’Tout est poison, rien n'est poison, tout est une question de dose.’’
Pathologie expérimentale (1872)
Translation: Everything is poisonous, nothing is poisonous, it is all a matter of dose.
Medical toxicology is a unique and dynamic specialty that combines components of emergency medicine, critical care medicine, occupational and environmental medicine, pediatrics, and public health practice. Medical toxicologists have the expertise to identify and treat chemical‐induced disease, environmental and hazardous material exposures, and other toxicological emergencies. Medical toxicology’s scope of practice is broad and includes acute and chronic poisoning, adverse drug reactions, substance abuse and withdrawal, envenomation, workplace chemical exposure, drug effects and metabolism, and mass exposure to industrial chemicals and chemical, biologic, and radiologic weapons among others.
Our Medical Toxicology Fellowship program is based at Rocky Mountain Poison & Drug Safety (RMPDS), a department of the Denver Health and Hospital Authority and I am honored to serve as the program director. The fellowship is a two-year program during which the fellow is given ample opportunities to publish and gain valuable hands-on experience in toxicology. Poison center training and most didactics are based at RMPDS, and bedside clinical care is provided at Denver Health Medical Center, the University of Colorado Hospital, and Children’s Hospital of Colorado. Clinical training and mentorship are provided by a committed group of 24 board-certified medical toxicologists and 2 ABAT-certified clinical toxicologists. Research training and support are provided by a group of approximately 50 full-time research professionals, three of whom are also members of the faculty. Fellows play a major role in providing education in medical toxicology to other physicians in emergency medicine, pediatrics and internal medicine departments within the Denver area as well as those who rotate with us from around the nation and the world.
The Rocky Mountain Poison Center (RMPC), in operation since 1956 and certified through the American Association of Poison Control Centers, is the one of the busiest and one of the oldest poison centers in the US. Our primary service area encompasses Colorado, Montana, Hawaii, and Nevada (helping serve Mississippi at night); though physician phone consultations extend nation and worldwide. The RMPC handles approximately 100,000 human exposure calls per year of which approximately 4,000 involve direct input from medical toxicology physicians. The fellowship is operated through Denver Health Medical Center, a Level 1 regional trauma center within Denver Health and in conjunction with its emergency medicine residency.
Our Medical Toxicology Fellowship Program has been continually accredited by the Accreditation Council for the Graduate Medical Examination (ACGME) since July 1, 2000. Graduates of the fellowship are eligible to take the subspecialty examination in Medical Toxicology which is approved by the American Board of Medical Specialties. The sponsoring boards for this examination are the American Board of Emergency Medicine, the American Board of Pediatrics, and the American Board of Preventive Medicine.
Christopher Hoyte, MD
University of Colorado School of Medicine