Forensic pathology remains stigmatized by clinical professionals and the wider public. A recent review in The American Journal of Forensic Medicine and Pathology explored this issue and how social media use could improve the overall view and workforce shortage in forensics. Here, Casey P. Schukow connects with some of the minds behind this initiative, alongside forensic pathologists at different stages of their careers, to discuss the advantages, challenges, and best practices for a social media/forensic pathology synergy.
What are the most significant benefits of using social media in forensic pathology?
Erik Handberg: Social media allows a broad audience to hear different opinions on the role of forensic pathology in public health, medicine, and the justice system. Rather than hear the same descriptions from the same people on the same television shows, they can find someone who explains things in a way that speaks to them personally. In short, we can offer our expertise to a broad group of people that may have otherwise not been reached.
Patrick Hansma: The reach of social media is enormous. Some posts get millions of views – far more than even the most groundbreaking scholarly articles in journals with the highest impact factors. On social media platforms, you never know who you will reach with your content. The outcome is equally unpredictable. The hope is always that people who did not know about this career will find your content and choose forensic pathology for their career.
Omar Rayes: Social media provides a platform for forensic pathologists to share interesting cases and autopsy findings. It helps medical students and professionals learn from real-world examples of gross and microscopic pathologies. Most importantly, social media educates the public about forensic pathology and supports recruitment efforts.
Nicole Jackson: First and foremost, I view social media as a tool for workforce development. It is a free, instant, and lasting engagement with potential future doctors, pathologists, and autopsy and forensic pathologists. It’s also a space to engage with and learn from people in other medical specialties and fields related to forensic pathology, such as toxicology and anthropology.
As someone from groups underrepresented in medicine and pathology, it is also a space to find and forge connections with people with shared experiences and obstacles that I otherwise would not come across in my day-to-day life. I try to use my platform to highlight others from underrepresented groups – liking, commenting, and reposting content, particularly from other women and people in underrepresented communities who continue to be overlooked and whose voices are less likely to be amplified.
I use social media to stay up-to-date on recent trends and issues in public health, which directly relate to things we see in practice. My mailboxes, both professional and personal, are so overloaded with emails that social media has become my preferred method of staying abreast with professional organization announcements, new publications, and federal regulations.
Darin Wolfe: Forensic pathology is widely misunderstood by the public, largely due to incorrect or sensationalized depictions in popular media. A more expansive presence of forensic pathologists on social media has improved education on exactly what it is we can and cannot do. In addition, there has long been a shortage of qualified forensic pathologists, and our social media presence has introduced a younger generation of medical, college, and high school students to our careers. This may result in increased numbers of forensic pathologists in the future – a necessity in a growing population.
What do you consider the biggest challenges or drawbacks of engaging with social media as a forensic pathologist?
Handberg: All interactions can be misunderstood and statements can be used against us (or our colleagues), which means we have to be extra careful – not only when talking about our personal opinions, but when talking about the science itself. There are often differing opinions on how to practice based on region/jurisdiction, training, and experience. I don’t want something I say to be used out of context but I can almost guarantee it will happen eventually.
Hansma: Because the reach is enormous, there is always a lot of noise. The productive comments, responses, and conversations can get lost. Similarly, the recipients can overwhelm your ability to respond (my various inboxes are often flooded). There’s just one of me and a million of them. I can’t answer every question, and some people respond angrily when they feel ignored.
On the other end, I’ve also felt ignored when the algorithm doesn’t work to my advantage. A post I thought was perfect might only get a couple of views, making me wonder why I bother if no one is seeing my posts. My advice for people feeling like this is just shake it off – plan to reuse your unseen content in the future as a follow-up to a post that does get traction.
Rayes: Discussion about death and autopsy findings can attract individuals who may question the accuracy of diagnoses, spread conspiracy theories, or engage in unprofessional debates. While social media can be a valuable tool for education and public awareness, it also exposes pathologists to criticism and inappropriate remarks. Forensic pathologists should maintain professionalism while responding to unproductive, disrespectful, or sarcastic comments.
Jackson: One of the largest challenges is simply finding the time to create quality content in the face of sustained increased workloads. I would love to do more on social media but once I left training, I quickly realized how little free time I have,
Another common challenge is figuring out how to appropriately and delicately post content that is educational but not scarring or triggering to the average viewer, which could be anyone. Much of our work is incredibly graphic, and for those who are unaccustomed to seeing extensive pathology or injury, stumbling across our content could be a traumatizing experience. This is why there are certain educational topics that I avoid posting images of – particularly gross images, such as those related to non-accidental pediatric trauma. One of my workarounds has been to post more histologic images, as the average social media user has no idea what they’re looking at.
