Fellowship application
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The Eastern Virginia Medical School (EVMS) in conjunction with the Office of the Chief Medical Examiner (OCME) of Virginia offers residency/fellowship training in the subspecialty of forensic pathology. The program is under the direction of the Deputy Chief Medical Examiner of the Eastern (Tidewater) District of Virginia and is conducted in the Chief Medical Examiner's Office at 830 Southampton Avenue, Suite 100, Norfolk, Virginia, 23510-1046. The Office of the Chief Medical Examiner is on the south campus of the EVMS.
The three board-certified forensic pathologists of the Medical Examiner's office are faculty in the Department of Pathology at EVMS and the Department of Legal Medicine at the Virginia Commonwealth University/Medical College of Virginia. The forensic pathology training program is designed to provide flexibility in training and experience depending upon the individual physician's career objectives. The Medical Examiner’s office staff has full access to EVMS.
1. A 1 or 2 month experience for the trainee who desires a brief exposure to forensic pathology as part of a general anatomic pathology program.
2. A 3 to 6 month experience for trainees desiring more intensive exposure as part of a general anatomic pathology program.
3. A 12 month experience for a trainee desiring eligibility to take the American Board of Pathology examination in forensic pathology.
The Tidewater District Office of the Virginia Medical Examiner System provides forensic pathology and medical examiner administrative services to the county and city medical examiners in the eastern region of Virginia including the Norfolk, Virginia Beach, Hampton, Portsmouth, and Newport News metropolitan areas.
The Tidewater OCME serves a population of approximately 1.5 million. The office processes the medical examiner's death reports of all violent, suspicious, and unusual deaths in the southeast portion of Virginia, pursuant to Virginia Code Section §32.1-277 et seq. Medical examiner deaths in the Tidewater metropolitan area and many from nearby counties are brought to the medical examiner's facility morgue in Norfolk. Approximately 1,200 dead bodies per year are viewed at the Tidewater office and approximately 600 per year are autopsied. The trainee in Tidewater receives experience in the on-scene disposition and external examination of medical examiner death cases, not merely in the performance of autopsies. Of those autopsied, approximately 25% are homicide victims. The demographic characteristics of eastern Virginia indicate that the trainee in Tidewater will see many gunshot and stab homicides, and adequate numbers of water-related, burns, poisonings, motor vehicle fatalities, hangings, strangulations, farm-type accidental deaths, industrial and on-the-job deaths, child abuse cases, as well as unidentified and skeletal remains. The case material in the Tidewater office is considered representative of the various categories of violent and suspicious death in this country. A medicolegal library is on the premises, as is access to Medline, electronic mail, and the internet through the Virginia Department of Health and EVMS.
The trainee is expected to manage cases from the time of finding the dead body through external examination, autopsy if indicated, collection of evidence, correlation of reports, and court appearances. The trainee must have valid medical licensure in Virginia, in order to function as a medical examiner for the Tidewater Metropolitan area, thus having the legal standing to perform the death investigation in all its aspects. The trainee can then be the legal signatory of the medical examiner's report, death certificate, and autopsy report. The trainee is given the authority along with the responsibility for making the decisions in the case and for the development of the case so that it is properly presentable from a legal standpoint. The trainee is guided and directed by the staff, commensurate with demonstrated experience and capability, with the hope that by the spring of the training year, the trainee can function essentially independently except when asking for consultation from the senior staff. The senior staff monitors performance by a daily staff conference discussing all cases of the day and by daily consultation in the morgue and in the office. The senior staff reviews every medical examiner's report and autopsy protocol at least four stages:
The senior staff is available for consultation when the trainee receives subpoenas for court and in the preparation of the case for presentation in court.
A particular strength of the program is the integration of forensic pathology with forensic science. Housed in the same building with the medical examiner's office and morgue is the Eastern District office of the Virginia Division of Forensic Science. This unit encompasses all the forensic sciences: firearms and tool-mark examination; gunshot residues; DNA lab; fibers and trace evidence; questioned documents; fingerprints utilizing AFIS, street drug analysis; breathalyzer operation; forensic photography; and forensic toxicology. The trainee has available consultation both in the morgue and in the laboratory the specialists in each of those disciplines. The trainee spends one month exclusively in the laboratory to become familiar with the variety of tests and procedures that forensic science offers. Attendance at forensic science training classes is encouraged. Copies of the laboratory results are filed with the medical examiner's reports and autopsy protocols. The trainee is given instruction in and is expected to carry out proper evidentiary procedure with cases and to be able to defend the protocol, records, and conclusions in court. The police investigators involved with the case, primarily in homicides and motor vehicle fatalities, and especially those from nearby cities, come to the morgue when their cases are autopsied. There is the opportunity for direct personal interchange between the pathologist and police investigator concerning the cases. This is invaluable training for both parties. A medical investigator assists the trainee in tracking down needed information.
The trainee has all the facilities of the EVMS for consultation. The trainee is encouraged to attend conferences and seminars at EVMS. Medical Examiner's staff provides instruction in forensic medicine to students, housestaff and others. The trainee is encouraged to attend those sessions and, as more experience is gained, to help with some of the instruction. The department also conducts continuing education courses through the Virginia Institute of Forensic Science and Medicine for medical examiners, physicians, hospital administrators, rescue squads, funeral directors, commonwealth attorneys, and law enforcement officers. The trainee may participate in these sessions.
Training in special techniques such as identification problems or skeletal remains is provided. Local dental consultants provide training in forensic odontology.
The fingerprint divisions of the local city police departments, the Virginia State Police, and the Division of Forensic Science give instruction in that specialty. There is access to fingerprint records of the Central Criminal Records Exchange and FBI by means of the automated fingerprint identification system (AFIS). The trainee may attend the physical anthropology course at the Smithsonian Institution held yearly. The trainee is also encouraged to attend the one-week basic forensic pathology course at the Armed Forces Institute of Pathology.
There is emphasis upon medical jurisprudence in addition to forensic pathology. The trainee receives instruction in practical points of law about physicians and hospitals, evidence, criminal law, and personal injury litigation. The emphasis upon the law in addition to the pathology is thought to be a strong point through the year. The trainee who demonstrates the ability will be permitted to exercise a great deal of responsibility and to make decisions.
The trainee also receives a moderate amount of experience in the administrative aspects of a state-wide medical examiner system. The performance of medicolegal autopsies is but one aspect of a properly operated medicolegal death investigation office. Familiarity will be gained with budgetary processes, policy making, and interaction with other state and local agencies.
Trainees are expected to undertake a research project and may access a statewide database. Computer support is available.
It is the aim of the Forensic Pathology training program at EVMS that, by the end of the fellowship year, the trainee can adequately manage the great majority of medicolegal deaths with self-assurance and technical competence. The trainee should be equipped to step into a position as an able assistant in an established Medical Examiner's or Coroner's Office of a county, city, or state.
For more information, contact:
Wendy Gunther, M.D.
Assistant Chief Medical Examiner
830 Southampton Avenue, Suite 100
Norfolk, Virginia, 23510
Phone: (757) 683-8366
FAX: (757) 683-2589
email: wendy.gunther@vdh.virginia.gov