and commitment, mirrors closely the range

found by doctors when dealing with patients. As a result, the skills that a doctor usesto communicate with a patient can be used to great effect in communicating with a

jury.


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7.0SUB-SPECIALITIES OF ANATOMICAL PATHOLOGY

7.1SURGICAL PATHOLOGY

Surgical pathology is the most significant and time-consuming area of practice for

most anatomical pathologists. Surgical pathology involves the gross and microscopic

examination of surgical specimens, as well as biopsies submitted by non-surgeons

such as general internists, medical subspecialists, dermatologists, and interventional

radiologists. Surgical pathology increasingly requires technologies and skills

traditionally associated with clinical pathology such as molecular diagnostics.

7.2RENAL PATHOLOGY

Renal pathology is a sub-discipline of anatomical pathology concerned with the

diagnosis of medical (non-tumor) kidney diseases, including both native kidneys and

transplants. Renal pathologists routinely employ techniques of immunofluorescence

and electron microscopy, in addition to light microscopy, for kidney biopsy and

nephrectomy specimens. The renal pathologist integrates the microscopic findings

from these three techniques along with the clinical presentation of the patient and the

patient's clinical laboratory results to arrive at a diagnosis.

7.3CYTOPATHOLOGY

Cytopathology is a sub-discipline of anatomical pathology concerned with the

microscopic examination of whole, individual cells obtained from smears or fine

needle aspirates. Cytopathologists are trained to perform fine -needle aspirates of

superficially located organs, masses, or cysts, and are often able to render an

immediate diagnosis in the presence of the patient and consulting physician. In the

case of screening tests such as the Papanicolaou smear, non-physician

cytotechnologists are often employed to perform initial reviews, with only positive or

uncertain cases examined by the pathologist. Cytopathology is a board-certifiablesubspecialty in the U.S.


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7.4MOLECULAR PATHOLOGY

Molecular pathology is an emerging discipline within pathology, and focuses in the

study and diagnosis of disease through the examination of molecules within organs,

tissues or bodily fluids. Molecular pathology shares some aspects of practice with

both anatomic pathology and clinical pathology, molecular biology, biochemistry,proteomics and genetics, and is sometimes considered a "crossover" discipline. It is

multi-disciplinary in nature and focuses mainly on the sub-microscopic aspects of

disease and unknown illnesses with strange causes.

It is a scientific discipline that encompasses the development of molecular and

genetic approaches to the diagnosis and classification of human tumors, the design

and validation of predictive biomarkers for treatment response and disease

progression, the susceptibility of individuals of different genetic constitution todevelop cancer, and the environmental and lifestyle factors implicated in

carcinogenesis.

7.5AUTOPSY PATHOLOGY

General anatomical pathologists are trained in performing autopsies, which are used

to determine the disease factors contributing to a person's death. Autopsies areimportant in the ongoing medical education of clinicians, and in efforts to improve

and verify the quality of medical care. Dieners are non-physicians who assist

pathologists in the gross dissection portion of the autopsy. The recently established

field of Pathologists Assistant has taken over the role of Diener and contributes a

great deal to the pre-diagnosis of disease within the pathology laboratory. Autop sies

represent less than 10% of the workload of typical pathologists in the United States. ]

However, the autopsy is central to public perceptions of the field, in part due to

portrayals of pathologists on television programs such as Quincy, M.E. and SilentWitness.


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7.6DERMATOPATHOLOGY

Dermatopathology is a subspecialty of anatomic pathology that focuses on the skin

as an organ. It is unique in that there are two routes which a physician can use to

obtain this specialization. All general pathologists and general dermatologists are

trained in the pathology of the skin; however, the dermatopathologist is a specialist inthis organ. In the USA, either a general pathologist or a dermatologist can undergo a

1 to 2 year fellowship in the field of dermatopathology. The completion of this

fellowship allows one to take a subspecialty board examination, and becomes a

board certified dermatpathologist.

(http://en.wikipedia.org/wiki/Anatomical_pathology )

(http://en.wikipedia.org/wiki/Pathology)


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8.0FAQS : PATHOLOGY & FORENSIC PATHOLOGY

1 Q. What is forensic pathology? A. Forensic pathology is the subspecialty of pathology that focuses on themedicolegal investigation of sudden or unexpected death.

2 Q. How many years of schooling and training does it take to become aforensic pathologist?

A. After high school you'll have to undertake:

y 4 years of college, to get a bachelors degreey 4 years of medical school, to get the doctor of medicine (MD) degreey 4 or 5 years of residency (4 for anatomic pathology only, or 5 for

combined anatomic/clinical pathology, the latter track beingrecommended) to become eligible to take the Board exams inpathology

y 1 or 2 years of forensic pathology fellowship, to be eligible to take the

subspecialty Board exam in forensic pathology

3 Q. Wow! Thirteen to fifteen years after high school before you can get ajob? To hell with that!

A. It's not as bad as it sounds. Of course you have to pay tuition and livingexpenses for the eight years of college and med school, but residents andfellows earn a decent living wage (about $26,000/yr to start). From what I'veseen, the people who get in trouble financially are those that insist on startingfamilies while still in school and borrow a lot of money to finance a middle -class, American-dream lifestyle. When they finally finish training, they arebeset with the payback of onerous loans. On the other hand, if you're single,

live in not-the-best neighborhoods, and split expenses with housemates, medschool is very affordable, even fun.

