The Toxicology Division is dedicated to Clinical Care, Education, and Research in the area of Medical Toxicology.

Medical Toxicology

Medical Toxicology is a subspecialty devoted to the treatment of poisoned people. It is the youngest specialty in the United States, having been sanctioned by the American Board of Medical Specialties in 1992. The first board certification examination was given by the American Board of Medical Toxicology in 1994, and is given every two years. The professional organizations of medical toxicologists are the American College of Medical Toxicology and the American Academy of Clinical Toxicology. To become a medical toxicologist, one has to obtain a medical degree, complete a residency in either Emergency Medicine, Pediatrics, or Occupational Medicine, and complete a two year fellowship in Medical Toxicology. At the present time, there are three medical toxicologists at the Brody School of Medicine at East Carolina University, William J. Meggs, MD, PhD, FACEP, FACMT; Dr. Susan Miller, MD; and Dr. Mohan Punja, MD.

Clinical Care

The Toxicology Division is available 24 hours a day to provide consultations on the treatment of acutely poisoned patients. An emergency medicine resident and medical toxicologist are on call every day. The call schedule is published monthly and is available Vidant Medical Center, the Intensive Care Units, and hospital wards. In addition, emergency consultations are given by telephone to physicians in the hospitals in the catchment area of Vidant Medical Center. These hospitals often transfer seriously poisoned patients to Vidant Medical Center for evaluation and treatment. Helicopter transfer is available for seriously poisoned people via Vidant Medical Transport Air Medicine Service.


The toxicology division provides education in the area of clinical toxicology at the local, state, and national levels. There is a toxicology rotation available for medical students and residents. This rotation is mandatory for emergency medicine residents at Vidant Medical Center. Toxicology Grand Rounds are the third Tuesday of every month at 9 a.m., in the main hospital auditorium at Vidant Medical Center. Attendance at Toxicology Grand Rounds is certified for one hour of category 1 CME credit for physicians. Toxicology case conference meets once a month to review consultations of note. These conferences take place the last Tuesday of each month at 12 noon.

In addition, educational lectures, grand rounds, and presentation are given in a variety of areas and settings on an ongoing basis. These include Grand Rounds at regional hospitals, lectures at CME courses for physicians, nurses, and paramedics. The faculty actively publish educational materials in major textbooks in toxicology and emergency medicine, including Goldfrank's Toxicological Emergencies, Tintinalli's Study Guide to Emergency Medicine, and Greenberg's Occupational Toxicology.


The Toxicology Division is very active in medical research. The main research focus of the division has been studies to answer important questions in the management of acute poisonings in experimental systems. Other areas of special interest include the toxic induction of asthma and rhinosinusitis, chemical sensitivity, and studies that overlap the fields of toxicology and allergy and immunology. The Toxicology faculty gives presentations of their research results at national and international meetings. They publish frequently in peer-reviewed research journals.