Medical Toxicology Fellowship

The Toxikon Consortium offers a prestigious two-year Medical Toxicology Fellowship in partnership with the University of Illinois Chicago, Cook County Hospital, and the Illinois Poison Control Center.

Founded in the 1950s as the first Poison Control Center in the United States, the Illinois Poison Center set the standard for toxicology services nationwide. Our fellowship program was also the first to achieve full accreditation in the country. We specialize in research areas such as street drugs, natural poisons and venoms, antidote therapy, pharmaco/toxicokinetics, and environmental/occupational toxicology. Over the past 20 years, we've trained over 30 fellows who have gone on to lead in medical toxicology.

Goals and Objectives Heading link

Fellowship Goals

The Toxikon Medical Toxicology Fellowship Program aims to provide comprehensive postgraduate fellowship training in medical toxicology for qualified physicians. The program’s goal is to develop future leaders in medical toxicology. These individuals will be able to perform at a high level as bedside and outpatient medical toxicology practitioners. They will develop the skills required to serve as medical backups for poison control centers and understand the skills needed to be a medical director. They will be among the finest academic teachers in medical toxicology. They will be highly skilled in reading the literature critically and have the necessary tools to contribute to the ongoing body of evidence in the medical toxicology literature.

Fellowship Objectives

The primary emphasis of The Toxikon Program includes:

Attain clinical experience in the diagnosis and management of acute and chronic poisoning of adults and children
Develop skills in teaching and lecturing in toxicology.
Learn the core content of medical toxicology.
Develop an understanding of the basic science of toxicology, including pharmacokinetics.
Develop an appreciation and an approach to environmental and occupational toxicology.
Develop a foundation in epidemiology, biostatistics, and preventive medicine as related to toxicology.
Develop experience with laboratory toxicology.
Describe the basics of research methodology.
Engage in community service.
Receive training in administration that would lead to opportunities as a medical director of a poison control center.
Be prepared for the written board examination in medical toxicology.

Educational Experience Heading link

Educational Experience

M-F: Daily morning clinical toxicology rounds at Cook County Hospital, University of Illinois (UIC), and Illinois Poison Center (IPC)
- Currently in-person on Tues, Wed, Thurs, Most Mondays, and all Fridays remain virtual
Fellow-led teaching rounds, supervising rotating residents and students, opportunities to try different teaching methods
Every Monday: Journal Club, three carefully chosen articles, led by tox faculty.
- Each fellow will run one journal club per year
Home call 6x / month
- primary call as junior
- intermediate supervisory call as senior
Every Wednesday: Fellow’s conference (fellow-developed content)
Wednesday afternoon: Toxicology clinic at UIC
Twice-monthly fellow toxicology core content review/chapter club
M-F: bedside consultations at UIC or Cook County
Combined Emergency Medicine Residency – Toxicology case conferences at University of Illinois and Cook County Hospitals
Twice yearly: Occupational Medicine – Toxicology conference
Friday mornings: Addiction Clinic – Cook County Hospital
Collaboration with RUSH University attendings for additional in-patient addiction medicine experience, if desired
Conference time: Annual North American Congress of Clinical Toxicology (NACCT), fall meeting
Conference time: American College of Medical Toxicology (ACMT) Annual Scientific Meeting, spring meeting
Control Quality projects and Lectures for IPC

Clinical Experience

The fellow provides bedside consultations for poisoned patients at Cook County Hospital and the University of Illinois Hospital. In the first year, the fellow acts as an initial medical backup for the Illinois Poison Center and as an intermediate backup in the second year, supervising residents on call.

On Wednesdays, the fellow will see patients in ambulatory clinic settings at UIC, supervised by Dr. Sean McCann and Dr. Trevonne Thompson.

There will be opportunities to consult with local and regional governmental agencies.

Fellows trained in Emergency Medicine work an average of 6 shifts per calendar month. In their first year, they work at the University of Illinois and, in their second year, at Cook County Hospital.

Weekly Fellowship Schedule

Monday: Didactic teaching rounds, journal club for all fellows, attendings, residents, and students.

Tuesday: Didactic teaching rounds, resident-level educational session, Chapter Club every other week.

Wednesday: AM Fellows conference, toxicology clinic in the afternoon.

Thursday: Didactic teaching rounds.

Friday: Didactic teaching rounds, resident presentations, and addiction clinic in the morning.

Monthly Fellowship Schedule

Division Meeting – updates on the fellowship program, led by Dr. Aks

Research

Fellows must work on one research project per year and complete two minor and one major project by the end of the fellowship.

Research Program

From Dr. Mark Mycyk, Director of Research

The Division of Toxicology supports a productive research program that benefits from our diverse faculty talents and collaborative relationships with multiple institutions. Our goal is to advance the science and improve the practice of medical toxicology.

