Anatomic Pathology Program

Forensic Pathology

Rotation Director:

Wayne Ross, MD


Goals and Objectives:

1.  Procedural Skills (patient care) and Medical Knowledge:


Autopsy pathology

  • Perform a dissection by Virchow method, including opening and evisceration
  • Select appropriate sections of each organ system evaluated
  • Be familiar with laws regarding referral of cases to the coroner's office and the classification of autopsies requiring medicolegal status
  • Discuss the cause, manner, and mechanism of death for each case
  • Understand infectious disease precautions and follow safety procedures to limit risk
  • Perform external exam and discuss relevance of external findings and postmortem changes
  • Review microscopic findings as appropriate for each case
  • Review decedent history and scene history and develop a specific differential, including conditions to rule out or things to look for before starting each case.



Forensic pathology

  • Gunshot and shotgun wounds
    • Know the basic differences between handguns, rifles, and shotguns
    • Be familiar with entrance and exit wound characteristics
    • Establish direction of fire and involved (injured) structures
    • Identify range characteristics (soot, stippling, muzzle abrasions)
    • Describe bullet features and estimate caliber (small, medium, large)
    • Identify buckshot, birdshot, and wad material
  • Sharp force injuries
    • Identify and describe stab wounds and incised (i.e., cutting) wounds
    • Identify sharp and blunt angles
    • Establish direction and depth of penetration
  • Blunt force injuries
    • Identify abrasions, lacerations, contusions and fractures
    • Recognize chop injuries
  • Asphyxia
    • Be familiar with hanging findings including ligatures and ligature furrows
    • Recognize petechial hemorrhages (skin, eyes)
    • Identify fractures of the hyoid bone and thyroid cartilage
    • Be familiar with findings observed in anterior and posterior neck dissections
  • Drug related deaths
    • Acquire basic knowledge of common street drugs (cocaine, marijuana, methamphetamine, heroin, etc.)
    • Be familiar with toxicology results and their implications for the autopsy
    • Review NMS forms and different toxicology panels
    • Recognize when to order each panel and describe the samples that are required and any special handling needed
    • Perform collection of body fluid samples (e.g., vitreous, hearth blood, peripheral blood, and urine) and explain the reason they are needed for investigation
  • Ancillary testing
    • Understand when additional pediatric procedures such as metabolic screening and microbiology cultures are appropriate
    • Understand when histologic examination is appropriate and what sections are appropriate for a given case.
    • Identify cases that require special testing such as carboxyhemoglobin levels and testing for volatiles


2.  Interpretive Skills (PC, MK, SBP):  Be able to interpret, present, and synthesize gross and microscopic pathologic findings with the history and the results of other studies, to produce an autopsy report that explains the cause, manner, and mechanism of death. Discuss postmortem changes in decomposition.  

3.  Practice-based Learning and Improvement:  Demonstrate active growth of forensic pathology knowledge during the rotation, with development of greater accuracy and sophistication in the preparation of autopsy reports. If interested, attend at least one scene investigation.  Observe completion of death certificate.

4.  Interpersonal and Communications Skills:  Effectively communicate with autopsy assistants, funeral home personnel, family members, forensic pathologists, other medical personnel, law enforcement agencies, and attorneys.

5.  Professionalism:   Complete autopsy reports in the assigned timeframe, according to instructions, and show respect for the body of the deceased during the autopsy.  

6.  Systems-based Practice:  Develop a basic understanding of the medicolegal, social, professional, economic, educational, and health & safety ramifications of forensic pathology within society.  Attend court, review report before court date, and attend any meetings related to the court case when possible.



  • Level of training: PGY-2 or higher year, after the resident has gained a solid grounding in autopsy pathology
  • The resident's autopsy check list must be signed by the pathologist after every forensic autopsy. A log of participation by residents will be kept by the resident. In order to receive proper credit for the case, the resident will return the signed log to the Pathology Residency Coordinator to be placed in the resident's file.

Duration and Timing of the Rotation:

  • 4 week block

Teaching Staff:

  • Wayne Ross, MD


Background reading (covered independently by resident):

  • Medicolegal Investigation of Death. Spitz and Fisher, 3rd edition
  • Forensic Pathology. DiMaio, 2nd edition (in PSHMC residents room)
  • Gunshot Wounds. DiMaio, 2nd edition
  • Forensic Pathology: Principles and Practice. Dolinak, Matshes, Lew

Method(s) of Evaluation:

  • Residents will be evaluated based on direct observation by forensic pathologists and staff
  • After each rotation, residents will be evaluated by Dr. Ross in New Innovations