Fellowship in Medical Toxicology

Introduction

Welcome to the Medical Toxicology Fellowship, sponsored by the Department of Emergency Medicine, New Jersey Medical School (in the Rutgers School of Biomedical and Health Sciences) in conjunction with, and housed within, the New Jersey Poison Information and Education System (NJPIES). We are a dynamic and growing program, founded in 2019, and are excited to share what we think makes med tox training in Newark a fantastic experience.

NJPIES is the statewide poison center, serving a population of 9 million, with over 50,000 poison-related calls annually from the public and healthcare providers. Our medical toxicology division, staffed by a diverse and accomplished toxicology faculty, and our dedicated fellows, provides medical consultation to both the poison center as well as our active hospital-based toxicology consultation service.

We are a fully accredited two-year program through the ACGME’s Review Committee for Emergency Medicine. We accept physicians board-eligible or board-certified in a primary specialty. Candidates must meet the requirements to obtain a license to practice medicine in New Jersey and meet the requirements to obtain a U.S. Drug Enforcement Administration registration before beginning the fellowship. Completion of an ACGME-certified med tox fellowship is required to sit for the Medical Toxicology Certification examination.

In addition to the categorical Medical Toxicology fellowship, we are proud to offer the only combined Addiction Medicine and Medical Toxicology fellowship at Rutgers University New Jersey Medical School in the nation. Over the span of two-and-a-half years, the program provides Fellows with a solid foundation in addiction medicine and toxicology, while fostering a multidisciplinary approach to patient care. Taught by a diverse and nationally recognized faculty in both specialties, the synergistic nature of these disciplines allows Fellows to acquire more comprehensive skills and a broader perspective on the overlapping aspects of addiction and toxicology. They will develop critical thinking skills, enhance their ability to identify and manage patients with complex toxicologic, compassionately treat patients with substance use disorders, and provide evidence-based interventions to prevent and treat drug-related toxicities. Furthermore, the program promotes collaboration and communication between Addiction Medicine and Medical Toxicology, resulting in more effective patient care and improved outcomes.

Both fellowships are currently accepting applications for the academic year beginning July 2025. Applications and supporting materials can be submitted through the Electronic Residency Application Service (ERAS). Our program identifier is 1183311002. For more information on dates and deadlines for the 2024-25 fellowship application season, please see the ERAS 2025 Fellowship Application Timeline. We participate in the National Resident Matching Program (“The Match”). Questions? Please contact the fellowship Program Director, Dr. Howard Greller (howard.greller@rutgers.edu).

Objectives of the Fellowship

Learn and incorporate the knowledge and skills necessary to provide excellent bedside and telemedicine care to patients with a range of toxicologic issues.
Acquire in-depth understanding of the core content of medical toxicology, including the diagnosis and management of poisoned patients, substance use and withdrawal, occupational and industrial exposures, environmental toxicology and toxinology, laboratory science, public health, and more.
Develop facility in acquiring, critically evaluating, and incorporating current and past literature that supports our practice, with an emphasis on understanding the controversies and competing views.
Attain the skills and spirit of inquiry necessary to design and execute research in medical toxicology.
Become an effective representative for the specialty, through research, teaching, lecturing, publications, and public outreach.
Attain the competence to practice independently and pass the board certification examination.

Fellowship Highlights

A practice location with a diverse patient population, located at the one of the three Level 1 trauma centers in the State of New Jersey, with a broad variety of clinical experiences and exposures.
Directly integrated and housed at the only poison center in the State, with a broad case experience, approximately 50k poisoning-related calls per year. Serve as the primary backup for our exemplary Certified Specialists in Poison Information (CSPIs), with attending backup 24/7.
Renowned faculty and departmental and program leadership with a passion and devotion to medical toxicology education and professional development.
An active bedside clinical consultation service at University Hospital, with over 500 consults per year, managing critical overdose, withdrawal, and toxicology patients of all ages at all levels of care.
A robust educational program, including daily didactics, teaching of rotating residents and students, journal clubs, case conferences, and many other activities devoted to fellow education. See below for details.
Direct relationship and cross-teaching with the faculty and fellows of the Addiction Medicine fellowship training program, participation on clinical rounds, and departmental guideline development opportunities.
Regular clinical exposure to occupational and industrial toxicology through our relationship with the preeminent Environmental and Occupational Health Sciences Institute (EOSHI) of Rutgers University.
Myriad opportunities to learn public health outreach and education, poison prevention initiatives, poison center administration, and more.
Participation through NJPIES in consultation and management of public health emergencies (e.g., COVID-19, carbon monoxide, industrial releases.)
Vast opportunities for research, administration, mentorship, and teaching
Access to the resources of a large university system, including an extensive biomedical library, teaching opportunities at the graduate level, and dynamic collaboration with other schools including the Rutgers Department of Medical Informatics, the Ernest Mario School of Pharmacy, Rutgers School of Public Health, and the Rutgers Center for Pharmacoepidemiology and Treatment Science (PETS)

Fellowship Education and Curriculum

Fellowship is an incredible learning experience, with a vast amount of information to absorb. A majority of the learning comes through the interaction of clinical cases with bedside care, discussion, reading, supplemental materials, and follow up. This is all supported through a formal curriculum and the knowledge and teaching of the faculty and CSPIs, as well as the diversity of cases that come through NJPIES on a daily basis.

