Is there a stigma towards students applying to pathology with an interest in forensics? This topic discussion recently caught my eye on Twitter/X, and there’s a lot to unpack.
Hunter Koster states, “Everyone is told to lie if they are interested, in fear that programs will toss their apps or look at them differently.” And with such a high demand for forensic pathologists, can we risk this stigma pushing people away from the field?
Alison Krywanczyk, Forensic and Cardiovascular Pathologist, commented, “I was told a few times ‘it’s a waste you’re going into forensics’ in both med school and residency. I don’t think you need to hide it, but it is wise to at least show interest in other subspecialties during an interview.”
This begs the question: why do some physicians view forensics differently from other subspecialties? Below, we hear four pathologists’ views on this topic.
Nicole Jackson, Assistant Professor and Director of Autopsy and After Death Services, Department of Laboratory Medicine and Pathology, UW Medicine, USA
“Everyone is told to lie…” is an exaggeration. Certainly, some training programs seek to recruit and retain aspiring pathologists interested in research-centered, hospital-based practice, but this is not true for every or most programs. For instance, I trained in New Orleans at a program with a busy and robust autopsy service that proudly and consistently produces autopsy and forensic pathologists. The same can be said for where I did my fellowship training and where I currently practice. None of these institutions encourage medical students to hide their interest in forensic pathology or view them differently than applicants expressing interests in other subspecialties. I review applications every year and see students expressing their interest across subspecialties, including forensic pathology, and most go on to match in a pathology residency.
While there is some stigma within the general pathology community towards forensic pathology, it is not universal. Part of the stigma and negativity some vocalize originates from resource contention – we need more pathologists, and subspecialties are fighting to recruit people from the same pool to help with ever-increasing workloads. Unfortunately, some faculty have negative autopsy and forensic pathology experiences during their training, whether on an autopsy service staffed by a pathologist who either did not know or care about what they were supposed to be teaching, or placed in a busy office that did not prioritize teaching. That negative taste has lingered and manifests in a biased and negative voice.
Many understand the vital roles autopsy and forensic pathologists serve in helping families with closure and within the criminal justice and public health systems and, therefore, do not dissuade interest in this career path. Institutions that support residents interested in forensic pathology prioritize training solid anatomic and/or clinical pathologists who are well-poised to assume their next level of training or practice, whatever it may be. As a pathology community, I hope we all move to this and put aside our personal preferences and biases.
Julia Kochanowski, Clinical and Translational Sciences graduate student at University of North Dakota School of Medicine and Health Services, USA
I’m in the process of applying to medical school to become a forensic pathologist. After working as an autopsy technician for five years, I fell in love with the field. However, I was told by my peers to either not mention my interest in forensic pathology or to list several specialties when interviewing.
I was interviewed by a family medicine physician for a place in medical school, and when discussing my experience within pathology, I was told that "pathology does not count as medicine". I have also shadowed in other areas and volunteer at the local hospital. Yet, because I had worked in pathology, the physician refused to accept any of my experiences and called them invalid – claiming they couldn’t trust me to be a good medical student and that I didn't know what being an MD was. I was lectured for about 35 minutes out of my hour-long interview about how pathology is bad. It was a really disheartening experience – my experience in pathology is so important to me and it was upsetting to see someone react that way.
Marta Helenowski, Forensic Pathologist, USA
Forensic pathology is a field that requires a degree of exposure for someone to pursue as a long-term career goal. I was able to participate in a medical school elective during my senior year of medical school. When I rotated at the Office of the Cook County Medical Examiner in Chicago, Illinois for the first time, my experience opened a completely new dimension of medical career. There was a sense of excitement when I first saw an autopsy in the medical examiner setting with numerous professionals involved. A completely different world with medical examiners, police, the fire department, and various health agencies coming together to unravel a case that needs to be solved.
My medical school rotation in forensic pathology laid a stepping stone which I revisited during my pathology residency at the University of Illinois in Chicago. It was that initial rotation in forensic pathology which fueled my desire to return to CCME for an elective rotation during my pathology residency. An elective, which is normally offered during the fourth year of residency, was something I wanted to pursue at the start of my second year in residency. In my first year, different attending pathologists encouraged me to pursue my passion, which I’m very thankful for. The general trend in pathology at the time was to enroll in a hospital-based fellowship after residency, so without this encouragement, I’m sure I would have followed the typical route.
After the early rotation in forensics, I was able to apply to CCME for a fellowship position that, after completion, allowed me to continue as a forensic pathologist. I continue to practice at this great institution to this day and believe this is largely due to my rotation during medical school. Because of my positive early experience in forensics, I volunteer by giving presentations at a local high school and return to my pathology program to assist pathology residents by giving lectures on various forensic topics. I hope that this way, I can spark an interest in someone who may also one day decide to pursue forensic pathology.
Cameron Negron, medical student at CUNY School of Medicine, New York, USA
I’m currently navigating the Match 2025 cycle. After a decade-long journey through undergrad and medical school, I am finally on the brink of becoming a pathology resident – a path I’ve been passionate about since I was 12. Throughout this process, I’ve encountered stigma at every step. If it weren’t for the connections I made with pathologists on my own, I doubt I would have had the experiences that reinforced my interests. Unfortunately, many advisors, faculty, and clinical preceptors discouraged me from pursuing pathology, particularly forensics. The only people who supported my goals were pathologists, surgeons, and others who work closely with pathologists.
I believe this stigma begins early in medical school, often due to a lack of exposure to the field and an inadequate pathology curriculum. There is a significant gap in understanding the role of pathologists and how forensic medicine contributes to clinical practice. For example, when I applied for an away/elective rotation at a medical examiner’s office, my initial proposal was rejected for being "unsuited for a fourth-year medical student." It wasn’t until I gained support from my advisor and revised my proposal that it was accepted. My evaluator was expected to give feedback such as, "provided empathetic responses to patients." This highlights how clinical medicine is unwelcoming to forensics.
Throughout my clinical rotations, I was often told that pathologists "aren’t people persons," that they "lack bedside manner," and that they "don’t enjoy talking to patients." On the first day of most rotations, I was greeted with eye rolls, scoffs, and assumptions about my work ethic when I mentioned my interest in pathology and forensics.
When applying to residency, I was repeatedly advised not to mention my interest in forensics, or to add that "the door is still open" to other specialties. Depending on the interviewer, my interest in forensics was either met with enthusiasm or with relief that I was "keeping my options open." After speaking with other medical students, pathology residents, and forensic fellows, I’ve realized that I am far from alone in facing this stigma.
I hope that one day this changes. We need more individuals who are willing to follow their dreams and break the cycle. We need greater exposure to pathology and forensics in medical school. As a future resident, I am committed to contributing to medical education in the hopes of inspiring future generations of pathologists.
If you have anything to add to this conversation, please get in touch: edit@thepathologist.com
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