activities range from molecular biology to epidemiology, as long as they deal in some way with the toxic effects of chemicals. The term clinical toxicologist implies a more clinical orientation, but likewise has no specific definition or implications. Medical toxicologists are physicians with specific training and board certification in the subspecialty of medical toxicology, which focuses on the care of poisoned patients.
Specialists in poison information are health care professionals (primarily nurses or pharmacists) who serve as poison control center staff with the primary responsibility of responding to telephone calls regarding poisoning exposures or requests for information. Poison information providers are individuals who may lack training in nursing, pharmacy, or medicine but serve in a similar capacity to SPIs within poison control centers, but with supervision by an SPI or a medical or managing director.
Medical toxicology is a subspecialty for physicians defined by the Accreditation Council for Graduate Medical Education (ACGME) as a “clinical specialty that includes the monitoring, prevention, evaluation and treatment of injury and illness due to occupational and environmental exposures, pharmaceutical agents, as well as unintentional and intentional poisoning in all age groups” (Accreditation Council for Graduate Medical Education, 2003). Medical toxicologists first complete training in any primary medical specialty (usually emergency medicine, occupational medicine, pediatrics, internal medicine, or pathology), and then an additional 2-year fellowship in medical toxicology (Wax and Donovan, 2000).
AAPCC requires a board-certified medical toxicologist as medical director as a condition of poison control center certification. In this capacity, medical toxicologists provide overall clinical supervision and medical backup of poison control center personnel and contribute to teaching, administrative, and research efforts within the center. Medical toxicologists also serve as consultants to centers, providing medical backup, teaching, or research expertise.
Common roles for medical toxicologists outside poison control centers include direct care or consultation regarding poisoned patients, teaching of medical toxicology fellows and other health care professionals, toxicology research, and medicolegal consultation. A smaller number of medical toxicologists work in various capacities in public health or government agencies, including CDC and the U.S. Food and Drug Administration, or in industry (Wax and Donovan, 2000).