Fellows rounds and case review - daily, mediated by faculty and fellows
Didactic rotator rounds - daily, coordinated between fellows, faculty, and ATEAM
Core content - regular reading assignments from the Core Content of Medical Toxicology, with fellow generated question bank / flashcards, which complements our board review efforts for Fellow Friday
Structure of the Week, Toxicology History of the Month
“Metal Monday", “Occ Tox Tuesday”, “Pharmacology Friday”, and other alliterative educational sessions
Journal Club - recurring weekly - twice monthly with current articles of interest, once monthly with classic content, and once monthly in collaboration with ATEAM
ATEAM - Academic Toxicology Education Alliance of the Mid-Atlantic. An exciting collaborative educational effort between our fellowship (NJPIES), the Maryland Poison Center, and The Philadelphia Poison Center. Provides core content lectures for rotators and fellows, regional case conference and presentation, a journal club, and more. Multiple opportunities for fellow engagement and presentation.
The American College of Medical Toxicology (ACMT) National Case Conference, National Journal Club
Regular participation in the Rutgers University Hospital Department of Emergency Medicine Wednesday conference

Research Opportunities

Research opportunities abound at Rutgers. As part of the training, fellows are expected to explore and develop an area of interest and expertise, and utilize their training and mentorship to develop an original project. This scholarly pursuit can take many forms, from bench research to development of a curriculum to grant-funded clinical trials. We have access to the full resources of the University, the experience of the faculty, and the research team in the Department of Emergency Medicine.

Leadership

Howard A. Greller, MD - Program Director, Medical Toxicology Fellowship
Diane P. Calello, MD - Medical and Executive Director of New Jersey Poison Information and Education System (NJPIES)
Lewis S. Nelson, MD - Chair, Department of Emergency Medicine; Chief, Division of Medical Toxicology

Meet the Faculty

Lewis S. Nelson, MD
Dr. Nelson is Professor and Chair of the Department of Emergency Medicine and Chief of the Division of Medical Toxicology at Rutgers New Jersey Medical School in Newark, NJ. He is a past member of the Board of Directors of the American Board of Emergency Medicine, Chair of the Subboard in Medical Toxicology, and Past-President of the American College of Medical Toxicology. He remains an active consultant to several governmental agencies, including the CDC, FDA, and DHS, and deeply involved with several professional organizations. He is an editor of Goldfrank’s Toxicologic Emergencies, and his areas of toxicological interest include pain management, consequences of opioids, alcohol withdrawal, and addiction medicine.

Diane P. Calello, MD
Dr. Calello is the Executive and Medical Director of the New Jersey Poison Information and Education System, and Professor of Emergency Medicine at Rutgers New Jersey Medical School. She is board certified in Pediatrics, Pediatric Emergency Medicine, Medical Toxicology and Addiction Medicine, and is actively involved in national leadership in several professional organizations as well as state and federal advocacy efforts. She is on the Board of Directors for the American College of Medical Toxicology, on the CDC/AAPCC Toxicosurveillance Team, and participates in several multi-center research efforts including the study of fentanyl analogues through the ACMT and the leadership team of the Toxicology Investigators Consortium Registry. Her specific areas of interest include the impact of pediatric poisoning fatalities, environmental lead poisoning, the pediatric consequences of the opioid epidemic, substance use disorders, toxicosurveillance and population health, and the role of poison centers in public health emergencies.

Howard A. Greller, MD (he | him)
Dr. Greller is Associate Professor of Emergency Medicine, and the Program Director of the Medical Toxicology Fellowship. He is board certified in Emergency Medicine, Medical Toxicology, and Addiction Medicine. He currently serves as the Deputy Editor of the Journal of Medical Toxicology, and has served on the board of directors of both the American College of Medical Toxicology and the Medical Toxicology Foundation. He is co-founder and editor of the Tox and the Hound blog, and is the ‘&Howard’ of the Dantastic Mr. Tox & Howard podcast. He additionally promotes his educational outreach as co-host of the Emergency Medicine show on Sirius/XM Doctor Radio. Dr. Greller has an interest in the care and management of substance use disorders and withdrawal, toxicology education, and anything and everything having to do with caffeine.

Mehruba Parris, MD
Dr. Parris is an Assistant Professor of Emergency Medicine at Rutgers New Jersey Medical School and a Medical Toxicology Consultant with the New Jersey Poison Information and Education System. Dr. Parris is board-certified in Emergency Medicine and Medical Toxicology. She completed her Medical Toxicology Fellowship at Emory University/Centers for Disease Control and Prevention. Dr. Parris is interested in Public and Global Health in Toxicology, Diversity in Medical Education, Women in Medicine and Patient Quality & Safety.

