Visiting Resident Medical Toxicology Rotation

• Identify and discuss the initial identification and management of a poisoned patient.
• Describe the rationale and role for the administration of oxygen, naloxone, dextrose, thiamine and other antidotes, and understand the risks associated with their administration.
• Evaluate and apply the appropriate methods of gastrointestinal decontamination to a poisoned patient. Specifically, understand the risks, benefits, indications and contraindications of cathartics, whole bowel irrigation, orogastric lavage and activated charcoal.
• Define toxic syndromes (toxidromes) for patients with opioid, sympathomimetic, anticholinergic, and cholinergic agent poisoning.
• Create a differential diagnosis for drugs causing abnormal vital signs. Specifically:
  • Tachycardia and bradycardia
  • Tachypnea, bradypnea, and hyperpnea
  • Hypertension and hypotension
  • Hypothermia and hyperthermia
• Create a differential diagnosis of drugs that cause cardiac dysrhythmias and myocardial dysfunction.
• Create a differential diagnosis of drugs that cause agitation, coma, seizures, delirium, psychosis and ocular abnormalities.
• Understand the evaluation of anion-gap and non-anion-gap metabolic acidoses, with specific reference to poisoned patients.
• Learn to identify toxins by their odors and other physical characteristics.
• Learn about less common toxins and the appropriate use of unique antidotal therapy, if available.
• Learn the indications for extracorporeal drug removal via hemodialysis or hemoperfusion.
• Understand the diagnosis, management and complications of withdrawal from ethanol, opioids, sedative-hypnotics, barbiturates and cocaine.
• Develop a thorough understanding of the pathophysiology, evaluation, management and disposition of poisoned patients.

The Toxicology rotation includes observation and participation in the daily activities of the NYC Poison Control Center as well as daily rounds with fellows and core faculty.

The rotation is entirely virtual from 8:45 a.m. to 4 p.m. Monday to Friday. You will receive a link to the secure WebEx for all meetings once you are accepted into the program. Your camera must be on at all times, and we will track your attendance. Absences will be noted and reported to your program.

There are set times for the various academic activities each week following the below rubric. If there is a change in the schedule, we will email you during office hours.

Monday

• 8:50 a.m.: Orientation (new rotators only)
• 11:30 a.m.: Fellow Office Hours
• 1 p.m.: Rounds with Core Faculty

Tuesday

• 10:30 a.m.: Welcome to the NYC PCC (first Tuesday of the month only)
• 11:30 a.m.: Fellow Office Hours
• 1 p.m.: Rounds with Core Faculty

Wednesday

• 3 p.m.: Rounds with Core Faculty

Thursday

• 9:10 a.m.: Journal Club
• Noon: Fellow Office Hours
• 1 p.m.: Rounds with Core Faculty

Friday

• 11 a.m.: Attending Conference with Core Faculty (e.g., Classic Journal Club or other teaching)
• 1 p.m.: Rounds with Core Faculty

*On the first Thursday of the month, there will be no journal club or afternoon rounds and all toxicology rotators will attend the Grand Rounds and Consultants’ Conference from 1:15 p.m. to 4 p.m..

For full consideration, all prospective applicants must email nycpcctoxrotation@health.nyc.gov with the following details:

• Full name
• Preferred contact email
• Affiliation
• Specialty
• Year of training
• Program coordinator’s full name
• Program coordinator’s email
• Program coordinator/affiliation’s full address (address line, city, state, ZIP, country)
• First choice dates of rotation: start (mm/dd/yyyy) to end (mm/dd/yyyy)
• Second choice dates of rotation: start (mm/dd/yyyy) to end (mm/dd/yyyy)
• Attach: Photograph (scan of a government- or school-issued ID is preferred)
• Attach (as PDF): Letter from your home institution, on the official letterhead, specifying that you are in good standing and will have your salary and malpractice coverage provided

Applications that do not include all of the above will not be considered.

This is a highly sought-after educational experience, so space is limited. All applications must be received at least one month in advance of the first choice rotation week.

Note: Space is limited and choosing a section does not mean you will be registered for that start date. The earlier you apply, the more likely we will be able to accommodate you. We will be in touch with you shortly after receiving your email to determine your eligibility.