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Interest in Forensic Work

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I’m a new grad PA who has encountered some significant difficulty finding a suitable position in my area (South Florida). Relocation isn’t an option at this point. I’ve posted about that before, but I’m hoping someone could help guide me or offer any insight into potentially entering into the field of forensic work as a medicolegal death investigator. I know that states such as NY and VA have utilized PAs in this context, but I haven’t been able to get a hold of any to chat with them and get insight.

I have an interview with the office of the Medical Examiner this week for an available position that I might be able to carve a niche for myself in. However, I’m concerned about the fact that this is non-traditional (non-clinical) work. I’m assuming working in this capacity would force me to pick up another job on the side because I’d lose my ability to be employed anywhere else if I ever decided to leave. Might anyone have some insight or know any PAs working in this capacity that I could get in touch with? 

 

 

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Not sure how much my experience will help you, but I've been a deputy county medical examiner in upstate NY for a few years.  It's an appointed, not elected, position, and there are only three of us in the office:  an IM MD, a nurse practitioner, and me.  We don't share cases; whomever is on call gets the case.  It's a rural county, so we only average a few cases each per month.  We do it all - scene investigation, whatever additional investigation we deem necessary, decision on whether to refer for autopsy, coordination with law enforcement, pathologists and funeral directors, determination of cause/manner of death, and completion of the death certificate.

I actually enjoy my forensic work much more than my clinical work, but it doesn't pay well.  For the above (10 days of 24 hour call per month, plus 4--6 cases) I make about $15k per year.  I consider it more as community service than a source of decent income.  Obviously for a full time MLDI or coroner, depending on your state, it might pay more, but the forensic field is not known for good pay.  I've maintained full time clinical practice, 30 years of EM, now critical care.  If I'm ever able to retire from clinical work, I hope to continue the forensic position.  However, if I could earn a decent living doing the forensic work, I'd do it in a heartbeat.  

As mentioned above, New York City OCME has long employed PAs as investigators, though they have recently started hiring non-clinician MLDI's from other jurisdictions.  I actually interviewed with them less than a year ago.  Had I been offered a position (I was not - they brought in four of us for interviews.  I was the only PA; the other three were experienced MLDIs from large metropolitan areas) the low salary would have likely been untenable.  

If you're interested in the field, especially as a new PA, you'd be well served to get some education.  The actual ABMDI MLDI exam requires that you be working in the profession for a time prior to sitting for the exam, so that can be a barrier to entry if you are just looking to join the profession.  There is training available, but unless you're already affiliated with an agency, you'll probably have to pay out of pocket.  The Cuyahoga County Medical Examiner's office in Cleveland, OH offers a well-recommended course, as does the University of North Dakota, as well as a guy named Darren Dake at ditacademy.org in Missouri.  (I have no connection to any of these organizations, and have not taken their courses, but they are all highly recommended.)

With some basic education, it does open some doors, but you'll still likely need to know someone, and be persistent if this is what you really want to do.  If you live in a coroner state, you'd need to be elected, which is usually about how well known you are locally, not how qualified you are.  However, many of the larger coroner offices in the US do hire investigators and deputy coroners, though again, the pay is usually dismal compared to clinical practice.

Finally, if this is your preferred career, I wouldn't worry too much about your ability to do clinical work.  You can always work part-time in clinical medicine to maintain those skills.

I hope this answers some of your questions!  Feel free to PM if I can be of further help!

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