Commentary on: Quarino et al. Mandatory certification of forensic science practitioners in the United States: A supportive perspective. Forensic science international: Synergy 2019; 1(1): 161-169.

To the Editor:

I read, with great interest, the recent review on certification of forensic science practitioners by Melbourn et al. [1] I was particularly struck by this paragraph, which was the only paragraph germane to forensic pathology:

“An exception to voluntary certification, forensic pathologists are required to be certified by the American Board of Pathology, which is a current member of the American Board of Medical Specialties. Applicants for this certification must have completed medical school, possess an unrestricted license to practice medicine, and have completed a program in pathology or a pathology subspecialty. Forensic pathology is the only discipline of forensic science which mandates that practitioners be board-certified. However, this requirement more likely than not demonstrates that the practitioner is competent as a medical doctor rather than demonstrating competence in forensic science.” (emphasis added).

The authors appear to be unaware that certification in forensic pathology in the United States is a lengthy process that includes:

Graduation from an accredited medical school (4 years)

Passing a multistep medical licensing examination

Completion of an accredited residency program (3 + years) in anatomical (or anatomical and clinical) pathology

Passing the anatomical pathology board examination administered by the American Board of Pathology (ABPath)

Completion of an accredited forensic pathology fellowship (1 year)

Passing the forensic pathology board examination administered by the ABPath

A forensic pathology fellowship is an intense immersion into the subspecialty. The forensic pathology board examination focuses almost entirely on assessment of knowledge of forensic pathology, and includes written questions, microscopy, and interpretation of images.

The authors could have readily researched the competencies in forensic pathology promulgated by the ABPath and the Accreditation Council for Graduate Medicate Education (ACGME) [2].

The authors’ claim that certification in forensic pathology “more likely than not demonstrates that the practitioner is competent as a medical doctor rather than demonstrating competence in forensic science” conflates two different things. Forensic pathologists are physicians, not scientists. We are medical subspecialists who practice forensic pathology. The authors’ claim would have been more accurately worded, though ironically even more wrong, had they made it about forensic “pathology” rather than “science."

It’s unfortunate that this review made such a claim about forensic pathology at all. The National Association of Medical Examiners (NAME) has long held the position that all medicolegal death investigation systems should be accredited to national standards, and all practitioners be board certified forensic pathologists. One would be hard-pressed to find another forensic discipline in which the training is so long, or the examinations so numerous and so rigorous. The certification standards forensic pathologists must meet could be used as a model for other forensic disciplines. Indeed, the coda to the paper’s title (“a supportive perspective”) would have been far better served had the authors accurately characterized the certification process in forensic pathology. Erroneous claims that our certification process is not demonstrating competence in the specialty does nothing to further that goal.