Cynthia Santos, MD
Dr. Santos is Assistant Professor at Rutgers New Jersey Medical School and is board certified in Emergency Medicine, Medical Toxicology, and Addiction Medicine. She is a Medical Toxicology Consultant with the New Jersey Poison Information and Education System, an Addiction Medicine Consultant, and a Course Director for the Rutgers School of Graduate Studies. Her current interests focus on research and education related to medications for opioid use disorder (MOUD), toxicology surveillance, and pharmacogenomics. She is PI for several grants that support educational training and navigator programs to improve outcomes in patients with OUD, MOUD pharmacogenomics, and substance use trends based on ED surveillance and urine drug screen results. She completed her Medical Toxicology Fellowship at Emory University/Centers for Disease Control and Prevention and her Emergency Medicine Residency at Mount Sinai Hospital.

Christopher Meaden, MD
In addition to being the first graduate of the fellowship program, Dr. Meaden is Assistant Professor of Emergency Medicine at Rutgers New Jersey Medical School and a Medical Toxicology Consultant for the New Jersey Poison Information and Education System. He is board certified in emergency medicine and board eligible in medical toxicology. Dr. Meaden has a Master of Science degree in molecular and cellular biology. His interests include education in medical toxicology, acute care of the poisoned patient and chemical agents of war. He is involved with the American College of Medical Toxicology and currently serves as their associate chair for the 2023 ACMT Annual Scientific Meeting. Research interests include epidemiology and management of opioid overdose, poison centers and toxicosurveillance, and pharmacogenomics.

Bruce Ruck, PharmD. DABAT
Dr. Ruck is the Managing Director of New Jersey Poison Information Education System and has been with the Poison Center since 1989. Dr. Ruck is a Diplomat of the American Board of Applied Toxicology and holds adjunct faculty appointments at Rutgers College of Pharmacy and Nursing. Dr. Ruck is active with several professional organizations and works closely with members of the NJ Department of Health and Senior Services. He recently was elected to the Board of Directors of the American Association of Poison Control Centers. In addition to toxicology, his areas of interest include health care professional education, quality assurance and delivery of accurate unbiased information to help in the management of the exposed patient. Dr. Ruck has a special interest in public health as it relates to poison center activities as well as in drug-induced diseases.

Meet the Fellows

Christopher Counts, MD (2nd year fellow)
Chris Counts grew up in Colorado and attended the Johns Hopkins School of Medicine. He completed residency in Emergency Medicine at Mount Sinai and Elmhurst Hospitals in New York. His interests include drug shortages, alcohol withdrawl, and health policy. During his free time, Chris is likely exercising, speed-listening to podcasts, or playing with his dog.

Tony Spadaro, MD (2nd year fellow)
Tony Spadaro attended the University of Pennsylvania where he completed his MD and MPH. He then completed his residency in Emergency Medicine at the Hospital of the University of Pennsylvania. As a resident, his research interests included naloxone distribution in the ED, the impacts of fentanyl on precipitated withdrawl, and emerging novel psychoactives in the drug supply such as xylazine. He is also interested in harm reduction and social emergency medicine. In his free time, he enjoys running long distances, walking his dog, and watching Star Trek.

Ivan Ivanov, MD (1st year fellow)
Dr. Ivanov recently completed his emergency medicine residency at South Brooklyn Health (formerly Coney Island Hospital.) He is originally from Chicago and attended medical school at Midwester University - CCOM. He developed a strong interest in toxicology during his intern ICU block when he had several beta blocker overdoses. Hence, he currently enjoys dardiotoxins. Outsode of medicine, Ivan enjoys fishing, snowboarding, and travel.

Alison Yarp, MD (1st year fellow)
Dr. Yarp grew up in The Woodlands, TX (north of Houston), and recently moved to New Jersey from Austin, after finishing a public health and preventive medicine residency at the Texas Department of State Health Services (DSHS). She attended Emory University in Atlanta, GA for college, double majoring in Anthropology and Biology. SheI graduated from UT Health San Antonio Long School of Medicine with a MD/MPH and initially matched into psychiatry, completing her intern year in 2020. Ultimately, she switched specialties, which brought her to Austin. Last spring, she discovered an interest in toxicology while working with data from the Texas Poison Center Network, specifically suspected suicides and attempts in children, adolescents, and young adults before and during the pandemic.

Her professional interests include medical/public health education, mental health, injury/violence prevention, health technology/social media, health literacy, and health policy and advocacy at the national level. Outside of work, she enjoys hiking and being outside, along with her cats. She used to play tennis and was in orchestra and choir, and hopes to find new opportunities in those areas.

Alumni

Trevor Cerbini, MD (2024)
Noah Berland, MD (2023)
Thuyet-Anh Nguyen, MD (2023)
Mohammed Jefri, MD (2022)
David Loughran, MD (2022)
Christopher Meaden, MD (2021)