A central component of our mission is to support the scholarly development of our fellows-in-training. Mentorship from experienced faculty at Cook County Hospital, the University of Illinois Medical Center, Rush Medical College, Northshore University, and the Illinois Poison Center allows our fellows to design, conduct, present, and publish high-level original research. Our fellows routinely present their research findings at annual meetings such as the North American Congress of Clinical Toxicology (NACCT), the American College of Medical Toxicology (ACMT) Annual Scientific Meeting, the American College of Emergency Medicine (ACEP) Research Forum, the Society for Academic Emergency Medicine (SAEM) Annual Meeting, and the Illinois College of Emergency Physicians (ICEP) Academic Forum.

Our fellows also participate in a research curriculum that includes the following:

Weekly journal club
Monthly scholarship seminar
ACMT Spring scientific meeting
ACEP-sponsored EMBRS research course
Mentored manuscript review for various journals

Our research program also assists students and residents from various disciplines with planning research, applying for IRB approval, implementing studies, analyzing data, as well as abstract, poster, and manuscript preparation.

Further information about our scholarship curriculum can be accessed at the Fundamentals of Study Design and Scholarship Development website.

Additional details at the Toxicon Consortium site

Selected Publications

Kim T, Chhabra N, Weech DM, Leikin JB. Short-Term Graft Failure of Organs Procured from Drug-Related Deaths Compared with Other Causes of Death. J Med Toxicol 2020 [in press].

Eswaran V, Allen KC, Bottari DC, Splawski JA, Bains S, Aks SE, Swoboda HD, Moore PQ, Tran TH, Salisbury-Afshar E, Lank PM, McCarthy DM, Kim HS. Take-Home Naloxone Program Implementation: Lessons Learned From Seven Chicago-Area Hospitals. Ann Emerg Med 2020;76(3):318-327.

Routsolias JC, Gimbar RP, Zell-Kanter M. Clinical Pharmacists: Essential During a Poison Outbreak. J Med Toxicol 2020 [in press].

Mycyk MB. ECMO shows promise for treatment of poisoning some of the time: the challenge to do better by aiming higher. Crit Care Med 2020; 48(8):1235-1237.

Bryant SM, Kim T, Colibao L, DesLauriers C. Pediatric poison center exposures and outcomes in the context of grandparent supervision. J Pediatr. 2020;222:263.

Agunbiade A, Routsolias JC, Rizvanolli L, Bleifuss W, Sundaresan S, Moskoff J. The effects of ceftriaxone by intravenous push on adverse drug reactions in the emergency department. Am J Emerg Med. 2020; S0735-6757(20)30164-9

Rushovich T, Arwady MA, Salisbury-Afshar E, Arunkumar P, Aks S, Prachand N.J Opioid-related overdose deaths by race and neighborhood economic hardship in Chicago. Ethn Subst Abuse. 2020:1-14.

Bryant SM, Lu JJ. Salicylate toxicity following undetectable concentrations. Clin Toxicol (Phila). 2020 Mar;58(3):212.

Mycyk MB. Addressing the vexing challenge of bleeding from oral anticoagulants in the ED. Amer J Emerg Med 2020; 38:1209-1210.

Chhabra N, Aks SE.Treatment of acute naloxone-precipitated opioid withdrawal with buprenorphine. Am J Emerg Med. 2020;38(3):691.e3-691.

Devgun JM, Rasin A, Kim T, Mycyk MB, Bryant SM, Wahl MS, DesLauriers C, Navon L, Moritz ED, Thompson TM, Swoboda HD, Lu J, Aks SE.An outbreak of severe coagulopathy from synthetic cannabinoids tainted with Long-Acting anticoagulant rodenticides. Clin Toxicol (Phila) 2019 [in press]

Neumann N, Chai PR, Wood DM, Greller HA, Mycyk MB. Medical Toxicology and COVID-19: Our role in a pandemic. J Med Toxicol 2020; 16(3):245-247.

Kopec KT, Kim T, Mowry J, Aks S, Kao L. Role of dantrolene in dinitrophenol (DNP) overdose: a continuing question? Am J Emerg Med. 2019 Jun;37(6):1216

Myers K, Giblin E, Zell-Kanter M. It’s Just Math-Unless It’s Toxic! AEM Educ Train 2019;4(1):64-67.

Black E, McCann S, Rasin A, Aks S. Articles you might have missed. J Med Toxicol 2019;15(2): 136-8.

