Poison Control/Medical Toxicology Rotation

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Hi all,

I'll have a rotation this fall at the regional poison control center. I just wonder if anyone has done a rotation like this before. Can you please share what a typical day will be like?

I have limited knowledge on Toxicology during pharmacy school. Our school has an elective, but I didn't take it because I heard it was very poorly taught, so what kind of references or books I now might need to review before the start of rotation?

In terms of getting clinical experience for residency, how helpful is this rotation? I actually have a ER Medicine rotation right afterwards, so I think having a Poison Control/Med Tox rotation before might help, but I'm not very sure how everything works out. By the way, my preceptor is a MD certified in ER Med and Medical Tox Specialist. Not a Pharm D at all, so will he be a good one to ask for general PGY1 residency's LOR?

Thanks!

I did a tox rotation as a student and three as a PGY-2 resident - so I've seen 2 poison centers.

The rotations varied - the one I did as a student required me to actually man phones in the poison center (obviously with supervision and assistance and I was responsible for more duties as the rotation went on) and saw patients admitted to the teaching hospital next door - the rotation I did as a resident was with a large tox consult service so it was more "Monday morning Quarter Backing" as far as discussing cases from the previous day.

Both rotations had a large teaching component, with an hour or so of didactic teaching daily. Student rotation required writing a paper and developing a protocol for the poison center to treat the subject of the paper while the resident rotation required a 15-20 minute presentation to the other rotators (primarily EM medical residents and the tox fellows)

If your school has Access Pharmacy you can get Goldfrank's Toxicologic Emergencies - my favorite tox text book. Some people like the Lange or Paloucek/Leiken handbooks.

I would review the bread and butter - APAP and ASA. Have a familiarity with the high dose insulin and glucagon for CV meds, but I hope in the rotation you will discuss the mechanisms at length.

Poison control was my favorite rotation by far, you will learn many strange and interesting things (mostly about people, but medicine too). Most of our time was spent reviewing cases and picking ones we wanted to present daily. I am not sure if they will allow you to take calls, we were not allowed due to liability issues, but we could listen in.

I really loved presenting cases and tried to find ones that went beyond the typical ASA/APAP overdose. I presented a case of ergot poisoning and had a great time exploring its history, also did dihydrogen monoxide, snake venom and various other things. My favorite story was when a guy called in frantic because his ferret had gotten into his nonoxynol-9. You will learn cool stuff like if you drink gasoline it is fairly harmless, however if you aspirate it, a tiny drop can be lethal.

During the end of the rotation I had to sit at a poison control center information kiosk where they handed out stickers and pamphlets about the services provided. I hope you have a good time, for me it allowed ti chance to see a side of drug therapy that was completely foreign, and I still talk to my friends there to this day.

Originally Posted by Dr Wario

also did dihydrogen monoxide.

Water poisoning?

Originally Posted by bacillus1

Water poisoning?

Yup, and yes it is a real medical condition, but that is not quite how I presented it.

Originally Posted by all4rx

In terms of getting clinical experience for residency, how helpful is this rotation? I actually have a ER Medicine rotation right afterwards, so I think having a Poison Control/Med Tox rotation before might help, but I'm not very sure how everything works out. By the way, my preceptor is a MD certified in ER Med and Medical Tox Specialist. Not a Pharm D at all, so will he be a good one to ask for general PGY1 residency's LOR?

Thanks!

It will teach you to think differently and develop some critical thinking skills. See how the rotation goes and if you know the residencies you are applying to maybe you can ask how they feel about letters from non-pharmacists.

Are there any pharmacists at that rotation even if they aren't your direct preceptor? As an ER pharmacist I know that we work very closely with our physicians and would not be opposed to receiving LORs from physicians for a candidate.

Thanks for all the replies! Very useful! And yes, I don't think any PGY1 programs I intend to apply mind about a LOR from physician. As long as LORs are written by healthcare professionals, they're fine. I'm just a bit worried if my preceptor MD is familar with the term of PGY1 and pharmacy residency like almost every Pharm D would ... And I just want to make sure if a rotation like this is considered "clinical" at all, as I always think that clinical rotations are like acute care, ID, cardio, onco, etc.

What you guys described the job seem very interesting to me. Has anyone thought about the job market for pharmacists in this field? I'm sick of retail, and I'm definitely thinking about clinical residency. But something like toxicology/poison control is really new to me. To be honest, I didn't put this down in my "wish-list" for rotations. For some reasons, the director for rotations at my school messed up and got me this. I was mad at first, but now thinking it may be a good twist for me ... who knows?

obviously I'm biased.

Traditionally the major market for those with tox fellowships was poison control stuff. However, with all of the funding decreases these positions are getting harder to find and maintain. A strong tox background can only help you as an EM pharmacist though. Same in the MICU.