4 Q. What do forensic pathologists do at work?A. Forensic pathologists split their time among

1) performing autopsies,

2) acquiring data from investigating officers, and

3) testifying in court.

Occasionally they may visit scenes of crimes or accidents, but I think this is

uncommon for most.

5 Q. What personality characteristics are required in a good forensicpathologist?

A. Varying combinations of the following ingredients:

y A talent for and interest in science. This should include not onlybiology, but physics, chemistry, and the social sciences (anthropologyand psychology). For the bread-and-butter technical part of your work,


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you should especially have a good grasp of spatial relationships.y Good communication skills.You will not only be interacting with law

officers, but you'll be trying to convince judges and juries that yourfindings are valid.

y Strong stomach.You'll be routinely dealing with dismembered and/orrotting bodies. From a pure visceral standpoint there is no job moredisgusting than forensic pathology.

y Thick skin.You willbe periodically raked over the coals by the localmedia, who apparently cannot to resist the urge to armchair-quarterback your work. You will also make many enemies among thecitizenry. For instance, when you determine that Daddy killed himself,and he wasn'tpoisoned by that blond bimbo who was only interested inhis money, you are going to have some very angry children buzzingaround you.

y The mind of a detective. You will have to constantly be on guardagainst being fooled by malefactors smarter and more focused thanyou. You will have to have some insight into the heart and min d of acriminal.

6 Q. Where should I go to high school/college? Where should I do mypathology residency/forensic pathology fellowship?

A.You can go to high school anywhere. At any school, rich or poor, public orprivate, most of the teachers are mediocre, a few are totally incompetent, anda few are wonderful. The bottom line is that you, the student, are ultimatelyresponsible for your education. Even if you are so unfortunate as to be thevictim of uniformly abysmal teaching, the information is out there, and it is upto you to get it. Also, if you develop good time management skills in highschool, college will not only be easier, but fun, too. The potential for anenjoyable social life in college is great, but you have to come armed with asense of priorities to succeed both socially and academically on campus.

The choice ofcollege is a little more important. I am going to tell you right offthat I have a strong bias against two-year colleges (from which you couldtheoretically transfer to complete your premedical education at a four -yearcollege). These are cold, dismal places populated by desperate studentswhose joie de vivre was left behind years ago. At eighteen, you don't needthis.

I have a smaller bias against large, state -sponsored, four-year universities.For one thing, you are lost in the crowd. More importantly, your huge survey -level classes are often taught by unmotivated graduate students who may or

may not be able to speak understandable English. Do you really want this?(Of course, many grads of large universities are quick to defend their almaematres, such as one individual whose e-mailed argument was so eloquentthat I just had to post it here.)

This leaves four-year liberal arts colleges, which I highly recommend. Believeme, twenty years later, you'll be happy you made this choice. I think thecollege education is the single most i mportant (but least appreciated) part ofone's education. Its value is subtle, though, and it may take decades for its


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promise to flower.

Medical school is an easy choice: go to the cheapest one you can get into.The quality of education is the same in every U.S. school. You have the sametextbooks, the same human bodies with the same diseases, and the samequality of faculty. Unfortunately, faculty members in med schools are not hiredor promoted based on their teaching skills, but on their practice skill s and

research accomplishments. Don't get me wrong; there are plenty of excellentmedical educators, but you never know where they'll turn up.

The choice ofresidency is more important. I strongly suggest a programassociated with a university, not a private hospital (although you can rotate atprivate hospitals under the aegis of university -based teaching programs). Somuch of the value of a residency program depends on the rapport betweenresidents and faculty. This is a hard parameter to measure from a distance,so you should consider doing a med school pathology elective in one or moreof the departments you are looking at for residency training. It is usually easyto arrange this, even between schools in different states.

Regarding yourforensic pathology fellowship, you will have to go to a bigcity to get sufficient experience. You will want to look for a program in whichthe fellow (you) does about 250 autopsies a year. Too many less than that,and you won't get enough experience. Too many more, and you'll be so busyyou won't have time to read, study, and do thorough workups on your cases.Of course, you will also want to look for a place that has senior faculty youcan respect and have rapport with.

7 Q. What are the advantages of being a forensic pathologist?A. The hours are better than for most other physicians, but this is not a nine -to-five office job by any means. Don't even think about going to med school ifyou are a clock-watcher.

You have the satisfaction of not only helping to put criminals away, but ofcomforting grieving families, thus, "It was over very quickly. She did notsuffer."

The job is very challenging, and boredom will not be a problem.

(http://web2.airmail.net/uthman/forensic_career.html)


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9.0BIBILIOGRAPHY

1. David Ranson, The Role ofForensic Pathology

2. http://en.wikipedia.org/wiki/Pathology

3. http://careers.stateuniversity.com/pages/412/Pathologist.html

4. http://www.wisegeek.com/what-is-anatomic-pathology.htm

5. http://en.wikipedia.org/wiki/Anatomical_pathology

6. http://web2.airmail.net/uthman/forensic_career.html

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