Specialty Profiles

What it’s like in forensic pathology: Shadowing Dr. Cohle

As a medical student, do you ever wonder what it’s like to specialize in forensic pathology? Meet Stephen D. Cohle, MD, a forensic pathologist and a featured physician in the AMA’s “Shadow Me” Specialty Series, which offers advice directly from physicians about life in their specialties. Check out his insights to help determine whether a career in forensic pathology might be a good fit for you.

“Shadowing” Dr. Cohle

Specialty: Forensic pathology.

Practice setting: Group.

Employment type: Employed by group.

Years in practice: 36.

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A typical day and week in my practice: Our primary job is doing autopsies, which frequently take all morning. Our other responsibilities include finishing autopsy reports, reading literature relevant to our cases, testifying in court, consultations with police, attorneys or family members, and administrative meetings.

A workweek ranges from 40–60 hours, depending on whether we are on call. Part of being on call is taking calls from our investigators, which can occur at any time during the day. In some forensic pathology practices there will be days in which one has to do autopsies and days set aside for signing out cases or administration.

The most challenging aspects of forensic pathology: Among the more difficult facets of forensic pathology are investigating complex cases, such as decomposed bodies, multiple gunshot or stab wound homicides, and child abuse cases. “Negative” autopsies, with no apparent anatomic or toxicologic findings, are a big challenge.

The most rewarding aspects: Finding the cause of death in cases in which the cause is not apparent initially, especially when you identify a disease or condition which is inherited and which may save the lives of close relatives of the deceased. Also gratifying is identifying a toxin that was not suspected initially.

Three adjectives to describe the typical forensic pathologist: Thorough, inquisitive and persistent.

How my lifestyle matches, or differs from, what I had envisioned: In general, you have control of your time. Evenings are usually free, as are weekends when you’re not on call. You have time to read about your cases. The hours are pretty much what I would have anticipated. You can usually attend family functions, including kids’ sporting events.

Skills every physician in training should have for forensic pathology but won’t be tested for on the board exam: The main personality trait is inquisitiveness, and a willingness to dig deeply on cases in which no answer is immediately apparent. An ability to detach oneself form the emotional aspects of the tragedy families undergo is essential.

One question physicians in training should ask themselves before pursuing forensic pathology: Am I OK with not treating living patients?

Books every medical student interested in forensic pathology should be reading: Knight’s Forensic Pathology, Medicolegal Investigation of Death, Working Stiff, Cause of Death and Skeletons in the Closet.

The online resource students interested in forensic pathology should follow: The blog by Judy Melinek, MD.

Quick insights I would give students who are considering forensic pathology: The most important aspect to consider is job satisfaction, part of which is the ability to really dig deeply into a case and learn about a disease or condition that you encounter in your week.

Mantra or song to describe life in forensic pathology:Diggin’ Up Bones,” by Randy Travis.