Candidates wishing to pursue a career in forensic pathology should do so with a sound background in histopathology, such that they have a satisfactory knowledge of disease mechanisms and systemic pathology, and a more than adequate familiarity with autopsy techniques and microscopy. A number of examination routes are possible:
· Part 1 MRCPath in forensic pathology (slanted) followed by Part 2 in forensic pathology
· Part 1 MRCPath in histopathology followed by Part 2 in forensic pathology
· Parts 1 and 2 MRCPath in histopathology followed by the Diploma in forensic pathology.
Whichever examination route is chosen, at the end of any training programme candidates should have acquired a broad knowledge of medicolegal systems and legal aspects of clinical practice; familiarity in performing post-mortem examinations in a wide range of natural and non-natural deaths, including specialist techniques and related investigations; and an awareness of the responsibilities involved in dealing with suspicious deaths and of giving evidence in courts.
The requirements for each of the above stages in the examination process, and the structure of the examinations themselves, are as follows.
Part 1 slanted towards forensic pathology
A minimum of 2½ years training is required, of which 1½ years must have been in the specialist registrar (SpR) grade. This should be in departments of histopathology and forensic pathology that have been recognised for training purposes and the 2½ years must include at least six months full-time practice in forensic pathology and at least three months experience in each of neuropathology and paediatric pathology. (The last two need not necessarily require a full-time attachment for the whole of the specified period and proof of continuing informal exposure over a longer timescale may be considered an acceptable alternative after an initial two months). Additional knowledge of the general principles of cytopathology should be acquired, sufficient to address any questions posed in paper 1 of the examination.
Paper 1 will be the same as for general histopathology, to cover general pathological processes including cytopathology. Paper 2, the slanted component, will cover all aspects of sudden natural death, deaths related to accidents and suicide, and basic aspects of homicides. There may also be questions in relevant aspects of neuropathology and paediatric pathology.
Should any candidate wish to change direction in training after gaining the slanted Part 1, they must be aware that this examination does not give exemption from the Part 1 in histopathology.
Part 2 in forensic pathology
Candidates with the Part 1 examination in either general histopathology or forensic pathology (slanted), who wish to take the Part 2 examination in forensic pathology, must have been training for at least 4½ years, of which 3½ must have been in the SpR grade. Of the 4½ years, at least two must have been spent in full-time forensic pathology, in a department recognised by the College for such training. Candidates must also have had at least six months experience in each of neuropathology and paediatric pathology. (As with the slanted Part 1 examination, the six months in each need not necessarily require a full-time attachment for the whole of the specified period and proof of continuing informal exposure over a longer timescale may be considered an acceptable alternative after an initial three months). During their two years in forensic pathology it is desirable that candidates become exposed to the principles of toxicology and forensic science procedures, acquire a basic knowledge of forensic anthropology, and have experience of attendance at scenes of suspicious deaths.
The examination has the following components.
· Casebook: submission of a casebook of 20 medicolegal cases, covering a wide spectrum of forensic work. The intention of the casebook is to demonstrate that candidates have had an adequate exposure to different types of cases during their training, are capable of drawing appropriate conclusions from the findings and are able to formulate good quality reports with well reasoned discussions. The cases chosen must be only those in which the candidate has had substantial involvement and must include not only a detailed record of the autopsy findings but appropriate discussion of the particular issues raised by the case and a survey of the relevant literature. It would be usual to include photographs and other illustrative material, with due regard to confidentiality.
The casebook will be marked by two assessors and given one of three grades:
A = pass
B = some modification or additional work required
C = unacceptable.
Casebooks should be submitted at least four months before the closing date for the Part 2 examination for which the candidate wishes to enter. Applications for the compulsory practical and oral component of the Part 2 will not be accepted until the written option has been awarded a pass mark by the Examinations Committee.
· Practical examination: a two-day examination designed to assess the competence of candidates to practice forensic pathology independently.
Autopsy may include special dissection techniques.
Microscopy histological examination of 20 sections, to include material not only of overt medico-legal interest but from any aspect of general histopathology relevant to autopsy practice.
Case reports preparation of reports based on documents and other material, which may include toxicological analyses.
Gross specimens wet tissues, bones, X-rays, etc.
Oral with emphasis on aspects of forensic practice not covered elsewhere, which might include ethical, legal and management issues.
Candidates will be assessed on all components of the examination, although particular importance will be placed on those aspects of greatest relevance to forensic practice, not least the performance of the autopsy.
Diploma in forensic pathology
This qualification is intended for those who have pursued the full MRCPath in histopathology and who then wish to specialise in forensic pathology. The requirements are similar to those for the Part 2 in forensic pathology.
The examination may be taken after a period of training, which has included a minimum of two years substantial involvement in Coronial/Fiscal autopsy practice, of which at least 18 months must have been in forensic pathology departments approved by the College. Candidates must also have had at least six months experience in each of neuropathology and paediatric pathology, although the qualifications in regard to this time period, outlined in the Part 2 MRCPath above, would equally apply here.
The examination has three components.
· Written examination: a single three-hour paper to cover any aspect of forensic/autopsy pathology and which might also include such topics as service provision, quality assurance and relevant legal issues.
· Casebook: a casebook of 20 medicolegal cases, the purpose and format of which is exactly the same as for the Part 2 MRCPath. Candidates submitting a satisfactory casebook but failing to achieve the required standard in other components of the examination will not be required to submit a new casebook at any subsequent attempt at the examination.
· Practical examination: the same format as for Part 2 MRCPath, to comprise autopsy, microscopy, case reports, gross specimens and oral.