Given the number of residents who expressed an interest in the field, we developed an ACGME approved fellowship that accepts 2 fellows annually. The two-year curriculum included coverage of the entire curriculum laid out in Annals of Emergency Medicine. This includes acute care, environmental, and occupational toxicology. Fellows evaluate patients at Barnes-Jewish Hospital and Saint Louis Children's Hospital in addition to spending time at the Missouri Regional Poison Control Center. They lead our daily teaching rounds and are in charge of our consultation service, which includes residents, medical students, and pediatric emergency medicine fellows. In addition to emphasizing education, a major emphasis is placed on how fellows can translate what they are learning into a future career. While working in an academic center is one option, they also develop the skills to work in research, industry, and work full-time as a toxicologist.
The fellows also work in close collaboration with the director and medical director of the Missouri Regional Poison Control Center (PCC). At the PCC, the fellow assists with reviewing the protocols and lecturing tot he 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 in their office at the PCC. This is in addition to their office at Barnes Jewish Hospital where they have access to a full toxicology library.
Every week, there is a formal didactic session. The session is attended by the toxicology faculty, SPIs from the PCC, and the toxicology service from Saint Louis University School of Medicine. At this session, we review both classic journal articles and recently published articles. One week of the month is dedicated to reviewing chapters in Goldranks and one week is reserved for occupational toxicology. Dr. Tom Kibby, an occupational physician, leads didactics that week. The rotators also educate the fellow with their weekly presentation 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. Fellows participate in or present:
- Monthly ACMT National Case Conference
- ACMT Grand Rounds
- Toxicology Scholar Track
- Emergency Medicine Didactics
- Lecture to other groups on campus and at regional meetings
- P and T committee meetings
Fellows also work in the toxicology and addiction medicine clinic. Clinic runs 2 to 3 half days a month. Fellows 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 generally accept fellows who have completed an EM, Internal Medicine, pediatrics or occupational medicine residency but all residents are welcome to apply. This is a two year program and pay is competitive as it goes beyond the standard PGY level system. 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. This is in addition to the CME money that they receive. 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 S. Schwarz an updated CV, three letters of recommendation (including one from their program director), and a personal statement describing they are interested in medical toxicology.
Interested applicants should contact: schwarze@.wustl.edu
Division of Emergency Medicine
Washington University School of Medicine