Fellowship application
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The VCU School of Medicine 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 Chief Medical Examiner of Virginia, and is conducted in the Chief Medical Examiner's Office at 400 East Jackson Street , Richmond , Virginia , 23219-3694 . The Office of the Chief Medical Examiner is adjacent to the campus of the VCU School of Medicine.
Fellowship candidates must have completed an approved residency in pathology and successfully completed the USMLE parts I, II, and III or the ECFMG parts I, II and III or the NBOME. Prior to the first day of employment, the candidate must have a license to practice medicine in Virginia.
The three board-certified forensic pathologists of the Medical Examiner's office are the core faculty of the Department of Legal Medicine at the VCU School of Medicine, and faculty in the Division of Forensic Pathology of the Department of Pathology of the VCU School of Medicine. Medical Examiner's office staff have full access to facilities at the VCU School of Medicine and its medical, dental, pharmacy, hospital administration, nursing, and other health science schools.
The forensic pathology training program is designed to provide flexibility in training and experience, depending upon the individual physician's career objectives.
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 Richmond Office of the Virginia Medical Examiner System provides forensic pathology and medical examiner administrative services to the county and city medical examiners in the central region of Virginia including the Richmond Metropolitan area.
The Richmond OCME serves a population of approximately 1.3 million, of which approximately 550,000 is in the Richmond Metropolitan area. The Richmond office processes the medical examiner's death reports of all violent, suspicious, and unusual deaths in the central portion of Virginia, pursuant to Virginia Code Section 32.1-277 et seq. Medical examiner deaths in the Richmond metropolitan area and many from nearby counties are brought to the medical examiner's facility morgue in Richmond. Approximately 1,500 dead bodies per year are viewed in the Richmond facility and approximately 850-900 per year are autopsied. The trainee in Richmond 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 central Virginia indicate that the trainee in Richmond will see many gunshot and stab homicides, and adequate numbers of drownings, burns, poisonings, motor vehicle fatalities, hangings, strangulations, farm-type accidental deaths, industrial and on-the-job deaths, child abuse cases, and unidentified and skeletal remains. The case material in the Richmond 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 the VCU School of Medicine.
The trainee is expected to manage cases from the time of finding of 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 Richmond 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 Richmond office of the Virginia Division of Forensic Sciences. This unit encompasses all the forensic sciences: firearms and tool-mark examination, gunshot residues, DNA lab, hairs, fibers, and trace evidence; questioned documents; fingerprints utilizing AFIS, street drug analysis; breathalyzer operation; and forensic toxicology. The trainee has immediately available consultation both in the morgue and in the laboratory the specialists in each of those disciplines. The trainee spends one month 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 Richmond City , 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. Medical investigators assist the trainee in tracking down needed information.
The OCME has in-house consultants in pediatric pathology, anthropology and forensic epidemiology, as well as consultants in neuropathology, radiology, and cardiovascular pathology. Training in special techniques such as identification problems and examining skeletal remains is provided. The Department of Dental Pathology from VCU School of Medicine’s Dental School provides dental consultation and training.
The trainee has all the facilities of the VCU School of Medicine for consultation. The trainee is encouraged to attend conferences and seminars in any of the schools and specialties. The Department of Legal Medicine, which is essentially conterminous with the 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.
The fingerprint divisions of the Richmond City Police, the Virginia State Police, and the Division of Forensic Science give instruction in that specialty, there is access to their fingerprint records and Central Criminal Records Exchange by means of the automated fingerprint identification system (AFIS). The fellow will attend the AFIP dental and anthropology courses held yearly.
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 encouraged to undertake research projects including epidemiologic and case studies, utilizing the statewide database. Computer support is available.
It is the aim of the Forensic Pathology training program at the VCU School of Medicine 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:
Deborah Kay, M.D.
Assistant Chief Medical Examiner
400 East Jackson Street
Richmond , Virginia , 23219-3694
Phone: (804) 786-1033
FAX: (804) 371-8595
email: BethA.Plutro@vdh.virginia.gov