Medical Toxicology is an ACGME accredited fellowship. The sub-specialty is sponsored by Emergency Medicine, Pediatrics, and Preventive Medicine. Additionally, you can do a combined fellowship with either pediatric emergency medicine or addiction medicine.
Our two-year curriculum is based on the Core Content of Medical Toxicology, as well as on what we believe is necessary for toxicologists to know.
Fellows evaluate patients at Barnes-Jewish Hospital and Saint Louis Children’s Hospital in addition to spending multiple afternoons each week at the Missouri Poison Center. Fellows lead our daily teaching rounds and are in charge of our consultation service, which includes rotating residents, medical students, and pediatric emergency medicine fellows. Our fellows also work in our weekly medical toxicology and addiction medicine clinic. We evaluate patients with concerning exposures both at home and work, patients with unexplained organ dysfunction, patients with abnormal labs, and patients with substance use disorders. We recently resumed telehealth service which is used for both clinic patients as well as for consultations at other BJC-system hospitals.
The fellows work in close collaboration with the executive director and medical director of the Missouri Poison Center. At the poison center, fellows assist with reviewing the protocols and educating the specialists in poison information (SPIs). They also assist in case review and are available to take call and assist the SPIs with any challenging cases. In their downtime, the fellow can work on scholarly activity or preparing lectures for staff at the poison center.
In addition to daily didactics, every week, there is a formal didactic session. The session is attended by the toxicology faculty, SPIs from the poison center, the toxicology service from Saint Louis University School of Medicine, and occasionally toxicologists from Bayer. At this session, we review both classic journal articles and recently published articles. One week of the month is dedicated to reviewing chapters in Goldfrank’s Toxicologic Emergencies and one week is reserved for occupational toxicology. Dr. Tom Kibby, an occupational medicine physician, leads the occupational toxicology curriculum. The rotators also educate the fellows with their weekly presentations and end of rotation projects which serve to cover parts of the curriculum that are outside of the typical exposures that we evaluate and treat. We also participate in:
- ACMT National Case Conference
- ACMT Grand Rounds
- Toxicology Scholar Tracks
- Emergency Medicine Didactics including Grand Rounds and Emergency Medicine Experts
- Lectures to other groups on campus and at regional meetings
- P and T committee meetings
- Emergency Medicine Journal Club (generally lead 1 journal club a year)
- ACMT National Journal Club
We generally accept fellows who have completed an Emergency Medicine, Internal Medicine, or Pediatrics residency. We have also accepted applicants from Occupational Medicine in the past. Medical Toxicology is a two-year program and pay is competitive with starting salary being set based on PGY level. The program also pays for the fellow to attend the North American Clinical Congress of Toxicology and the American College of Medical Toxicology Annual Scientific Meeting each year. This is in addition to the fellowship allowance that they may receive. Our fellows also have a large, shared office with their own computer and space. In addition, we do place an emphasis on fellow life to make sure that they enjoy their time inside and outside of the hospital. Interested applicants should send Dr. Evan Schwarz an updated CV, three letters of recommendation (including one from their program director), and a personal statement describing why they are interested in medical toxicology.