Wolfe: There’s certainly legal concerns that prevent us from discussing current and criminal cases online. Another particularly challenging issue is explaining concepts that need several years of scientific or medical education to fully understand. The nature of social media lies in quick delivery and punchy segments, which doesn’t always lend to forensic pathology.
Is there any content in particular that forensic pathologists should avoid sharing on social media to mitigate legal or ethical risks?
Hansma: This is more difficult to answer than you might think. Some are obvious (eg, HIPAA-protected information and instructions on how you think someone would commit a perfect murder.) However, some things which seem innocuous, and you are confident are within the bounds of law, venue rules, and medical ethics, can unexpectedly upset people. Even if you’re completely within your rights and privileges, others may feel you crossed boundaries you should not have, particularly if they misunderstood you, and serious headaches can ensue.
Jackson: Much of this is common sense. Adhere to all policies of your office or institution regarding social media use. For some, this means including a statement in your profile that the views of your account are your own and do not represent those of your employer. Aside from this, the most important priority is respecting the individual who has died. Avoid posting anything that could identify them or anyway bring disgrace to them. Don’t post people's faces or any identifying marks on the body.
Although it appears that some forensic pathologists – as well as some pathologists’ assistants and morticians – post very graphic images, I avoid this. If something might be graphic, post a warning. If something is incredibly rare, I will publish it as a case report and then post that publication rather than posting directly from that case.
Another priority is not to post anything that could potentially impact a case. Don’t post anything related to an active or ongoing case. One office I worked at had a rule about waiting five years, even if things were completely de-identified. I think that is wise. I know many of the images I have posted are pulled from a collection that started way back in the 2010s, and I couldn’t tell you where I was located when the image was taken.
Wolfe: Nicole raises a good point: we must be careful not to accidentally identify a decedent or patient. Despite our cases involving the dead, we must employ basic HIPAA guidelines and refrain from discussing cases that could end up in court someday. There are some cases forensic pathologists have that are one in a million and talking too specifically about such cases publicly would make them easily identifiable.
I personally will change a mundane detail (such as age or sex) of a case if that information is not relevant. I don’t speak about any “current” cases, although this definition might be different from pathologist to pathologist. If I have signed the case out and it’s most likely not going to be a legal case, then I feel it is safe to talk about.
It’s also important not to seem too gleeful when talking about an interesting or unusual case. It is common for us in pathology to say something is a “cool/awesome case,” but that often means something horrific for the actual patient. We have to temper such excitement because ultimately, somewhere, loved ones are grieving for the person that provided us with that “cool case.”
Rayes: Always seek approval from the governing body before starting any office-related social media account. Avoid posting identifiable images to protect confidentiality and privacy. Maintain transparency with legal counsel, keeping them informed about social media activities. When in doubt, consult with them to ensure compliance with ethical and legal guidelines.
Handberg: Alongside everything mentioned above, I’d also recommend avoiding textbook specifics (eg, “12 pounds of pressure would cause ___”) because there are likely differing numbers in differing sources and your words could later be used to contradict someone in a setting you aren’t aware of yet.
Can you tell us how you’ve used social media to educate students, trainees, and the general public?
Wolfe: I was one of the first forensic pathologists to start sharing information online after I started working in my own private forensic pathology practice. Day after day I saw things that I had only read about in textbooks and I felt like these examples were essential to help the general public understand the nature of the human body and disease. I started on Instagram and expanded this to YouTube, Facebook, and TikTok. These accounts have been successful in reaching millions of people. I also started a podcast to speak about pathology experience narratively.
Hansma: I have largely tried to post educational content as stand-alone topical videos or as responses to comments and other media (such as TV and movie inaccuracies). I hope that people will learn to recognize the experts in the field, and maybe want to become an expert as well. If a topical video can get someone hooked on forensics, they’re likely to see the corresponding videos I’ve created about becoming a forensic pathologist. Hopefully this knowledge could lead more people into a forensics career.
Rayes: I use my social media account to share fascinating anatomic findings in a way that the general public can understand – helping them appreciate the importance of autopsies in uncovering the cause of death and advancing medicine. At the same time, this page may spark the interest of medical students and encourage them to consider forensic pathology as a career. In essence, my social media serves as an engaging and educational atlas of forensic pathology.
