About the Program

As the Division of Clinical Toxicology has evolved since its establishment in 2009, so have the opportunities for students, residents and fellows. This burgeoning program, which accepted its first fellow in 2011, fosters exploration of the field of medical toxicology in a collaborative environment. Fellows are able to contribute to the development and growth of the fellowship itself and the division as a whole.

Upon completion of the two-year, ACGME-accredited program, graduating fellows will possess a broad spectrum of skills that enable them to do the following: 

• Provide comprehensive and skilled consultation on clinical toxicology cases 
• Initiate an independent practice of medical toxicology 
• Integrate into an academic environment 
• Exhibit outstanding teaching skills 
• Manage and provide medical direction for poison centers 
• Conduct innovative, cutting-edge research  

Curriculum

Learn about our extensive curriculum.

This fellowship includes rigorous core content studies through weekly didactic sessions, faculty lectures and review of comprehensive articles and textbook chapters during the first year. Fellows also gain valuable teaching experience by engaging with the residency programs, School of Medicine and School of Pharmacy through lectures, simulation lab, small-group discussions and mock oral board examinations. First-year fellows also attend the Emergency Medicine Basic Research Skills (EMBRS) workshop through the American College of Emergency Physicians (ACEP). 

Second-year fellows lead teaching rounds in the Virginia Poison Center. Didactics during year two are increasingly focused on board preparation, with weekly case conferences and journal clubs progressively utilizing primary literature to address clinical questions, controversies or myths germane to the subspecialty. 

We encourage our fellows to pursue their unique interests and offer flexibility to modify the curriculum based on their aspirations. Elective clinical rotations include the following: 

• Addiction medicine 
• Forensic toxicology 
• Pediatric critical care 
• Fellows can also obtain and complete formal coursework in areas such as the following: 
• Medical review officer
• Advanced hazardous life support (AHLS) 

Fellows are directly involved in all aspects of the Division of Clinical Toxicology, which includes an active consultation service that evaluates about 250 inpatient and 40 outpatient clinic patients each year. 

The program also focuses on teaching, and the division runs the medical toxicology clinical rotation that annually hosts about 180 emergency medicine, internal medicine and pediatric residents, along with medical students, visiting residents and fellows and pharmacy students and residents. We also provide professional education for EMS providers, nurses, medical students, residents and physicians with at least 250 lectures at local, regional and national venues.  

A Week in the Life

Each week, fellows can expect a schedule along the lines of the following:

Research

Attending physicians, fellows, residents and medical students within the Division of Clinical Toxicology and Department of Emergency Medicine continuously engage in research and scholarly activities. Those interested in cutting-edge research, which ultimately translates to improved patient care, also have the opportunity to collaborate with scientists in the School of Medicine and the Vice Chair for Research in the Department of Emergency Medicine.

Compensation

What to expect as a Medical Toxicology fellow

Fellows work 12 hours per week clinically in our emergency department as teaching attendings (approximately five 10-hour shifts per month).

Working in the ED at VCU is an excellent experience for our fellows, especially for those interested in an academic career. VCU Medical center is the busiest Level 1 trauma center in Virginia and provides care for approximately 95,000 patients each year, including 4,000 trauma victims. Fellows work closely with and often mentor emergency medicine residents both clinically and with academic projects, building an excellent portfolio for a future in academic emergency medicine.

Fellows’ compensation includes the following: 

• Base pay of $62,782 
• Professional expense account of $2,500 
• Benefits including medical insurance, generous paid time off and hospital-based childcare coverage 

The fellowship also covers travel and expenses to the North American Congress of Clinical Toxicology (NACCT) and American College of Medical Toxicology (ACMT) meetings and ACEP Emergency Medicine Basic Research Skills (EMBRS) course.

Moonlighting is allowed, and fellows often choose to work additional shifts in our emergency department. With moonlighting factored in, our fellows earn an average of $95,000 per year. Additionally, the Richmond metropolitan area is very affordable with a lower overall cost of living than most other parts of the country.

How to Apply

Medical Toxicology is now using ERAS for applications. We accept applications in July for the following year, and interviews take place between July and October. Recognizing that your time is valuable, we offer a flexible interview process.  

We participate in the National Residency Matching Program (NRMP), and rank order lists are required by mid-November. Those who wish to apply after the match may be considered up to December.