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             Fellow Expectations

  

Year 1 (Junior) Medical Toxicology Fellows

·        The focus of the first year is on clinical evaluation and management. 

·        They will develop skills to perform consultations for the various specialties, including responding to them in an appropriate time frame, interviewing and examining the patient and providing recommendations for care.  They develop sound patient evaluation and management techniques, including the management of multiple acute toxicology patients and complex patient presentations

o       Perform evaluations and write consultations on patients while on shift in the ER if time permits.  This would apply only to patients being staffed by another attending physician

o       Perform evaluations and write consultations on patients in the ER who will be admitted with toxicologic considerations

o       Perform evaluations on toxicology-related patients already admitted to an inpatient service. 

·        Visit the Parkland and Children’s emergency rooms before starting Fellow rounds, Monday through Friday, to see if any toxicology patients need evaluation.  Recognize that the visit also (1) increases toxicology visibility, (2) enhances relationships, and (3) provides education for all health care providers. 

·        Participate in daily rounds, Monday through Friday, throughout the first-year unless he/she has another service or training obligation.

·        Take the First Call for the Poison Center during business hours Monday through Friday.  Night, Weekend, and Holiday First-call will be rotated among all Fellows.  However, the junior fellows will likely have more non-business hour first-call than the senior fellows.  

·        Participate in occupational and industrial programs

·        Teaching responsibilities are limited at first but rapidly grow over the first months of the program.  Focus is on the (1) rotators (medical and PA students, EM residents at all levels, and pharmacy students); (2) housestaff and faculty of the services for which consultations are provided, and (3) the specialists in poison information.     

·        Participate in daily rounds.  See “Rounds Expectations” for details.

·        Identify items of controversy and/or “special questions.”  Assist the rotators in pursuing these topics to learn what is really known.  Potentially pursue some of these ideas as personal research projects.

·        Administrative duties include participation in providing support for the poison center, assisting with projects such as mortality reports and education of the poison center staff.  

·        Call a senior fellow or faculty on all cases during the first month of the fellowship

·        Complete courses required to perform research at UT Southwestern.  These are available at the Institutional Review Board web site.

·        Collect rotator presentations into a databank of presentations that may be accessed by all toxicology personnel.

·        Collect articles that rotators have obtained and provide copies for other fellows.

·        Attend all toxicology related conferences.

·        Perform extensive self-reading of toxicology textbooks and toxicology-related articles. 

·        Prepare at least one case report

·        Provide a service and poison center orientation to rotating residents and students

·        Contact the toxicology faculty for the coming week to discuss the schedule.  If there is a change from the typical schedule, ensure the other fellows and rotators are aware.

·        Ensure that the attendance log is completed for each attending rounds

·        Evaluate EM residents, other rotating residents, rotating pharmacy students and medical/PA students.

 

Year Two (Senior) Medical Toxicology Fellows

 

·      Continue to provide clinical care.  The amount of clinical time will vary with the number of fellows available.

·      There is an increased focus on the pursuit of scholarly activities and on administrative education. 

·      They will be able to function more independently from faculty.  They will direct rounds on Thursdays; the day of the Emergency Medicine Conference Series.  Faculty will not be physically present for these rounds; but will discuss the cases with the fellows over the telephone at a minimum.  The fellow is to initiate the contact.

·      Have an increased teaching role

o     They will direct rounds once per week with the faculty present.  They have a greater role in the clinical teaching and didactics for medical students, rotating residents, rotating pharmacy students, and specialists in poison information

·      Participate in Poison Center administrative activities

·      Provide clinician back-up to the Poison Center

o     Function as the back up to the First-Year Fellows during business hours.  The Toxicology attending is the second tier of back-up during business hours. 

o     Provide first call back-up to the Poison Center during non-business hours.  This responsibility is shared with the First-year fellows.  The amount of time spent on first-call will vary inversely with the number of other fellows available.  The Toxicology faculty provides the immediate back-up for cases during non-business hours

·      Ensure that at least one fellow attends daily toxicology rounds.  

·      Ensure a service and poison center orientation is provided to rotating residents and students.  This orientation will generally be done by the first or second year fellows.

·      Provide services as outlined for junior fellows if a junior fellow is not available to do so

·        Ensure that the attendance log is completed for each attending rounds

·        Provide at least one toxicology Grand Rounds

·        Evaluate EM residents, other rotating residents, rotating pharmacy students and medical/PA students.

 

 

 

  

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