Bryant SM, Lu JJ. Salicylate toxicity following undetectable concentrations. Clin Toxicol (Phila). 2019 May 22:1. [in press]

Jang DH, Love JS, Mycyk MB. JMT’s research concepts section: a 5-year evaluation. J Med Toxicol. 2019 [in press]

Navon L, Moritz E, Austin C, Wahl M, Aks S, Layden J. The Public Health Response to a Large Poisoning Outbreak Involving an Illicit Substance: Synthetic Cannabinoids Contaminated With a Long-Acting Anticoagulant Rodenticide, Illinois, March-July, 2018. J Public Health Manag Pract. 2019 Apr 5 [in press]

Chhabra N, Pallasch EM, Wahl M, Bryant SM. Tramadol, naloxone, and seizures. Clin Toxicol (Phila). 2019;57(12):1160.

Maloney LM, Mycyk MB. Honest Disclosure of Conflicts of Interest Advances Emergency Medicine Scholarship. Acad Emerg Med. 2019;26(6):698-700.

Abbasi AB, Salisbury-Afshar E, Jovanov D, Berberet C, Arunkumar P, Aks SE, Layden JE, Pho MT. Health Care Utilization of Opioid Overdose Decedents with No Opioid Analgesic Prescription History. J Urban Health. 2019 Feb;96(1):38-48.

Mycyk MB. Synthetic Cannabinoid-Associated Coagulopathy. N Engl J Med. 2019;380(1):100-101.

Naloxone prescriptions from the emergency department: an initiative in evolution. Verdier M, Routsolias JC, Aks SE. Amer J Emerg Med 2019;37(1):164-165.

Mycyk MB. Responsible Attention to Conflicts of Interest Enhances the Credibility of Published Scholarship.J Med Toxicol. 2019;15(1):1-3.

Stolbach A, Bebarta V, Beuhler M, Carstairs S, Nelson L, Wahl M, Wax PM, McKay C. ACMT Position Statement: Alternative or Contingency Countermeasures for Acetylcholinesterase Inhibiting Agents. J Med Toxicol. 2018;14(3):261-263.

Larsen J, Thompson T, Mycyk MB. Reviewing the record: medical record reviews for medical toxicology research. J Med Toxicol 2018;14(3):179-181.

Naloxone access among an urban population of opioid users. Nikolaides JK, Rizvanolli L, Rozum M, Aks SE. Am J Emerg Med. 2018;36(11):2126-2127.

The virtual toxicology journal club: the dissemination and discussion of noteworthy manuscript using twitter. Chai PR, Ruha AM, Wong KE, Monette DL, Spyres MB, Lapoint J, Greller H, Mycyk MB. J Med Toxicol 2018; 14(3):212-17.

Emergency department patient burden from an electronic dance music festival. Chhabra N, Gimbar RP, Walla LM, Thompson TM. J Emerg Med 2018 Apr;54(4):435-439.

Hays GP, Mycyk MB. Confronting the opioid crisis by taking a long look in the mirror…and at our peers. Acad Emerg Med 2018; 25(5):594-6.

Khattar N, Routsolias JC. Emergency Department Treatment of Cannabinoid Hyperemesis Syndrome: A Review. Am J Ther 2018;25(3):e357-e361.

Chhabra N, DesLauriers C, Wahl M, Bryant SM. Management of severe bupropion poisoning with intravenous lipid emulsion. Clin Toxicol (Phila) 2018;56(1):51-54.

Kanter JA, Chhabra N, Zell-Kanter M. Mailbox Tox: Ingestion of a Pharmaceutical Product Stolen From a Mailbox. Ann Pharmacother 2018;52(3):299.

Theobald JL, Spoelhof R, Pallasch EM, Mycyk MB. The beef jerky blues: methemoglobinemia from home cured meat. Pediatr Emerg Care 2018;34(7):e122-e123.

Christian MR, Sergel MJ, Mycyk MB, Aks SE. Comparison of high-fidelity medical simulation to short-answer written examination in the assessment of emergency medicine residents in medical toxicology. Mo Med 2017;114(5):396-399.

McCabe DJ, Lu JJ. The association of hemodialysis and survival in intubated salicylate-poisoned patients. Am J Emerg Med 2017;35(6):899-903

Mycyk MB. Maintaining the Public Trust in Journals with Ethical Publishing. J Med Toxicol 2017;13(4):275-77.

Bryant SM, Welker KL, Khattar N. Treatment of Benzodiazpine Dependence. N Engl J Med 2017;376:2397-8.

Ho JH, Leikin JB, Dargan PI, Archer JRH, Wood DM, Brent J. Metal-on-Metal Hip Joint Prostheses: a Retrospective Case Series Investigating the Association of Systemic Toxicity with Serum Cobalt and Chromium Concentrations. J Med Toxicol 2017;13(4):321-328.

Witsil JC, Mycyk MB. Haloperidol, a Novel Treatment for Cannabinoid Hyperemesis Syndrome. Am J Ther 2017;24(1):e64-e67

Middelberg LK, Chhabra N, Mycyk MB. Carbon Monoxide Intoxication of Childhood. Pediatr Emerg Care 2017;33(3):e5.

