KIM A. COLLINS, M.D., Medical University of South Carolina, Charleston, SC and
S. ERIN PRESNELL, M.D., Medical University of South Carolina, Charleston, SC
The practice of forensic medicine is not limited to pathologists working in full-time medical examiners offices. Many medicolegal autopsies are being performed by "non-forensic" pathologists in private practice working on a contractual basis with the local coroner. Most residency training programs include 2 weeks to 3 months of forensic pathology training; this experience is inadequate to avoid the pitfalls of medicolegal diagnostics.
In most branches of medicine and pathology, the art of differential diagnosis is stressed. The approach to a problematic traumatic lesion should be similar to that employed on a melanocytic neoplasm or a focus of atypical glands on a prostatic core biopsy. When examining a body with a stellate wound on the back of the head, correlation of the circumstances, scene findings, gross features, and other characteristics may allow the forensic pathologist to discriminate between a hard contact entrance gunshot wound, a blow-out exit gunshot wound, a chop injury, or a blunt force impact site. If the pathologist does not consider all possible mechanisms of injury when investigating a wound, an erroneous diagnosis may be rendered and a miscarriage of justice may ensue.
This course is designed to assist the non-forensic-trained service pathologist in discriminating between problematic traumatic lesions and their mimickers. Differential diagnosis in forensic medicine will be generated through the discussion of unknown cases provided on transparencies to the participants prior to the seminar. Senior level residents preparing for Board examinations or interested in a career in forensic pathology will also find this course beneficial. A detailed syllabus discussing the cases will be distributed at the seminar.