Coroners and medical examiners both deal with death, and the two titles are often used interchangeably as a result. This usage is technically incorrect, since the job descriptions are actually very different. The qualifications for becoming a medical examiner are radically more strenuous than those for becoming a coroner, and the two go about their jobs in very different ways.

A medical examiner is a licensed physician who specializes in forensic pathology. When a death merits an autopsy, a medical examiner performs the autopsy and records the findings. Although medical examiners form an important part of a law enforcement team, they do not necessarily decide the course of an investigation or prosecution of a suspect. Because a medical examiner's job is based on professional skill, he or she is an appointed official.

This profession dates back to the early 1900s, when urban areas began to recognize the need for full time, qualified physicians to determine cause of death. In order to become a medical examiner, someone must go through the process of medical school, becoming a doctor and completing a residency in forensic pathology. Once the physician successfully qualifies as a doctor, he or she can apply for positions as a medical examiner. Since a medical examiner's office may employ multiple physicians, it is not uncommon to see several doctors working together under the supervision of a chief medical examiner.

A coroner is an elected official. In order to become a coroner, someone must typically be a resident of the region in which he or she works, and the candidate must also be of voting age. In some areas, the offices of sheriff and coroner are bundled, to conserve community resources. Coroners collect decedents and lead investigations into cause of death, contracting physicians to perform the actual medical examination. In a way, a coroner advocates for the dead, ensuring that the case is handled respectfully and efficiently.

The coroner system dates back several centuries. In England, the coroner confirmed deaths of citizens in his jurisdiction, and collected the Crown's share of the estate. If necessary, a coroner might lead an inquest to determine the cause of death, and to identify suspects if someone was murdered. Originally, a coroner was known as a “crowner,” a reference to his primary function, serving the crown. Coroners are responsible for collecting and identifying bodies, completing death certificates, and working with the survivors of the deceased. They may also be physicians, especially in rural areas with minimal resources, but medical experience is not required.