Rotating Physicians’ Orientation Guide

 

Welcome to Toxikon!

 

Congratulations on choosing the Toxikon Consortium for your clinical rotation in medical toxicology.  The Toxikon rotation is designed for clinical service, education and research.  You will be exposed to a wide variety of cases during calls and educational activities.  Expect an excellent month of clinical experience.  Emergency Medicine residents routinely rotate on our service from Cook County Hospital (CCH), U of I at Chicago (UIC), Chicago Osteopathic, Northwestern, and Resurrection.  Residents from other medical specialties rotate with us as well, as do Pediatric EM fellows from Children’s and CCH.

Much of your experience will be supervised by the toxicology fellows.  If you have any question or problem don’t hesitate to discuss it with one of the fellows or attendings.

 

 

Location

 

Toxikon is based in the Cook County Administrative Building (CCAB, which was previously the School of Nursing, CCSN) at 1900 West Polk Street, Chicago, in the Division of Occupational Medicine.  The division office is Suite 500, and all of our offices are on the 5th floor.  We typically meet in the Division Conference Room on the 5th floor every Tuesday and Thursday.  On Wednesdays we typically meet across the street in the University of Illinois College of Medicine West, 4th floor, Room 419. On Mondays we meet at the Illinois Poison Center, which is located on the 19th floor of the new Union Station building. 

A copy of the daily schedule is provided in your binder. 

Pay close attention to announcements; meeting times and locations change frequently!

 

 

Checking In

 

To successfully start and complete this rotation you MUST :

·         Have a current, valid Cook County Hospital ID (can be obtained on Mondays and Wednesdays ONLY)

·         Be available 8A – 5P Monday – Friday

·         Complete all records and turn them with your binder at the completion of your rotation.

·         Do a formal presentation

·         Please dress appropriately: we do bedside consults, attend tox clinic, and are regularly invited to special lectures and rounds throughout the city. (No white coat needed, just business casual dress.)

 

 

Attendance

 

At least two physicians are expected to be in the tox department at CCH each weekday until 5:00 PM.  Normally, one of these is the Toxicology Fellow.  On days when no fellow is in house, two rotating physicians are assigned for these hours.  The board outside the fellow's office contains the most current information re: who is covering each day.  The board is updated each Monday so that there is no confusion.  A11 other residents (who are not on short or long call) must be present daily for morning rounds and as directed for other educational activities.

 

 

Schedule changes

The monthly call schedule will be posted in advance of your rotation.  The schedule is a fixed entity and switches are strongly discouraged.  If you must make a switch you must obtain approval from Dr. Kanter.  Once the monthly call schedule is published, it is your responsibility to notify the poison control center (IPC), CCH and UICMC emergency departments, and the CCH page operator of any change to the schedule.

 

Absences

 

Unexcused absences from the daily and/or call schedule are unacceptable.  Again, the schedule is fixed.  In the event of extraordinary experiences that will necessitate your absence from daily attendance or from the call schedule, inform Dr. Kanter at the earliest possible moment, so that back-up arrangements can be made.  Any absence not approved by Dr. Kanter will be considered an unexcused absence.  Once approved, document your anticipated absence on the appropriate sheet on the board outside the fellows’ office.

 

 

Vacation

 

Vacation while on the tox rotation is allowed only if your parent program has an existing vacation policy arranged with Toxikon.  Even if this is the case, it is your responsibility to arrange your vacation time with Dr. Kanter at least two (2) months prior to the start of your rotation.  Requests (or “notification”) of vacation preferences after this time will not be honored, and it will be your responsibility to arrange call coverage in the event of any absence.

 

 

Moonlighting

 

Moonlighting at any time during the tox rotation is not permitted.  In particular, you may not work clinical shifts in the ED while you are assigned to primary (short or long) call for tox.  If you anticipate a problem complying with this policy, discuss it with Dr. Kanter at the earliest opportunity, to avoid any conflicts.

 

 

Presentations

 

Rotating residents and fellows are required to do a presentation while on tox.  CCH and UIC residents prepare a 30-minute lecture for their respective EM/Tox conferences.  Chicago Osteopathic, Northwestern EM residents, other residents and all medical students will do a 30-minute discussion on either a core topic of their choice, or a clinical issue of interest that comes up during the rotation month.  This will usually be on the last Tuesday of the rotation.  Be sure to sign up for a date and topic on the board outside the fellows’ office.

 

 

Toxikon Service Coverage

 

Toxikon provides consultation services to the entire state of Illinois through the Illinois Poison Center (IPC), and directly to patients at Cook County Hospital and UIC Medical Center.  Attendings are on call at all times to insure quality patient care.  You will always have back-up and are expected to cover the service with proper supervision.  Fellows usually provide initial backup, and attendings provide ultimate backup.  A single call pager is rotated among the first call residents and fellows.  It must be transferred to the person next taking call.

 

On Call Responsibilities

Rotating residents cover the call schedule 24 hours a day, 7 days a week, including holidays. You cannot take call without having a current and valid CCH ID.  Specifically, we have two types of call:  Long and short.  “Short call” residents or fellows are available in house starting at morning rounds, until 5:00 PM each day.  “Long” call starts at morning rounds and lasts until morning rounds the following day.  If you are assigned to either call, you are also expected to be present in the department until 5:00 PM that day (Mon-Fri).

 

Detailed On-Call responsibilities will be discussed on the first day of the rotation.