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MEDICAL TOXICOLOGY FELLOWSHIP
Medical Toxicology is a medical
subspecialty focusing on the diagnosis,
management and prevention of poisoning/toxicity and
other adverse health
effects due to medications, chemicals, occupational and environmental
toxins, and biological
hazards. Medical Toxicology is
officially
recognized
as a medical
subspecialty by the American Board
of Medical
Specialties (ABMS).
--- American College of Medical Toxicology.

The George
Washington University Medical Center Department of Emergency medicine,
in conjunction with the National Capital Poison Center, offers a
two-year fellowship in medical toxicology. This Fellowship was approved
by the
Accreditation Council for Graduate Medical Education (ACGME) in
September 2005.
The
training opportunity is:
-
Multi-institutional: Partners are The George Washington University,
the National Capital Poison Center, Children’s National Medical Center, and
the Uniformed Services University of the Health Sciences;
-
Multi-disciplinary: The primary training site is the National Capital
Poison Center, which is staffed by physicians, nurses, and pharmacists and
trains students and practitioners of those disciplines, as well as physician
assistants, and pre-hospital personnel;
-
Multi-cultural: Individuals from more than 150 countries live in or
visit – and seek health care in – the Washington, DC metropolitan area. In
addition, the National Capital Poison Center provides services to United
States diplomatic and military personnel overseas.
-
Multi-faceted: In addition to the additional training opportunities
afforded by partners (e.g. public health, health law, forensics), fellows
can avail themselves of public, private, and government-sponsored activities
and facilities to further their education and interests, ranging from
participation in public policy development to on-site research.
This
fellowship will provide closely integrated clinical and didactic instruction and
experience. Guided by the fellowship director and with the assistance of
specialty faculty, fellows will progress to competent independent practice, with
a goal of achieving board certification in Medical Toxicology and enhancing a
life-long practice of medicine.
Goals:
1. To maximize the care
provided to possibly poisoned patients by:
-
Providing
fellows with in-depth, well-rounded clinical skills and academic
background in medical toxicology;
-
Fostering
research skills and interests that will improve future patient care.
2. To provide career
development opportunities by exposing fellows to:
·
A variety
of clinical sites;
·
Multiple
venues for specialized research;
·
Opportunities for teaching; and
·
A range of
academic training opportunities.
Objectives:
At the conclusion of the two-year fellowship, participants will be able to:
-
Assess and manage
patients with acute poisoning from a variety of sources.
-
Assess and manage
patients with sub-acute/chronic exposures to toxic substances from a
variety of sources.
-
Assess the potential
contribution of workplace and environmental poison exposures to the
health of patients with physical complaints or documented illness.
-
Select and apply
relevant principles of pharmacology and toxicology to the management of
poisoned patients.
-
Select and interpret
relevant assays and laboratory testing procedures when evaluating
patients, potential research questions, and forensic studies.
-
Identify poison
prevention strategies relevant to common poison exposure scenarios in
the home, workplace and environment as well as iatrogenic exposures.
-
Incorporate
epidemiologic data into research questions, protocol development, and
poison prevention strategies.
-
Complete a research
project, including: selection of a research problem; selection of the
appropriate methodology; development and execution of a research plan;
data analysis; presentation of findings; and possible preparation of a
scientific manuscript.
-
Develop and present
educational programs with objectives and content which are
scientifically accurate and take into account the audience and learning
environment.
-
Participate in
poison center operations with knowledge of administrative functions,
essential elements of budgeting, staffing requirements, certification
standards, computerized documentation of patient records, and legal
elements of record keeping.
-
Participate in
agency and community disaster planning for toxic agent release as a
result of industrial accidents, hazardous materials events and chemical
and biological warfare events.
-
Through exposure to
patients and health care professionals of many backgrounds, consider the
importance of culture, language, available resources and infrastructure
when planning approaches to patient care, patient education and
education of other health care workers.
Curriculum
Our 2
year curriculum seeks to foster the basis for a complete understanding of
the many facets of toxicology, so that the fellow will be able
to find the niche that is most suited to their future practice in medicine.
The curriculum is a blend of conference-style
didactic learning, course work, hands-on bedside (ICU, ED, floor patients)
and clinic (Adult, Pediatric) consultations, poison center based phone
consultations, and research. Specific areas addressed by our curriculum
include:
-
The
clinical manifestations, differential diagnosis and management of various
poisoning.
-
The
pharmacology, pharmacokinetics, potential teratogenesis, and toxic effects
of various therapeutic drugs.
-
The
biochemistry, metabolism, mechanisms of acute and chronic injury and
carcinogensis of various compounds.
-
Research
skills include experimental design, statistical analysis, and the principles
of epidemiologic study as well as skills to critically read, reviewing and
interpret the scientific literature.
-
Interpretation and methodology of analytical toxicology laboratory results
and techniques.
-
Occupational toxicology, including acute and chronic exposure in the
workplace.
-
Poisoning
prevention and the role of regulation and legislation as effective tools to
promote this, particularly in the workplace.
-
Environmental toxicology including the basic principles of mass incidents
including logistics of resource management and decontamination.
-
The role
of poison control centers as well as their financing and management.
-
Educational skills particularly oral, visual, and written communication.
Diversity of experience
is obtained by rotations and involvement at diverse clinical sites; GWUMC,
Children's National Medical Cener,
National Capital Poison Center (NCPC),
Uniformed Services of the Health Sciences (USU),
and
District of Columbia Medical Examiner. There will be ample opportunity
for the fellow to expand their exposure into areas of specific interest
including; public health, health policy, HAZMAT.
Fellows will spend 9
months the first year and 10 months the second year at the NCPC. They will
spend 2 months each year at USUHS and one month during the first year at
GWUMC. They will participate in Occupation and Environmental Clinic for 6
months of each year. See the
sample rotation
schedule.
The
curriculum will follow the
“Core Content for Medical Toxicology”, published in February 2004 (Wax,
Ford, Bond et. al. The core content of medical toxicology. Ann Emerg Med
2004;43:209-214; (http://www.annemergmed.com/article/PIIS0196064403009429/fulltext)
Fellows may use
coursework in the School of Public Health completed during the Fellowship towards a
Masters in Public Health or in the Graduate Certificate Program in
Environmental and Occupational Health.
Application Procedure
Complete
an application form and email along with a copy of your CV to
cat@poison.org.
Download application in MS Word by
RIGHT clicking on this link and then "save target as".
Fellow Benefits
The Fellows’ salary is set at their PGY level.
A
detailed description of benefits can be found at:
http://financeoffice.gwu.edu/taxpayrollbenefits/benefits/residents.html
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