Handberg: I prefer to use my platforms to engage with the general public – explaining what we do, how we do it, and why we do it is difficult, but necessary. I like to use plain language videos to introduce concepts or explain basics so that people can better engage with our field and even recognize misinformation about our field that is presented in other media.
Jackson: Initially, at least on Instagram, I was posting very simple, important-to-know microscopic findings. I initially started with the strategy of posting an image and asking for people to chime in with what they thought it was. I would then release the answer a few days later. Due to time constraints and now being in academia, this has transitioned to posting articles I have either published or have come across that are of educational value mixed with visually appealing microscopy.
Can you share a memorable or impactful experience related to your use of social media as a forensic pathologist?
Handberg: More than once I have had someone say something like, “It has been more than 10 years since my mother died and today is the first time I actually understand how that happened. I don’t know why it had to be through TikTok, but regardless I appreciate it. Thank you.” I am happy to be able to help in that way, and I know many of my colleagues are also exceptional communicators and could do the same.
Jackson: A little more than a year ago, a course director at Meharry Medical College, Nashville, Tennessee, reached out to me via social media, stating he had a small group of students interested in pathology. Since the school lacked exposure to pathology, he asked if I would be willing and able to create something for them. I was able to make a virtual forensic pathology journal club for them and get to know the group.
With the support of my department, I was also able to create our inaugural Summer Autopsy Research Fellowship and Summer Laboratory Research Fellowship, which funded two medical students to spend the summer with us engaging in research. The laboratory fellow spent the summer in Tristan Jordan’s lab working on viral resistance, while the autopsy fellow spent the summer with me conducting research related to breast cancer survival, shadowing me in autopsy, and spending time at the King County Medical Examiner’s Office in Seattle, Washington. I’m proud to report that our summer autopsy fellow went from loosely considering pathology to fully committing to becoming a forensic pathologist.
Wolfe: This is my 8th year online teaching about forensics and pathology, so I’ve had many positive experiences with patient/decedent families. I’ve lost count of the number of thank you letters and messages I’ve received referring to how I’ve helped them understand a long-misunderstood family death or that my information helped them prevent certain deaths by getting tested for a particular disease. Forensic pathologists are a forgotten asset in the world of public health; being the final doctor for many patients and by way of our procedures being the most thorough in physical disease assessment, we have the potential to change the public’s perception of disease. We pull back the curtain for both others in the medical field and the general public. As Leonardo da Vinci said, “Learning is the only thing the mind never exhausts, never fears, and never regrets.”
In what ways can social media be used to attract new talent to the field of forensic pathology, especially in light of the current workforce shortage?
Handberg: We need to reframe how we present our field online. Nothing shuts down interest in a field faster than “debunking.” Rather than simply shutting down the fanciful portrayals that sparked someone’s interest, try explaining the real (and still impressive) ways we work to achieve what they do on TV and that helps people imagine themselves in this field in the real world. Please – other professionals – stop debunking and start reinforcing how interesting, fun, and cool this job really is!
Rayes: Being active on social media increases the visibility of forensic pathology among medical students who may not be aware of this specialty. By sharing interesting cases and unique autopsy findings, we can highlight this field’s significance and make it more appealing to aspiring medical professionals.
Jackson: It is incredibly important to the future of our workforce that the next generation see us finding fulfillment in our careers. Generation Z, also known as “zoomers,” “iGeneration,” and “digital natives,” are the first generation that does not know a life without the Internet. They are accustomed to being online with easily accessible and visually stimulating information at their fingertips.
We need to leverage social media as a workforce development tool – it is free advertisement for our profession and workplaces, and there are many options depending on your personal preferences and interests. For those more inclined to write, text-based platforms like X and BlueSky are good places to start. For those who are more interested in creating video content, YouTube and TikTok are strong starting points. For those who are more into spoken word, ClubHouse and podcasts are good options. And those who like a mix of media should consider Instagram, Facebook, and LinkedIn. The benefit of all of these is that they all have options for free usage. We and the general public know what we do is interesting and important. The next generation of forensic pathologists are out there scrolling on their devices – we might as well provide content they stumble across and take an interest in.
Wolfe: One of the things that struck me when I was in residency and fellowship was how medical students would come in for a rotation – after having picked their specialty – and then regretting not picking pathology and forensic pathology. After seeing this happen several months in a row, I realized that medical students often crave these in-color and hands-on examples of human disease. For centuries before modern medicine, this is how doctors learned about disease, and true medicine cannot exist without pathologic understanding.
