EM Resident interested in tox fellowship

[FilibertoWarfield]

I'm an EM PGY-2 and I've become more interested in med tox. Fortunately there's a fellowship program here and I have good access to the faculty and I've gotten to do a tox rotation.

I've read through most of the relevant threads here and I wanted to ask a slew of questions to get a view from outside my program. I'm planning on meeting with the fellowship director soon as well. I've tried looking through websites for various programs but they're relatively sparse.

1. What's the breakdown on where most people end up after fellowship? Academic tox doing shifts at an academic ED? Community shop and working with regional poison center? Industry, consulting, etc? How do you split your time between tox and ED (or whatever your primary specialty is?) Does anyone do 100% tox?

2. What's life like as a fellow? How much time are you doing in the ED as required shifts? Moonlighting? What's a typical day like? How much call?

3. What's reimbursement like for tox duties? I'm guessing that overall salary would be less than straight ED.

4. Anecdotally I hear the boards are a beast with one of the lowest first time pass rates. Is this a big deal?

5. Can grads of 3 year EM programs do fellowship at places with 4 year EM programs? It seems they'd want you to moonlight elsewhere rather than supervising residents who are also PGY-4.

6. How limited will I be in location after fellowship? I'm not necessarily a big city type of person and I'd like to end up somewhere west of the Rockies.

7. How are the hours as an attending? Typical tox call schedule? Typical number of ED hours per month?

8. I know there are only about 30 programs, how competitive is it? What makes a strong applicant?

9. What would your advice be to someone considering a tox fellowship?

Thanks in advance!

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[Daiphon]

Hey FW -

Cool to hear you have the bug, and the experiences & opportunity to explore it as a viable career option.

I'm pretty sure BADMD or I have answered most of these questions in some fashion, so take a look through here... namely 1-4, & 7-9.

5) depends on the program. I trained with Toxikon in Chicago, which is split betwixt UIC (3 years) and Stroger (4 years)... Stroger won't let grads of 3 year programs supervise for the exact reason you mention: same PGY.

6) Again, depends. You'll be EM trained, so you can really go anywhere; it becomes a function of how much tox you want to do (and your boss will let you do). West coast is traditionally tight for EM peeps, but having tox can get you into places as a "strategic hire," especially academically or potentially with Kaiser.

That said, bigger cities tend to have bigger hospitals with bigger budgets that can support your toxicology practice...

Cheers!
-d

 

[FilibertoWarfield]

Thanks for the reply. I dug through a few more discussions and found some answers to my other questions. I suppose I was just hoping for a variety of opinions but I guess this board isn't super active.