Becoming a Medical Toxicologist

What is Medical Toxicology?

Medical Toxicology is a field of medicine dedicated to the evaluation and treatment of poisoned and envenomated patients. This also includes adverse health effects of medications, occupational and environmental toxins, and biological agents. Medical Toxicology is an officially recognized subspecialty by the American Board of Medical Specialties.

What are some examples of problems evaluated by Medical Toxicologists?

Medical Toxicologists are involved in the care of people who come into contact with drugs, substances, or other agents that cause potentially adverse health effects. This entails expertise in many areas, such as:

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  • Unintentional and intentional overdoses of such agents as:
    • Therapeutic drugs including antidepressants, cardiac medications, and many others
    • Over-the-counter medicines
    • Drugs of abuse
  • Exposure to industrial chemical products and environmental hazards such as:
    • Pesticides
    • Heavy metals
    • Household products
    • Toxic gases
    • Toxic alcohols
    • Other industrial and environmental agents, including radiation exposures
  • Drug abuse management including:
    • Inpatient care for acute withdrawal states from addictive agents such as alcohol and drugs of abuse
    • Outpatient addiction medicine treatment
  • Diagnosis and management of exposures such as:
    • Snake, scorpion, and spider envenomations
    • Marine toxins
    • Ingestion of food-borne toxins
    • Ingestion of toxic plants
  • Independent medical examinations, assessing injury or disability resulting from toxic exposures

Training in Medical Toxicology prepares you to work in a variety of settings including:

  • Emergency departments and in-patient units where they directly treat acutely poisoned patients
  • Outpatient clinics and occupational health settings where they evaluate the health impact from exposure to toxic substances in the home or workplace
  • National and regional poison control centers where they provide medical direction for health professionals, personal responders, and the general public
  • Academic institutions where they are involved in teaching, research, and improving evidence-based patient care
  • Industry and commerce where they contribute to pharmaceutical research and development, product safety, occupational health services, and regulatory compliance
  • Governmental agencies where they provide toxicology expertise at all levels from local health departments to federal entities
  • Clinical and forensic laboratories where they aid in the design, conduction, and interpretation of diagnostic tests and forensic studies

Learn more about the core content in medical toxicology from the American Board of Emergency Medicine (ABEM) and ACMT’s Journal of Medical Toxicology.

Is Medical Toxicology for me?

Tips to explore the specialty:

  • Find clinical experience in medical toxicology and spend elective time. If you do not have an entire block to spend, some programs may be willing to accommodate shorter visits.
  • Join a professional society. The American College of Medical Toxicology (ACMT) represents physician toxicologists and has very reduced rates for students and residents. 
  • Network with local toxicology specialists. Contact an ACMT board member if you need help locating someone. 
  • Attend an ACMT meeting or event. You will learn more about the specialty and network with medical toxicologists who work in all settings.
  • View Directory of Clerkships 

How to become a Medical Toxicologist:

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1. Medical School and Residency

Complete medical school and residency training in any number of fields. The majority of medical toxicologists are trained in emergency medicine; however, many have backgrounds in pediatrics, preventive medicine, or internal medicine.

2. Fellowship

All medical toxicologists must complete a fellowship in medical toxicology. Fellowships are approved by the Accreditation Council for Graduate Medical Education and consist of two years of training. 

Learn more about the fellowship application process

3. Board Certification

After completing a fellowship, medical toxicologists must pass the Medical Toxicology Board exam required for certification. 

The Board Exam is offered every other year by the American Board of Pediatrics (ABP), the American Board of Preventive Medicine (ABPM), and the American Board of Emergency Medicine (ABEM). The candidate should take the examination through the certifying body commensurate with their pre-fellowship training. Diplomates of the American Osteopathic Board of Emergency Medicine (ABOEM) that have completed a fellowship accredited by the Accreditation Council for Graduate Medical Education (ACGME) may apply to take the exam through ABEM.

View ABEM Medical Toxicology Eligibility Criteria for Certification

 For more information and eligibility, click the links below.

Learn more about joining ACMT!