Emergency Medicine

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Medical Toxicology Fellowship

Medical Toxicology is the diagnosis, treatment and prevention of poisoning and related health effects from medication, biological agents and environmental or occupational toxins. Medical toxicologists provide comprehensive care to patients who have come into contact with drugs or other substances that cause a threat to their health.

The medical toxicology fellowship at IU School of Medicine is an ACGME-accredited, two-year program providing graduates with hands-on management of poisoned patients at the downtown academic health center. The toxicology division supports an inpatient clinical toxicology consult service at IU Health Methodist Hospital, Eskenazi Hospital, IU Health University Hospital and Riley Hospital for Children, which are regional and statewide tertiary referral centers. Fellows also provide phone consultations on poisoned patients throughout the state of Indiana and surrounding areas via the Indiana Poison Center. This inpatient toxicology service is the only one of its kind in Indiana, and one of only a few in the country.

Weekly didactics cover all areas of toxicology. Fellows participate in forensic toxicology cases and assist in the clinical education of residents and students rotating on the toxicology service (emergency medicine residents spend one month on the toxicology service.) Fellows participate in research and scholarly activities, with mentorship from toxicology faculty.

Clinical Curriculum

Monthly coverage for the hospital and Indiana Poison Center requires that first-year fellows take call 7-9 days per month. Second-year fellows have reduced call requirement. Along with the fellow, a faculty member is available 24 hours a day for staffing or direct patient care. Call for this fellowship is taken from home.

The Medical Toxicology fellow is responsible for working 21 clinical hours in the emergency department. Additional moonlighting is permitted, providing program requirements are met.

Medical Toxicology fellows lead daily rounds, present grand rounds for emergency medicine, and may participate in teaching and interesting case presentations with pediatrics, critical care, internal medicine, and psychiatry/addiction medicine. Fellows in this program also participate in the Emergency Medicine Junior Faculty Development program, which offers didactic teaching and hands-on workshops designed to provide junior faculty and fellows with the skills required to enhance their academic careers.

Curriculum Didactics

Medical Toxicology fellows participate in an ongoing didactic series designed to cover both pertinent material for the management of toxicology patients and prepare them for the Medical Toxicology Board Examination. This includes weekly readings with quizzes, weekly journal club to review both current and historical toxicology articles, review of Poison Center cases and monthly presentations on selected topics in toxicology.

Occupational / Forensic Experience

Medical Toxicology Fellows are responsible for seeing all patients scheduled in the Occupational Toxicology Clinic, typically one or two days per month. This involves seeing patients referred for neurotoxicology issues such as neuropathy. Medical Toxicology fellows participate in the Neurotoxicology Clinic with neurotoxicologist Dr. Laura Tormoehlen. Patients are typically scheduled 1-2 days per month. Fellows also see patients in the Pulmonary Occupational Clinic. For forensic cases, Medical Toxicology fellows research specific topics related to pathologic, criminal or legal cases and develop the skill set necessary to become an expert in both criminal and legal proceedings involving medical toxicology.

Research

Fellows gain an understanding of the strengths and weaknesses of published research by participating in either a research project or scholarly activity. Research projects can include basic science, clinical studies, database studies or chart reviews. A scholarly activity may include publication of a case report, case series, book chapter or review article in toxicology.

During the second year, fellows are afforded necessary protected time to present at the North American Congress of Clinical Toxicology yearly meeting; the annual Midwest Toxicology symposium; and local venues such as the Indiana Poison Center toxicology symposium, Emergency Medicine Research Day, and Indiana University School of Medicine Emergency Medicine Grand Rounds.

Benefits

The Medical Toxicology fellowship stipend is equivalent to PGY-4 and PGY-5 level for Indiana University School of Medicine residents. In addition, an attractive benefit package includes health care insurance, malpractice insurance, disability and life insurance and loan deferment. A meal stipend is offered as well. Find information about employment terms and benefits for IU School of Medicine fellows through the Office of Graduate Medical Education.

People

Division Chief: Daniel Rusyniak, MD
Fellowship Director: Louise Kao, MD

Fellowship Coordinator: Alison Banta

Jerry Snow, MD
Laura Tormoehlen, MD
Jennifer Acciani, MD
Anna Arroyo, MD
Blake Froberg, MD
Danyal Ibrahim, MD
Ayrn O’Connor, MD
Kris Nanagas, MD
Bryan Judge, MD
Louise Kao, MD
Lisa Snyder, MD MPH
Daniel Rusyniak, MD
William Dribben, MD
Christopher Holstege, MD
Mary Wemuth, MD
Jane Witman, MD