Bryant SM. The POPOP (puffing on pulse oximeter probe) sign of ethanol withdrawal. Am J Emerg Med 2016; 34(5):895-8.

Thompson TM, Toerne T, Erickson TB. Salicylate Toxicity from Genital Exposure to a Methylsalicylate-Containing Rubefacient. West J Emerg Med 2016;17(2):181-3.

Theobald JL, Spoelhof R, Pallasch EM, Mycyk MB. The Beef Jerky Blues: Methemoglobinemia From Home Cured Meat. Pediatr Emerg Care 2016.

Chhabra N, Bryant SM. Snapchat Toxicology: Social Media and Suicide. Ann Emerg Med 2016; 68(4):527.

Weeks MA, Clark E, Mycyk MB. Characteristics of heroin-dependent patients seeking asthma care in the ED. Am J Emerg Med 2016. 34(5): 895-8.

Lim SM, Marcelo C, Bryant SM. Those Salicylate Cases-How Sweet Are They? Am J Ther 2016;23(5):e1155-6.

Chhabra N, Valento M, Bryant SM, Aks SE. Digoxin-Specific Antibody Fragment Dosing: A Case Series. Am J Ther 2016;23(6):e1597-e1601.

Welker KL, Mycyk MB. Pharmacology in the Geriatric Patient. Emerg Med Clin North Am 2016;34(3):469-81.

Mycyk MB. When Your N >1: Drawing Meaningful Conclusions from Registry Studies. J Med Toxicol 2016;12(3):219-20.

Thompson TM. Medical Toxicology Education in a World of Limited Resources. J Med Toxicol 2015;11(3):281-2.

Palmer RB, Aks SE. Retained pill fragments at autopsy: time to rethink gastric decontamination? Clin Toxicol (Phila) 2015;53(2):82-4.

Bryant SM. Wartime toxicology: perspectives from a downrange medical toxicologist. J Med Toxicol 2015;11(1):157.

Zell-Kanter M, Quigley MA, Leikin JB. Reduction in ephedra poisonings after FDA ban. N Engl J Med 2015;372(22):2172-4.

Doyon S, Aks SE, Schaeffer S. Expanding access to naloxone in the United States. J Med Toxicol 2014;10(4):431-4.

Friedman LS, Krajewski A, Vannoy E, Allegretti A, Wahl M. The association between U.S. Poison Center assistance and length of stay and hospital charges. Clin Toxicol (Phila) 2014;52(3):198-206.

Visit the Toxikon website

Toxikon

Fellowship History

The Toxikon Consortium was founded in 1988 through the vision of Dr. Daniel Hryhorczuk and a grant from the Chicago Community Trust to pool scarce toxicology resources and develop toxicology education, clinical service, and research. The consortium brought together Cook County Hospital, the University of Illinois, and Rush-Presbyterian-St. Luke’s Medical Center. Each of these institutions provided critical resources to the fellowship program.

Cook County Hospital has been the administrative core of the program. The Section of Toxicology (Division of Occupational Medicine) provided initial support and space. Since 2004, we have resided within the Division of Toxicology (Department of Emergency Medicine) at Cook County Hospital.
In the early 1990s, the University of Illinois provided drug information and emergency medicine resources through a newly formed Division of Toxicology in the Department of Emergency Medicine.
RUSH was the original home of the Northeastern Illinois Regional Poison Control Center. In 1995, the Poison Center moved to MCHC (Metropolitan Chicago Healthcare Council) as the Illinois Poison Center. MCHC and the IPC are located in downtown Chicago, above Union Station. The Illinois Poison Center (IPC) now acts as the sole poison information resource for the State of Illinois, and the Toxikon Consortium provides medical backup.

The medical toxicology fellowship was originally approved by Cook County Hospital in 1985. The original pathway for training was a preceptorship program that was completed by four individuals. This was followed by the formation of the two-year fellowship program. The ABMT (The American Board of Medical Toxicology) was the initial credentialing body for our Medical Toxicology trainees. The ABMS (American Board of Medical Specialties) and AOA (American Osteopathic Association) specialty boards are the current credentialing bodies.

In addition to training toxicology fellows, Toxikon has also become a model of excellence in toxicology training for medical/pharmacy students and residents from multiple specialties, including Emergency Medicine, Pediatrics, Pharmacy, and Occupational Medicine. We train approximately 110 residents and 60 medical and pharmacy students per year.

The Medical Toxicology Fellowship Program is the centerpiece of The Toxikon Consortium. We are proud to produce outstanding leaders in our field and take tremendous pride in advocating for public health and safety in all matters involving medical toxicology.

For questions, contact: Heading link

Trevonne M. Thompson

Professor of Emergency Medicine, Director of Medical Toxicology Fellowship

Your browser is unsupported