Medical Toxicology Fellowship

Armed Forces Institute of Pathology (AFIP)

During the 2-month rotation at USU, fellows will spend 5 mornings over one week attending a course at the Armed Forces Institute of Pathology Forensic Toxicology Division, focusing on forensic toxicology.  The focus of this curriculum will include forensic instrument review, case reviews, and certification and drug testing issues.

Training Program

1.  Introduction to AFIP Forensic Toxicology:

• Overview slide presentation of testing operations
• Tour of the laboratory
• Examples of documentation reporting for various case types.

2.  Instrumentation Review:

• Theory and Use of GC/MS, LC/MS, GC/MS/MS and LC/MS/MS
• Use of Ion traps etc
• Selection of column types
• Selection of solid phase extraction cartridges

3.  Instrumentation Review:

• Immunoscreen Theory
  • RIA,  ELISA, KIMS, FPIA, EMIT

4.  ABFT Certification Issues

• Methods Validation
• QC/QA

5.  Selected Case Review of Volatiles:

• Ethanol Intoxication
• Huffing
• Post-mortem putrefaction
• Discussion of Selected Court Cases
  • Widmark extrapolation

6.  Selected Case Review of Cocaine and BZE

• Relationship of cocaine and BZE urine extraction
• Passive Exposure Issues
• Unknown Ingestion issues
• Methylecgonine, para-hydroxybenzoylecgonine and meta-hydroxybenzoyecgonine

7.  Selected Case Review of parent THC and THC acid.

8.  Selected Case Review of Opiates

• Heroin and 6-AM
• Codeine, morphine
• Oxycodone/oxymorphone

9.  Selected Case Review of Benzodiazepines

• Metabolic pathways of common benzodiazepines

10. Selected Case Review on Amphetamines, Methamphetamines, Designer Drugs

• Isomeric Analysis and Methoxy compound analysis.

11. Specialty Drug Testing:

• Considerations in development of specialty testing.