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Reducing Forensic Pathologist Shortages: Funding

October 06, 2021

Typically operating within medical examiners’ or coroners’ offices, forensic pathologists are trained physicians who investigate deaths, perform autopsies, and determine the cause and manner of death for many scenarios, including deaths due to homicides, suicides, overdoses, work-related incidents, and infectious diseases. However, due to an aging workforce and problems recruiting and retaining these trained professionals, the United States is experiencing a severe shortage of forensic pathologists. Given the surge of opioid overdose deaths over the past decade and the increased demand for forensic pathologists, addressing this critical shortage should be a priority for state, local, and territorial health officials who rely on the mortality data they collect.

Most medical students do not consider, much less pursue, a forensic pathology career, partly because of inadequate funding to pay competitive salaries, which are lower than many other specialties and all other pathology subspecialties. Increased funding for loan repayment programs and higher forensic pathologist salaries would help the discipline compete with other specialties. This brief spotlights funding strategies, resources, and examples to help state, local, and territorial health officials identify ways to improve funding and support the forensic pathologist workforce.

Local Spotlight: Maricopa County, Arizona

In an effort to address financial disincentives associated with public sector medical practice, the Maricopa County Office of the Medical Examiner funded a loan forgiveness program for new forensic pathologists entering the field. The average medical student will graduate with close to $200,000 in loan debt. Under this program, qualifying applicants can receive $25,000 annually in loan reimbursement, up to $100,000. While novel to local-level forensic pathology, loan repayment has worked well at both the state and federal levels as a recruiting and retention tool in geographically underserved areas for other medical professions. Maricopa County framed forensic pathology as a “professionally underserved area” to justify allocating general county funds to the loan repayment program. This program is a model for what could become a new practice in medical examiners’ offices nationwide.

Federal Funding Opportunities and Resources

States and territories can seek funding, training, and technical assistance resources from the U.S. Department of Justice—particularly from the National Institutes of Justice (NIJ) and the Bureau of Justice Assistance (BJA)—and the National Institutes of Health (NIH) to train new forensic pathologists. The partial list of resources below is a starting point for exploring funding partnerships that support this work. Please note that although some Fiscal Year (FY) 2021 funding opportunities have closed, jurisdictions should monitor the links to stay up to date on future opportunities.

  • National Center on Forensics: Funded by NIJ, this opportunity provides $2 million to award recipients over three years to establish and operate a National Center on Forensics. This work will bring together practitioners from academic and professional settings to provide “medico-legal learning opportunities for medical students to train as deputy medical examiners/coroners in underserved rural areas,” among other activities. George Mason University, the FY 2020 recipient, is conducting a needs assessment to develop and deliver requested forensic science training. The anticipated FY 2021 recipient will receive $4 million over three years to start a similar program.
  • Strengthening the Medical Examiner-Coroner System Grant Program: Established in FY 2017 by NIJ and currently administered by BJA, this program offers $150,000 for ACGME-accredited fellowship programs to reduce the nationwide shortage of board-certified forensic pathologists. Up to $50,000 of this award can be used for loan repayment. However, since there are many unfilled forensic pathology fellowship positions in existing training programs, this approach is unlikely to fully succeed until fellowship programs can recruit more residents. (See the Bureau of Justice Assistance’s Medical- Examiner Coroner Program Factsheet for more information.)
  • Paul Coverdell Forensic Science Improvement Grant Program: Funded and administered by BJA, these awards include both formula and competitive grants to states and units of local governments to train forensic pathologists and accredit medicolegal death investigation systems. These funds can improve the quality of a practice environment and make the discipline of forensic pathology appear more attractive to potential candidates. (See the Coverdell Program Factsheet for more information.)
  • NIH’s Division of Loan Repayment: This program offers up to $100,000 of loan repayment to clinical researchers over a period of two years. Applicants from medical examiner or coroner offices are eligible as long as they agree to engage in NIH mission-relevant research for an average of at least 20 hours each week for at least two years and are working with human material.
  • NIH’s Loan Repayment REACH program: New in 2021, this opportunity includes specific priority statements, and the National Institute of Drug Abuse states an explicit interest in applications from forensic pathologists and medical examiners working in the field of drug overdose. While the REACH program may primarily attract individuals interested in academic forensic pathology, it could be more broadly applicable to forensic pathologists and medical examiners conducting robust surveillance for drug overdose death.

Where to Find Current Opportunities

States and territories can find more information on current funding opportunities at the links below.