Toxicology Longitudinal Track
Emergency Medicine
VCU Health System
GOALS AND OBJECTIVES
The goal of this longitudinal track is to cultivate and expand upon an interest in
clinical toxicology. The resident must be prepared for active learning by working
alongside a clinical toxicologist in all aspects of the occupation. Teaching,
reading and a scholarly activity will also be necessary to diversify and intensify
this preparatory course. The resident can chose to attend the North American
Congress on Clinical Toxicology, and this is recommended if their abstract is
published in Clinical Toxicology. Once the resident has graduated with this
emphasis he or she, should be well equipped to handle routine toxicological
exposures. This track will appropriately prepare the resident to excel as clinical
toxicology fellow in the future.
Contacts: Kirk Cumpston, D.O.
1. CLINICAL OBJECTIVES
a. Improve clinical skills in the management of acute and chronic
toxicological exposures of:
 Drugs of Abuse
 Pharmaceuticals
 Chemicals
 Environmental
 Envenomations
b. Experience as a toxicology consultant
 Consults and call
c. Experience a toxicology clinic
d. Experience the inner workings of a poison center
e. Experience in the interpretation of toxicological laboratory testing
2. ACADEMIC OBJECTIVES
a. Complete an academic project
 Triage guidelines
 QA
 Research project
 Project:
_______________________
 Sign-off:
_______________________
b. Be exposed to research within the specialty of clinical toxicology and
provided with the opportunity to partake in research opportunities
3. METHODS
a. Curriculum
 Of the thirteen blocks in your second year of residency, you will
have requirements for each of your seven blocks in the
emergency department.
 During your seven blocks in the emergency department as a second
year resident, you will dedicate two days each block to this track.
You will be required to complete an activity each month. These
days spent performing activities related to the diagnosis and
management of patients referred to the Virginia Poison Center.
You will also be responsible for assisting in the collection of data
for research projects, teaching classes in the community (EMS
lectures, disaster training, etc.), participating in Toxicology
Clinic.
4. CLINICAL REQUIREMENTS
a. Virginia Poison Center-Call Center Experience
 The resident will learn about the history of poison centers and how
they function.
 Date/sign-off: _______________________
 The resident will learn about the training of the Specialists in
Poison Information (SPIs) and the service they provide to the
community, including resources they use to give medical advice,
when a toxicologist is called, and follow up.
 Date/sign-off: _______________________
b. Toxicology Consult Service
 The resident will be “first call” for toxicology consults at VCUH
and Central Virginia. All of these patient’s will be presented to a
Toxicologist on “back-up call.”
 Date/sign-off: _______________________
 Date/sign-off: _______________________
 Date/sign-off: _______________________
 Date/sign-off: _______________________
 Date/sign-off: _______________________
 Date/sign-off: _______________________
 Date/sign-off: _______________________
 Date/sign-off: _______________________
c. Didactics
 Toxic M&M – The resident will present a Toxic Morbidity and
Mortality to the faculty and residents during residents’
conference. The resident will present a case to the faculty and
residents and discuss diagnosis and treatment. This will include
educating the residents about the exposure, pathophysiology,
treatment and laboratory data pertaining to each case.
 Date/sign-off: _______________________
 Additional lecture – The resident will present a journal club or
grand rounds on a topic of their choosing in Clinical Toxicology
 Date/sign-off: _______________________
d. Toxicology Clinic
 The resident will participate in one of the regularly scheduled
toxicology clinics.
 Here the resident will gain a better understanding of the
appropriate care of those patient’s that have been treated for
toxic exposures and/or are presenting to the clinic for potential
toxic exposures.
 Date/sign-off: _______________________
e. Additional Requirements
 The resident will be required to read in Emergency Medicine: A
Comprehensive Study Guide, Tintinalli (the latest edition.) and
pertinent toxicology articles. The resident will be tested on
reading assignments. The resident will receive a pre-test before
starting the longitudinal track and a post-test upon completion.
Each month the resident will meet with their advisor in the track
to discuss ongoing research and review the requirements which
have been completed and future endeavors.
 Date/sign-off: _______________________
Pre-test
 Date/sign-off: _______________________
Post-test