Goal/Objective: To introduce residents to the principles of forensic pathology and the approaches to a forensic autopsy and to acquire increased experience in autopsy pathology.

A resident typically spends two weeks during his/her second year of training at the Boston Medical Examiner's office, located in downtown Boston near the Boston City Hospital. Under the direction of Dr. Richard Evans, Chief Medical Examiner, this office is a busy site, having as many as 10 autopsies a day.

Residents participate in all aspects of forensic cases which include reading the case files, actively assisting in the prosections, and discussing the cases with the forensic pathologists; they have the opportunity to go to a crime scene and to court. The level of resident participation in the prosection varies with the complexity of the case, however residents assist in all types of forensic cases, including accidents, suicides, homicides, and natural deaths. All cases are supervised and reviewed by experienced forensic pathologists who are members of the BWH and Harvard Medical School teaching faculty. The Medical Examiners train rotating residents in forensic pathology by the socratic method at the autopsy table. Forensic topics (i.e., cause and manner of death, traumatic wounds, toxicology, forensic histopathol-ogy, neuropathology, trace evidence and evaluation of vitreous) are discussed as they pertain to cases.

Typically, a resident will be involved in 20+ cases during his/her rotation. The resident is expected to complete a written (but for legal reasons informal) report for each autopsy in which he/she participates. These reports which include a clinical summary, gross descrip-tion, diagnoses, and manner of death are transcribed and filed in the autopsy office at BWH. Documented autopsies may satisfy a portion of the autopsy requirements for Board certifica-tion (up to the allowed limit of 25 forensic cases).

Residents may be assigned topics to review and research. There are also references on medical forensics available during the rotation. The resident may also be involved in preparation of an unusual case for journal publication. An extended and augmented rotation is available, allowing increased autopsy participation and opportunities to become familiar with the broader range of responsibilities and technological tools of the forensic pathologist (e.g., crime scene investigation, Scanning Electron Microscopy (SEM)/Energy Dispensive X-ray Analysis (EDA-X).

In addition to the exclusive rotation, a series of lectures is presented at the Brigham and Women's Hospital twice yearly by the staff of the New York Office of the Chief Medical Examiner comprising the following: 1) Introduction: Role of the Medical Examiner's Office, Cause and Manner of Death; 2) Post-Mortem Changes; 3) Asphyxia, Drowning, Electrical/Thermal Injuries; 4) Motor Vehicle Accidents; 5) Neuropathology of Trauma; 6) Substance Abuse, Alcohol, Toxicology; 7) Gunshot Wounds; 8) Sharp/Blunt and Patterned Injuries; 9) Pediatric Forensic Pathology: Child Abuse, SIDS; 10) Death Certification.