Coroner vs. Medical Examiner: What’s the Difference?
- Breanna Cypers
- Aug 1
- 3 min read
It’s common for the public—and even professionals outside of pathology—to use the terms coroner and medical examiner interchangeably. However, these roles are not the same, and your hospital may interact with both depending on your location and jurisdiction.
What Is a Coroner?
A coroner is a public official responsible for investigating certain types of deaths, but the role does not always require a medical degree. In fact, coroners can come from a wide variety of professional backgrounds, including law enforcement, politics, hospital administration, or medicine.
The coroner system has historical roots dating back to 12th-century England, where coroners were appointed by the king to investigate deaths and protect royal interests. The first American coroner, Thomas Baldrid, served in St. Mary’s, Maryland, in 1637. The position evolved into an elected office in some jurisdictions.¹
One notable strength of the coroner system is that it allows the coroner to operate with independent authority, often holding equal status with other elected officials. This can make coroners powerful advocates for resources, especially when competing for public funding.²
While coroners are not required to be physicians, many states mandate formal training in death investigation, ensuring coroners are equipped to handle the complexities of the role.³
What Is a Medical Examiner?
In contrast, a medical examiner is a licensed, board-certified physician, typically a forensic pathologist. A forensic pathologist is trained to investigate sudden, unexpected, suspicious, or unnatural deaths and performs autopsies to determine the cause and manner of death. They must complete medical school, a residency in pathology, and a forensic pathology fellowship, followed by board certification in both anatomic and/or clinical pathology and forensic pathology. Their work also involves providing expert testimony in legal proceedings and collaborating closely with law enforcement and public health officials.⁴
Who Performs Autopsies—Coroners or Medical Examiners?
Approximately 20% of deaths in the US each year are investigated by either a medical examiner or a coroner. Both coroners and medical examiners can authorize autopsies. The autopsy examination is typically performed by a forensic pathologist or a general pathologist, depending on the state or county where the death occurred.
As of 2018, 23 states including the District of Columbia and Puerto Rico, were medical examiner systems, while 13 states were coroner systems, and the remaining 14 states were a mixed medical examiner and coroner system.6
Conclusion
Understanding the difference between a coroner and medical examiner is crucial for hospitals, especially when navigating the death certification process, coordinating autopsies, or responding to family inquiries. Regardless of the title, both coroners and medical examiners play vital roles in ensuring that deaths are properly investigated and documented.
Citations:
1. Washington County, NY. (n.d.). History of the coroner system. Washington County Government. Retrieved June 24, 2025, from https://www.washingtoncountyny.gov/1208/History-of-the-Coroner-System#:~:text=The%20king%20appointed%20a%20coroner,to%20the%20colonies%20from%20England
2. Institute of Medicine (US) Committee for the Workshop on the Medicolegal Death Investigation System. (2003). Medicolegal death investigation system: Workshop summary (Chapter 6, Comparing medical examiner and coroner systems). National Academies Press. https://www.ncbi.nlm.nih.gov/books/NBK221913/
3. Centers for Disease Control and Prevention. (2021, August 4). Coroner/medical examiner laws, by state. U.S. Department of Health and Human Services. https://www.cdc.gov/phlp/php/coroner/index.html
4. College of American Pathologists. (n.d.). What you need to know about forensic pathology. Retrieved June 24, 2025, from https://www.cap.org/member-resources/articles/what-you-need-to-know-about-forensic-pathology
5. Johns Hopkins Medicine. (n.d.). Autopsy. Retrieved June 24, 2025, from https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/autopsy
6. Brooks, C. (2021, November). Medical Examiner and Coroner Offices, 2018 (NCJ 302051). Bureau of Justice Statistics, U.S. Department of Justice. Retrieved July 28, 2025, from https://bjs.ojp.gov/content/pub/pdf/meco18.pdf