Fellowship Facts

• Number of fellowships: 32 medical toxicology fellowship training programs in the United States
• Number of fellowship spots: Typically, there are about 100 fellows-in-training at any one time (about 50 first-year positions per year).
• Length of fellowship training: Two years
• Primary Specialties that apply: Physicians from all specialties may apply to a Medical Toxicology Fellowship. The majority of applicants have primary training in Emergency Medicine, Pediatrics, Internal Medicine, Family Medicine, and Preventive Medicine.
• Board certification: Fellows are permitted to take the medical toxicology board certification examination after completing all of the requirements of a two-year ACGME-accredited Medical Toxicology fellowship. The board exam is administered every 2 years in the Fall.

How to choose a fellowship?

• Fellowship programs typically have 1-3 fellows per year. 
• Although all accredited programs must adhere to a core curriculum, some programs place varied emphasis on research, clinical care, addiction medicine, scholarly activities, or administration.
• Programs may vary in their emphasis on bedside consultations, Poison Center consultations, or inpatient clinical services.
• Some offer additional experiences (international opportunities) or degrees (MPH).
• For primary trained Emergency Physicians, the emergency medicine shift expectation varies from program to program.xpectation varies from program to program.
  • Certain programs will require fellows to work shifts in the emergency department as part of their fellowship program, while others do not require it and/or allow for moonlighting.

How do I apply for a Medical Toxicology Fellowship?

• Medical Toxicology Fellowships participate in the NRMP Match.
• Some, but not all, programs use ERAS to apply to fellowship. Be sure to check the website or directly contact the individual program to find out how to apply.
  • For programs using ERAS, applicants can begin to enter their information in early July. Programs will be able to see the applications in mid-July.
  • Letters of recommendation may take several weeks to write and upload. Program Directors encourage applicants to ask for letters several weeks before they are due.
• The date when applicant (and program) rank lists are due is typically the first week in November for programs starting the following July.
• Interested applicants are encouraged to get their applications in to programs early (by mid-July for ERAS programs) even if letters of recommendation are not yet uploaded or sent.
• Application requirements: This varies by program and instructions are typically found on each program’s website. However, most programs will require:
  •  a current Curriculum Vitae (CV)
  • three or more letters of recommendation
    • Most programs prefer at least one letter from a medical toxicologist, if possible
    • Some programs require a letter from your current, or most recent, Program Director.
  • a personal statement or letter of intent
    • Typically, these include the reason that you have chosen medical toxicology

Resources about fellowship program requirements and deadlines:

• View our directory of Fellowship Programs and contact individual programs.
• Click here for a printable directory of all Medical Toxicology Fellowship Programs (including applicant eligibility).
• Fellowship Application and Match Dates

How competitive is the match for Medical Toxicology?

• Medical Toxicology is a somewhat competitive specialty match. 
• In 2024,
  • 56 applicants applied for 53 positions
  • 91% of programs filled
  • 89% of applicants matched to a medical toxicology program
    • https://www.nrmp.org/wp-content/uploads/2024/10/Emergency-Medicine-MRS-Report-2024.pdf 
• Since most programs only accept 1-3 fellows per year, matching in a specific program may be more competitive. However, most applicants match into one of their top 3 programs.  

What if I don’t match?

• Applicants who do not match will have access to a List of Unmatched Programs from NRMP. A List of Unmatched Applicants will be available to Program Directors as well.
  • https://www.nrmp.org/fellowship-applicants/after-the-match/ 
• Once the match is completed, unmatched applicants may contact any of the unmatched program directors to discuss a position and/or set up an interview. 

2025 Match/2026 Appointment Year 
ERAS opens for applicants: July 3, 2025

ERAS applications available for Program Directors: July 17, 2025

Match Opens: August 20, 2025
Ranking Opens: September 24, 2025
Quota Change Deadline: October 22, 2025
Ranking Deadline: November 5, 2025
Match Day: November 19, 2025