death investigation systems 57This organization sets requirements and standards for training, examina-
tion, and certification in the field of pathology and its subspecialties, in this
case, forensic pathology.^24 This requires completion of accredited (by the
American Council of Graduate Medical Education) residency and fellowship
training programs in both anatomic and forensic pathology, with subsequent
successful completion of qualifying examinations given by the American
Board of Pathology in both areas. If these requirements are met, the physi-
cian will receive certification in anatomic pathology, and special qualifica-
tion in the field of forensic pathology, also referred to as board certification.
At this point NAME recognizes the individual as a forensic pathologist.^35
While this certification does not guarantee excellent practice, it does show
that the practitioner has met a minimum level of training and performance
in the field.^34 While some physicians utilize the term board eligible to indicate
that they have taken the requisite training in pathology or its subspecialties
but have not passed the board certification examinations, this designation
is not recognized by the American Board of Pathology, and should not be
used or accepted.
In addition to board certification, practitioners may now be held to pro-
fessional standards of practice in the field of forensic pathology. The National
Association of Medical Examiners has published such standards to provide
guidance and objective criteria for the assessment of the practice of forensic
pathology.^35 In 2003, NAME formed a committee to investigate the advis-
ability of formally adopting standards for medicolegal autopsy practice.^36
After much debate and discussion, including surveying the member ship
about proposed standards, the “Forensic Autopsy Performance Standards”
were approved by the membership of NAME and published in 2006 in the
American Journal of Forensic Medicine and Pathology. These set forth stan-
dards for practice of forensic autopsy pathology, provide some definitions
related to the field, and discuss standards for associated techniques, such as
toxicological analysis, radiography, histology, and written reports. While
broad and relatively basic, such standards do require a certain level of prac-
tice by physicians and can serve as an objective guide in assessing an indi-
vidual’s level of practice.
While certification and standards refer to the practitioner and his or
her practice, accreditation refers to the assessment of a death investigation
system or office as an organization, without assessing the performance
of any individual practitioner. Currently the only organization accredit-
ing medical examiners’ offices on a national basis is NAME.^37 In 1975 the
organization established a voluntary peer review system using criteria
developed for inspection and accreditation of death investigation systems.
Accreditation of a medical examiner or coroner’s office involves a thorough
inspection of the office by an outside trained forensic pathologist, utiliz-
ing a checklist devised by the Standards and Accreditation Committee of