By expanding my experiences onto social media platforms, this has raised awareness of the field and allayed concerns about not seeing living patients. Our goal is to find truth, and with this truth, we can attain both closure and justice.
Hansma: The hope is that high school students see our content, realize there is a career path, go to college, go to medical school, match into pathology residency, match into a forensic pathology fellowship, and choose a career doing full-time forensics. Of course, this is playing the long game as it will take a decade to watch the seed planted today mature into a full-grown tree. But patience is a virtue, I’m told.
How do you manage the time and effort required to maintain an active social media presence alongside your professional responsibilities?
Jackson: My social media usage and engagement have substantially declined since 2020, both due to far less time being spent at home and due to increasing time demands from work. The nice thing about social media is, like any other new skill, once you overcome the learning curve and use becomes second nature, depending on the content you create, posts take far less time.
In addition to my private accounts for engaging with friends and family and my public professional accounts I use for professional and workforce development, I co-run accounts for multiple organizations (the National Association of Medical Examiners, the American Journal of Forensic Medicine and Pathology, and the Society of Black Pathology). I set aside time on the weekend to create posts for the week or month. Certain platforms have features where you can store posts in drafts for a future quick post or allow for timed future posts. This strategy is nice as it allows me to retain focus at work during the workweek yet maintain engagement throughout the week. For posts that might be “controversial” or elicit negative comments, I will restrict who is allowed to reply, which helps maintain positivity and thwart undue harassment.
Wolfe: Similarly to Nicole, I don’t have the time to maintain it like I used to. My workload as a pathologist has been high, and so I really don’t have time to make high-quality professional videos. Thus, my content has moved largely toward a “reactionary” mode, where I will comment on stories or true crime cases in the news. This is something that takes very little effort, compared to teaching online lectures. Editing alone takes the most time with this kind of work.
Handberg: For me, social media is purely a hobby with good intentions. The work we do takes precedence – always. But if you make things you enjoy then it is not hard to continue to make it in your free time. If you feel that it is a burden, consider refocusing your efforts in a way that feels exciting.
Rayes: I primarily manage a single social media page, posting once a week in my free time on Saturdays. It is a collaborative effort, as I work with photographers who edit the images and upload the posts. I mainly select cases and author the annotations, ensuring the content is both educational and intriguing.
Hansma: Learn from my mistakes. I have accounts on most platforms and multiple accounts on the same platforms! Some are for my forensic work, some for my author work, and some for my rare book work (which you can read about in a recent article with The Pathologist). I also contribute to the social media accounts for the National Association of Medical Examiners, which totals around 15.
I admittedly dove in head first and was quickly inundated. For a couple of years, I was extremely active with each account to the point of exhaustion – complete burnout. I eventually had to dial it way down. If you’re going to get into this, start low and slow. Any contribution you make is better than none and you should only use social media if it’s enjoyable and productive. Without these elements, the negativity will eat away at you. Once negativity clouds your experience, back away from social media and take time to reassess. Otherwise, your real priorities – pathologist day job, family life etc – will suffer.
How do you think social media has influenced public understanding and appreciation of forensic pathology?
Handberg: This is difficult to know. Responses to posts are extremely diverse. but the hope is that our collective presence shows how heterogeneous we are as pathologists. I don’t think anyone can construct a stereotype for what a forensic pathologist is after watching videos from each of us.
Jackson: Agreed, it’s difficult to assess overall influence. However, one platform that does an excellent job engaging the general public – and which I firmly believe should be better utilized by forensic pathologists – is Clubhouse. I’ve participated in a few Clubhouse rooms, some specific to forensic pathology and others on public health issues such as the COVID-19 pandemic or gun violence in the US, and it is an incredibly powerful and rewarding experience to sit on a virtual panel with other medical professionals and speak directly to questions a virtual community has about a topic you are an expert in. The feedback is instantaneous and overwhelmingly positive and appreciative.
Handberg: Our field definitely has a PR problem. I have been told innumerable times that I don’t “look like” someone who would do forensic pathology. I believe that showing we have a diversity of personalities, backgrounds, and interests will help normalize our field of medicine and hopefully provide people with a more accurate mental depiction of who we are and why we do this work.
Rayes: I believe social media is helping the public understand why our work is crucial for the descendants and their families. It can also raise awareness of trends in diseases or conditions that lead to death, thereby contributing to public health efforts.
Wolfe: I agree with Omar – social media has certainly helped the public understand the difference between medical examiner, coroner, and mortician. I get messages every week indicating someone has an interest in going into the field or that one of my posts/videos helped them quit smoking/drinking or go get a symptom checked out. In that sense, it has been rewarding to see us helping living patients with what we have learned from the dead.
