In the state of Wisconsin, each county individually chooses between one of two death investigation systems: a Coroner system or a Medical Examiner system. A Coroner system is supervised by a 'Coroner' who is elected. Coroners in the state of Wisconsin are not required to be physicians. A Medical Examiner system is one in which the office is supervised by a 'Medical Examiner,' who is a county official appointed by the County Executive and/or the County Board of Supervisors. In the state of Wisconsin, the Medical Examiner is not required to be a physician. Both systems have the same authority under Wisconsin state statute.
Waukesha County operates as a “Medical Examiner system” and requires that the Medical Examiner be a licensed physician who is a board certified forensic pathologist. Forensic pathology is a medical subspecialty; certification is achieved by examination following training (residency) in pathology (5 years) and additional training (fellowship) in forensic pathology (1 year).
An important goal of the death investigation system is to determine the cause and manner of death. The cause of death is any injury or disease that alters one's physiology sufficiently to result in death - for example, gunshot wound, coronary heart disease, or cancer. The manner of death explains how the cause came about, and may be categorized as natural, accident, suicide, or homicide, or in some cases, "undetermined." Typically the cause of death is determined via autopsy, while the manner of death is based on investigation.