Career choice and interdisciplinary education in forensic pathology: a cross-sectional study

BACKGROUND: Early engagement in medical education is critical to influencing career choice. Exacerbated by a rapidly accelerating specialization timeline, there is currently a national workforce shortage of forensic pathologists. This cross-sectional study explores the widespread challenges of recruiting and retaining trainees through a broad educational lens, addressing interdisciplinary factors associated with workforce pathways over time, academic affiliations, and underrecognized collaborative opportunities in medical examiner and coroner (ME/C) education programs. The purpose of this study is to perform a needs assessment of learners interested in forensic pathology and ME/C education programs in the United States. METHODS: Two different surveys were developed for this study and distributed to (1) forensic pathologists and individuals pursuing a career in forensic pathology, and (2) ME/C education programs. Measures included factors associated with interest in forensic pathology and characteristics of ME/C education programs in the United States. Associations were analyzed using Pearson’s chi-square and Kendall’s tau-b. RESULTS: The sample included 313 participants and 163 ME/C education programs. Interest in forensic pathology emerged during residency (27%), medical school (26%), and high school (24%), with increases occurring earlier in the education timeline from non-traditional pre-medical majors, careers, and medical subspecialties. Impactful career choice factors included rotations during medical school/residency and the influence of professors/mentors. ME/C education programs predominately targeted medical students (92%) and residents (76%) by providing opportunities for autopsy observation. Although 48% of medical schools are affiliated with an ME/C office, only 5% of ME/C offices are facilitating these experiences. There is no association between the number of affiliation agreements held by ME/C education programs and forensic pathologist output. Interdisciplinary exposure during rotations is primarily limited to job shadowing with death investigators. Quantity of workload (65%), staffing (52%), and office space (52%) are the greatest barriers experienced by ME/C education programs. CONCLUSIONS: This study underscores the critical need for interdisciplinary collaboration and sustainable, innovative educational approaches to strategically engage future forensic pathologists. Proposed strategies include (1) facilitating rotations to a diverse student and interprofessional population; (2) increasing community engagement; (3) strengthening clinical and academic affiliations; and (4) empowering ME/C education programs with resources and support. CLINICAL TRIAL NUMBER: Not applicable.