What advice would you give to trainees or fellow forensic pathologists about using social media to build professional connections?
Wolfe: First and foremost, don’t try to “outdo” other pathologists by posting gruesome or graphic content for the sake of views. We should all be on the same page in that we are physicians and teachers first, and that the foray into social media isn’t for glamour or clicks. Secondly, I would advise someone just getting into the field to follow all the pathologists and forensic pathologists they can (including internationally. We can all stand to gain when we learn from each other.
Handberg: The content you make will show what you’re trying to build. Low-effort content meant to garner quick engagement makes me think, “this person could grow my following, but do I want to have followers that are engaged only superficially?” High-quality content aimed at the same goals I have makes me think, “this person could help me accomplish what I want to accomplish, and we could both gather and retain a broad audience over time.” In short, make good stuff if you want to work with good people. If you find someone that fits your mode of operation then reach out – it's a great place to develop a like-minded team.
Jackson: Social media is an excellent way to grow your professional network. An obstacle many in academia find challenging is building your recognition on national and international levels. Many of the invitations I’ve had to be a guest lecturer have come through social media. Easy ways to do this include posting your own research and professional activities, interacting with other professionals’s posts (eg, liking, commenting, and reposting), engaging in virtual journal clubs, and creating collaborative posts. Also, do not feel that you need to limit your content to strictly professional things. Some of the greatest connections have come through shared mutual interests outside of work.
Hansma: Though my goal has always been to reach future pathologists, I realized early on – and partially through mistakes – that it is a great way to reach other clinical specialties as well. Forensic pathology has, unfortunately, sequestered itself from much of the conversations in medicine. We need to engage our clinical colleagues, show them who we are, that we hear them, and that we have input to offer as well. Social media works well for that. Start following physicians of various specialties, and suddenly the pediatricians and vascular surgeons know you, as a forensic pathologist, exist, are approachable, and are knowledgeable.
Rayes: Some of my posts on social media have attracted attention from other medical professionals who have expressed appreciation for our work. These engagements foster productive discussions and strengthen connections between medical specialties.
What role do you envision social media playing in the future of forensic pathology, particularly in terms of education, recruitment, or public engagement?
Jackson: I believe social media will undergo exponentially increased use over the next decade, owing largely to the next generation entering our workforce. They’re already plugged in, making content related to forensic pathology before even undergoing a fellowship. I hope that, as a profession, we welcome rather than resist it.
Rayes: Having a social media presence will be essential for any medical specialty. In forensic pathology, it will continue to grow and become more engaging. It will also be a powerful tool for recruiting and connecting between pathologists.
Wolfe: Agreed, forensic pathologists must maintain a presence online. This is especially apparent for recruitment and expanded public education. In our current environment where public health and decades-long understanding of basic medical concepts are under attack, our place in this space is paramount.
Hansma: Social media use will certainly grow. Increasing numbers of future pathologists have already cultivated a large social media presence while they were in training. Many people today are, I’m sure, choosing their careers by finding something online they had not previously known. Forensic pathology will be no different.
Handberg: I believe social media is a mandatory part of the dissemination of information to the public. It’s critically important to clarify our importance in medicine, public health, and the justice system. Ultimately, if people know what we do and why we do it, I think the right people will gravitate toward the field.
Casey P. Schukow is Resident Pathologist at Corewell Health William Beaumont University Hospital in Royal Oak, Michigan, USA (@cpschukow on Instagram, LinkedIn, and BlueSky)
Patrick Hansma is Forensic Pathologist, Assistant Professor at Western Michigan University Homer Stryker MD School of Medicine, and Medical Examiner, Michigan, USA (@forensicpathologist on TikTok and @thegravebelow on Instagram)
Erik Handberg is Forensic Pathologist and Medical Examiner, Texas, USA (/u/ErikHandberg on Reddit)
Omar Rayes is Forensic Pathologist and Interim Deputy Chief Medical Examiner at the Wayne County Medical Examiner’s Office, Detroit, Michigan, USA (@detroitsdailydocket on Instagram)
Nicole Jackson is Autopsy and Forensic Pathologist at University of Washington Department of Laboratory Medicine and Pathology, USA (https://www.thrudeath.com/)
Darin Wolfe is Forensic Pathologist, Indiana, USA (@the_dead_letter on TikTok and Instagram, @drdarinwolfe on Substack, and Knife After Death on YouTube)
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