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Forensic pathology is pathology that focuses on determining the cause of death by examining a corpse. A post mortem examination is performed by a medical examiner or forensic pathologist, usually during the investigation of criminal law cases and civil law cases in some jurisdictions. and medical examiners are also frequently asked to confirm the identity of remains.
The forensic pathologist performs autopsies/postmortem examinations with the goal of determining the cause of death as well as the possible manner of death. The autopsy report contains conclusions made relating to the following:
The autopsy also provides an opportunity for other issues raised by the death to be addressed, such as the collection of trace evidence or determining the identity of the deceased. Autopsies are performed when a death occurs, when an unexpected death occurs, when someone dies while not under the care of a physician, to solve criminal cases, when a mass disaster occurs and requires the identification of the victims and upon request by the family or loved ones of the deceased. Typically, autopsies can cost anywhere from $3,000 to $5,000, however the price can vary from country to country.
The forensic pathologist examines and documents and injuries, along with the possible causation of those injuries, at autopsy, at the scene of a crime and occasionally in a clinical setting, such as rape investigation or deaths in custody.
Forensic pathologists collect and examine tissue specimens under the microscope (histology) to identify the presence or absence of natural disease and other microscopic findings such as asbestos bodies in the lungs or gunpowder particles around a gunshot wound.
They collect and interpret toxicological specimens of body tissues and fluids to determine the chemical cause of accidental overdoses or deliberate poisonings.
Forensic pathologists work closely with the medico-legal authority for the area concerned with the investigation of sudden and unexpected deaths: the coroner (England and Wales), procurator fiscal (Scotland), or coroner or medical examiner (United States).
In mass disaster settings, forensic pathologists will work alongside Forensic Odontologists, Forensics Anthropologists as well as other forensic specialties with the goal of identifying the victims of the disaster. The process of identification involves the recovery of the victims, the collection of antemortem data, the initial examination along with the collection of any postmortem evidence, and finally the comparison of the antemortem and postmortem data gathered in order to identify those victims.
They serve as Expert witness in courts of law testifying in civil or criminal law cases.
In an autopsy, the forensic pathologist is often assisted by an autopsy/mortuary technician (sometimes called a diener in the US).
Forensic physicians sometimes referred to as "forensic medical examiners" or "police surgeons" (in the UK until recently), are medical doctors trained in the examination of, and provision of medical treatment to, living victims of assault, including sexual assault, and individuals who find themselves in police custody. Many forensic physicians in the UK practice clinical forensic medicine part-time, and they also practice family medicine or another medical specialty.
In the United Kingdom, membership of the Royal College of Pathologists is not a prerequisite of appointment as a coroner's medical expert. Doctors in the UK who are not forensic pathologists or pathologists are allowed to perform medicolegal autopsies, as the wording of the Coroners and Justice Act 2009, which merely stipulates a "registered medical practitioner": anyone on the General Medical Council register.
Forensic pathologists make great contributions to public health and preventative medicine by studying the dead. By using their findings during Autopsy, they can use their knowledge to prevent the death of another person.
Similarly, the title "coroner" is applied to both physicians and non-physicians. Historically, coroners were not all physicians (most often serving primarily as the town mortician). However, in some jurisdictions, the topic of "Coroner" is exclusively used by physicians.
In contrast, a medical examiner is typically a physician who holds the degree of Doctor of Medicine (M.D.) or Doctor of Osteopathic Medicine (D.O.). Ideally, a medical examiner has completed both a pathology residency and a fellowship in forensic pathology. In some jurisdictions, a medical examiner must be both a doctor and a lawyer, with additional training in forensic pathology.
Ambroise Paré is also considered one of the fathers of modern forensic pathology and surgery. His inventions in the early 16th century include surgical instruments and techniques. He pioneered battlefield medicine and treatments of wounds. One technique he used was pouring boiling oil into wounds.
This history of forensic pathology can be traced all the way back to the fourth century BC in Babylonia but instead of practicing on deceased human bodies, the practice of forensic pathology was strictly practiced on animals. This was said to be done only to animals since humans during this era were believed to be sacred. Later on, in forensic pathology history, forensic pathology would be practiced among those who live in Asia. Muslim doctors would discover infectious diseases and as a result, would operate on deceased bodies; one of those doctors being Ibn Zuhr. Zuhr would go on to performing autopsies on bodies in postmortem and research diseases such as leprosy, mange, and sexually transmitted diseases.
While Zuhr was busy learning about contagious diseases, Yee Siung, a Chinese government official was assembling a group of physicians who were in charge of dissecting criminal murder victims. These victims’ cause of death would be investigated alongside the actual case itself and this would be the first time pathology would be used to help solve criminal cases.
Forensic pathology was first recognized in the United States by the American Board of Pathology in 1959 after toxicology and pathology had been used to solve thousands of criminal cases worldwide for years.
In Canada, it was formally recognized in 2003,Royal College of Physicians and Surgeons of Canada. Information by Specialty or Subspecialty. Available at: http://rcpsc.medical.org/information/index.php?specialty=417&submit=Select. Accessed on: 15 July 2008. and a formal training program (a fellowship) is currently being established under the auspices of the Royal College of Physicians and Surgeons of Canada.
The first section is a two year preclinical study period where individuals are introduced to the basics. A two month work period at a hospital must be completed between each semester in order to become familiar with everyday life in a hospital. A final exam on the basics concludes this portion.
