Good Tox fellowships

What makes good tox training varies by individual. Some prefer a heavy inpatient component, while others just want to read and discuss things.

Some great ones on the east coast:

- NYU/Bellevue/NYC Poison Control: no inpatient duties, mainly discussing call-ins with the attending the morning after your call, discussing cases with residents, attending lectures

- Emory/Grady Memorial/Georgia Poison Control: heavy consult service, lectures, discussing cases with residents

- George Washington/Capitol Poison Control: heavy consult service, lectures

I've heard that Arizona has a great program. Denver General/Rocky Mountain Poison Control is also a top program. Can't comment on how they are structured though since I haven't looked into any tox programs out west.

UIC/Cook County (Toxikon): very few inpatient duties (only Cook County patients where a formal tox consult is ordered), mainly discussing call-ins with the attending the morning after your call, discussing cases with residents, attending lectures. Has the advantage of a loose affiliation with all (I believe) of the Chicago EM residency programs (Christ may be the exception). Long history too!

- H

Christ has two Toxikon-trained toxicologists who maintain a close connection to the consortium. One of them even covers attending tox call for Toxikon on occasion. There are also Toxikon grads at Northwestern, U of C (as of this year), County and UIC.

I think one of Toxikon's greatest assets is excellent training in not just the "acute overdose/EM" side of toxicology, but also the occupational and environmental side of toxicology. Now you may be thinking (or not)--"yuck, boring, why would that be a plus?" Well, there is no point doing a two year fellowship if you can't pass the certification boards at the end. And for the most part, industrial and environmental toxicology are the areas that graduating fellows struggle with, and those areas are ALL OVER the certifying boards. Toxikon operates alongside the department of occupational medicine and there are a number of brilliant faculty with extensive background in industrial and envornmental toxicology who will teach you everything. That's why the fellowship program has an outstanding record for board certification. Also, I'll let you in on a little secret...any money I've made doing toxicology so far has been in the areas of industrial and environmental tox. The inpatient "acute overdose" consultations, while exciting, interesting, and far more common on a day to day basis, often end up being work "for the greater good," because most of these patients don't end up financially compensating you for your efforts. Anyway, I can go on, but you may not be interested in the Midwest. If you are and want more info feel free to IM me. One las thing--Toxikon has trained more toxicologists in the US than any other program. Long history, great respect, and a fantastic network.

FoughtFyr said:

UIC/Cook County (Toxikon): very few inpatient duties (only Cook County patients where a formal tox consult is ordered), mainly discussing call-ins with the attending the morning after your call, discussing cases with residents, attending lectures. Has the advantage of a loose affiliation with all (I believe) of the Chicago EM residency programs (Christ may be the exception). Long history too!

- H

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I'm not sure what the specfics of the relationship are, but a lot of the residents here at Christ do rotations at Toxikon. I rotated there as an MS IV and I enjoyed it. The people there are very personable, and the daily conferences were always enriching. I'll probably rotate there again as a resident, as I'm considering a tox fellowship. The only thing that would dissuade me would be a desire to rotate elsewhere before applying so that I could see the way somewhere else runs.