Resident Supervision

UTHSC Forensic Pathology Fellowship Supervision Policy

In the learning environment for forensic pathology, each decedent must have an identifiable, appropriately credentialed and privileged attending physician (or licensed independent practitioner as approved by each Review Committee) who is ultimately responsible for everything involving the decedent’s death investigation. This information should be available to fellows, faculty members, and other appropriate personnel. The program will provide the appropriate level of supervision for the fellows who evaluate the decedents. The responsibilities for each fellow and level of supervision will be based on severity and complexity of the death investigation case including autopsy, scene investigation, toxicology interpretation, available support services and fellow education and experiences.

There are three levels of supervision to ensure oversight of fellows and graded authority and responsibility:

1. Direct Supervision: the supervising physician is physically present with the fellow. With direct supervision, the supervising physician is physically within the hospital or other site and is immediately available to provide direct supervision.

2. Indirect Supervision: with indirect supervision, the supervising physician is not physically within the hospital or other site but is immediately available by means of telephonic and/or electronic modalities.

3. Oversight: the supervising physician is available to provide review of procedures/encounters with feedback provided after care is delivered.

Faculty lines of responsibility:

The privilege of progressive authority and responsibility, conditional independence, and a supervisory role delegated to each fellow is determined by the program director and faculty members. Faculty members functioning as supervising physicians should delegate portions of care to fellows, based on the complexity of the case, likelihood of court involvement and the skills of the fellows. Faculty supervision assignments should be of a sufficient duration to assess the knowledge and skills of each fellow and delegate to him/her the appropriate level of authority and responsibility.  The faculty member is ultimately responsible for the final autopsy reports, autopsy examinations, ordering and interpreting laboratory studies and consults, and scene visits of the fellow. The faculty member is required to be available for court testimony in all cases performed with the fellow.

Fellow lines of responsibility:

Fellows should serve in a supervisory role of residents or students in recognition of their progress toward independence, based on the needs of each decedent and the skills of the individual fellow.  A fellow should know the limits of his/her scope of authority, and the circumstances under which he/she is permitted to act with conditional independence. The program director and faculty will evaluate the fellow’s abilities based on specific criteria. When available, evaluation should be guided by specific national standards-based criteria.

Forensic Pathology Fellowship – Clinical Skills Chart

All supervision is provided by faculty forensic pathologists.

*Assumes the Forensic Pathology Fellow successfully completed a three-year pathology residency program and was AP only.