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The medical examiner is an official who is responsible for investigating the cause of a death and overseeing the death certification process. A medical examiner is usually trained in pathology. In the United States they may perform post-mortem examinations, and in some jurisdictions have the power to initiate inquests. In England and Wales, the medical examiner is mostly responsible for scrutinising the cause of a death where an inquest is not held by a coroner.
In England and Wales (and formerly in Scotland) coroners are judicial officers who have held a number of responsibilities since their inception, but today they are mostly responsible for holding inquests where the cause of a death may not be clear or suspicious. This system was adopted throughout the British Empire, including in the United States. In most of these countries, including parts of the United States, the coroner has retained this role, however parts of the United States may also have a medical examiner, which evolved from coroners during the latter half of the 19th century. The exact responsibilities of a medical examiner varies across jurisdictions, with over 2,000 separate jurisdictions for investigating unnatural deaths.
History
United Kingdom
Medical examiners in England and Wales have been used to investigate deaths that are not investigated by a coroner since September 2024, and a national medical examiner has been appointed since December 2025.
United States
In the United States, as the coroner is not necessarily a medical doctor, they may be a lawyer or a layperson. In the 19th century, the public became dissatisfied with lay coroners and demanded that the coroner be replaced by a physician. In 1918, New York City introduced the office of the Chief Medical Examiner and appointed physicians experienced in the field of pathology. In 1959, the medical subspecialty of forensic pathology was formally certified.
United States
In 2002, 22 states had a medical examiner system, 11 states had a coroner system, and 18 states had a mixed system. Since the 1940s, the medical examiner system has gradually replaced the coroner system and serves about 48% of the US population. The requirements to hold office vary widely between jurisdictions. The largest medical examiner's office in the United States is located in Baltimore, Maryland.
The types of death reportable to medical examiners are determined by federal, state, or local laws. Commonly, these include violent, suspicious, sudden, and unexpected deaths, death when no physician or practitioner was present or treating the decedent, inmates in public institutions, those in custody of law enforcement, deaths during or immediately following therapeutic or diagnostic procedures or deaths due to neglect.
A medical examiner's duties vary by location, but typically include:
- investigating human organs like the stomach, liver, and brain
- determining cause of death
- examining the condition of the body
- identifying unknown dead
- performing other functions depending on local law.
In some jurisdictions, a coroner performs these and other duties. It is common for a medical examiner to visit crime scenes or to testify in court.
Pilot studies in Sheffield and seven other areas, which involved medical examiners looking at more than 27,000 deaths since 2008, found 25% of hospital death certificates were inaccurate and 20% of causes of death were wrong. Suzy Lishman, president of the Royal College of Pathologists, said it was crucial there was "independent scrutiny of causes of death".
United States
Qualifications for medical examiners in the US vary from jurisdiction to jurisdiction. In Wisconsin, for example, some counties do not require individuals to have any special educational or medical training to hold this office. In most jurisdictions, a medical examiner is required to have a medical degree, although in many there is no requirement for specialized training in pathology. Other jurisdictions have stricter requirements, including additional education in pathology, law, and forensic pathology. Medical examiners are typically appointed officers.
Education
In the United States, medical examiners require extensive training in order to become experts in their field. A medical degree (MD or DO) is often required to become a medical examiner.
Career
The general job outlook for medical examiners in the United States is considered to be excellent.
See also
- Coroner
- List of fictional medical examiners
References
Further reading
- See also the links at the bottom of the linked article.