Toxicology Education

Education is one of the foremost responsibilities of the Division of Medical Toxicology. Rounds include daily didactics which includes lectures by medical toxicology fellows and attendings. Each week, there is a formal didactic session where key concepts in toxicology are reviewed. Content includes acute care toxicology, critical care, and occupational and environmental toxicology. Both recent articles as well as classic articles are reviewed at journal club. The occupational curriculum is delivered by the former head of occupational medicine at BarnesCare. Frequent contributors to weekly didactics include the St. Louis University toxicology service led by Dr. Tony Scalzo; Sarah Riley PhD, the Director of the Forensic Toxicology Laboratory at SLU; toxicologists from Bayer, and staff from the Missouri Poison Center.  There are also regular ‘field trips’ including to the Missouri Botanical Garden and the St. Louis Zoo’s Herpetarium.


Clinical Services:

Bedside teaching is critical to the understanding of the pathophysiology of toxicology.  The Toxicology service provides bedside consultations for all toxicological emergencies at both Barnes Jewish Hospital and Saint Louis Children’s Hospital. Last year, we saw approximately 900 beside consults. Consults are initially evaluated by either a fellow or rotator and then staffed in real-time with one of the medical toxicology attendings. Fellows evaluate patients in the emergency department, ICU, and medical wards. In addition, we have an active weekly clinic. The clinic is run by the Fellows who staff patients with the attendings. The attendings staff a teletocicology service at Missouri Baptist. Fellows also work at the Missouri Poison Center. Additionally, as long as they are in good standing, fellows are allowed to moonlight.

Research:

The Division is very active in research and scholarly activities. Dr. Mullins is an associate editor for Clinical Toxicology. He is also the editor-in-chief for Toxicology Communications. Dr. Baumgartner is on the editorial board for Clinical Toxicology. Dr. Schwarz serves as an associate editor for Internal and Emergency Medicine and is on the editorial board for Missouri Medicine. In addition to regularly producing textbook chapters including in the Washington Manual and CorePendium (an online emergency medicine textbook by EM:RAP), abstracts for national and regional meetings, and other manuscripts, the faculty are involved with clinical research. This includes being investigators in 3 SAMHSA grants and part of the ED-Innovation study out of Yale. Dr. Schwarz and Dr. Liss are also research physicians for the Emergency Care Research Core.

The Division also actively participates in the ACMT ToxIC registry. This is the only nationwide registry of patients evaluated by medical toxicologists. We regularly review the data for abstracts and previously won best platform at ACMT’s Annual Scientific Meeting for our abstract regarding physostigmine utilization using the ToxIC registry. We are part of the Fentalog study as well as the COVID FACT study.

The Fellowship:

We accept up to two fellows each year and participate in the toxicology NRMP match in November. Interviews begin in August but can occur earlier if need be. We accept applicants from emergency medicine, internal medicine and pediatrics. One of our former fellows was trained in occupational medicine. We require a CV, personal statement, and 3 letters of recommendation including one from your program director to apply. Please contact Dr. Schwarz if you are interested in applying. We are now using ERAS to manage the application process.

Additional information about the application process and interview cycle can be found here.

Interested applicants should contact:

Evan S Schwarz, MD

Division Chief, Medical Toxicology; Associate Professor, Emergency Medicine

Andrea Ramirez

Program Coordinator