Fellowship in Medical Toxicology
Introduction
Welcome to the Medical Toxicology Fellowship, sponsored by the Department of Emergency Medicine, New Jersey Medical School 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 medical toxicology 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 medical toxicology 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, etc.)
- 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. So much learning is derived through the interaction of
clinical cases with bedside care. This is supported through discussion,
reading, supplemental materials, and follow up. A formal educational curriculum, combined with the knowledge and teaching of the
faculty and CSPIs, as well as the diversity of cases that come through NJPIES,
rounds out the educational experience.
- Fellows rounds and case review - daily, mediated by
faculty and fellows
- Didactic rotator rounds - daily, coordinated between
fellows, faculty, and ATEAM (see below)
- Core content - regular reading assignments from the Core Content of Medical Toxicology, with fellow generated question bank / flashcards,
which complements our board review efforts
- 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 students, rotators and fellows, a
regional case conference, journal club, and more. Multiple opportunities for
fellow engagement and presentation.
- The American College of Medical Toxicology (ACMT)
National Case Conference, along with the ACMT 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 Associate Professor of Emergency Medicine 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 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
Chris Counts (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 withdrawal, and health policy. During
his free time, Chris is likely exercising, speed-listening to podcasts, or
playing with his dog.
Tony Spadaro (2nd Year Fellow)
Tony Spadaro attended the
University of Pennsylvania where he complete 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 include
naloxone distribution in the ED, the impacts of fentanyl on precipitated
withdrawal, 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 (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
Midwestern 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 cardiotoxins. Outside of medicine, Ivan enjoys fishing,
snowboarding, and travel.
Alison Yarp (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.