The second section is a one year clinical period to familiarize the students with the basics of clinical practice. The students complete the first part of the physician's exam at the end of this period.
The third section is another clinical period which lasts for two years, which practices non-surgical, surgical, neurological, ecological and general medicine domains. Here is where forensic medicine is first introduced. Between the first and second clinical sections, four months of medical clerkship are required, which consists of two months in a hospital and two months at any other medical institution. Students complete the second part of the physician's exam at the end of this period.
The final section is a one year practical period where students partake in three 4 month practicums: four months of internal medicine, four months of surgery and four months of clinical practical study of their choice. Students write the final part of the physician's exam before this period and have the oral part afterwards.
Once individuals have completed their medical studies, there is a minimum of six extra years of specialization training for forensic pathology. During this training individuals must complete at least three years and six months working for a legal medicine institution, focusing on clinical forensic pathology training. Then, at least one year of pathology work at a specialized institute is required partaking in autopsy technical training. As well, a minimum of 6 months working with forensic psychiatrists is also required. Finally, a single year of work in any field of medicine or legal medicine must be completed. During these work periods, it is required that these physicians write a number of opinions on their post-mortem examinations, crime scene investigations, crime scene reconstructions and insurance medical cases. There is also a minimum number of reports consisting of their own autopsies, police inquiries, histological investigation and other investigative results. Finally, the practicing physician must complete a certain number of oral court proceedings. Once all of this has been completed, an oral examination, overseen by the Chamber of Physicians (also known as the German Medical Association) is to be completed which allows individuals to officially become a forensic pathologist upon completion.
The majority of the specialists are attached to the Department of Forensic Medicine and Toxicology in various medical colleges. The classification of posts includes Assistant Professor (Lecturer), Associate Professor (Reader), and Professor. The work profile of the specialists includes conducting autopsies and clinical forensic examinations; apart from teaching the medical students. They have to regularly appear in the courts as expert witnesses. A typical department in a government institution conducts 100 to 5,000 autopsies a year depending upon the jurisdiction. Apart from this, clinical forensic examinations constitute a major part of the work and the number of cases can run up to ten thousand a year in an average institution.
The largest association of the specialty is Indian Academy of Forensic Medicine [6] (IAFM), which also publishes its quarterly Journal of Indian Academy of Forensic Medicine [7] regularly. This association has a specialist member strength of more than 1000.
Forensic medicine is also a mandatory round during medical school clerkship. Medical students assist the doctors on autopsies, and they may also be allowed to perform an autopsy under supervision, and to witness in the court.
To become a forensic pathologist, it requires individuals to pursue a four year undergraduate degree. After completing their undergraduate career, it is then required for individuals to attend medical school to either earn their Masters or Doctorates degree. After completing medical school, individuals are then required to have 2 years of mandatory postgraduate clinical education where they learn important clinical skills such as communication skills, common laboratory procedures such as Gram’s stain and urinalysis. When the two year mandatory clinical training is completed, another 3-4 years of training is needed to focus more on surgical procedures which is especially for forensic pathologists. During these last 3–4 years of training, forensic pathologists will learn more about specified human anatomy and they will also have the chance to interact with real patients as well as interacting with other forensic pathologists as well. The department of Forensic Medicine at Kyoto University in Japan has a legacy that can be traced back to 1899 when the department of forensic was first founded. The department has been active forces in promoting the significance of forensic medicine through its innovative programs, research, and analysis.
When their training is completed, forensic pathologists in Japan will then have the opportunity to receive their certificate of pathology awarded by the Japanese Society of Pathology
Entry to forensic histopathology specialty training requires completion of the UK Foundation Programme, stages A and B of histopathology specialty training, and a pass in the FRCPath Part 1 examination in histopathology. Candidates are in year 3 of specialty training (ST3) when entering forensic histopathology and progress immediately to stage C. Completion of stages C and D, and a pass in the FRCPath Part 2 examination in forensic histopathology allow the candidate to apply for the Certificate of Completion of Training (CCT).
Another option is to obtain the full FRCPath in general histopathology, followed by another 18–24 months of training in forensic pathology, which will qualify the candidates with either the Diploma of the Royal College of Pathologists in Forensic Pathology (DipRCPath (forensic)) or the Diploma in Medical Jurisprudence (DMJ). In England and Wales, the candidate will also need to be Home Office Accredited, which will require checks of the training portfolio and completion of a security check and the Expert Witness Training Course run by the Forensic Science Service.
Currently approved centres for forensic pathology training in the UK include Belfast, Edinburgh, Liverpool, Leicester, Cardiff, London, Glasgow and Dundee. Not all the posts are currently actively training.
In the United States, all told, the education after high school is typically 13–15 years in duration (4 years of undergraduate training + 4 years of medical school + 4–5 years of residency anatomic + 1–2 years of forensic pathology fellowship). Generally, the biggest hurdle is gaining admission to medical school, although the pass rate for anatomic and forensic pathology board examinations (in the U.S.) is approximately 80-90 and 90-100 percent, respectively. The courts do not require the American Board of Pathology certification in order for a witness to be qualified as an expert in the field of forensic pathology, and there are several "diploma mills" that give online certificates in the field.
Retrieved 2022-03-28.
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