Medical toxicologists specialize in the preventing, evaluating, treating, and monitoring an injury or illness from toxic exposure. Physicians attain subspecialty certification in Medical Toxicology by meeting the eligibility criteria, fulfilling specific credential requirements of their primary board, and successfully completing the Medical Toxicology Certification Examination.
ABEM, along with the American Board of Pediatrics (ABP)and the American Board of Preventive Medicine (ABPM), offer subspecialty certification in Medical Toxicology. ABEM is responsible for examination development, administration, scoring, and analysis. Each sponsoring board is responsible for credentialing its respective candidates and notifying them of their examination results.
Each sponsoring board appoints members to the jointly sponsored Medical Toxicology Subboard. There are four members from ABEM, two from ABP, and two members from ABPM. The primary functions of the Subboard are to develop examinations in Medical Toxicology and credential individuals at the request of individual sponsoring boards.
Eligibility
Physicians seeking Medical Toxicology certification must:
- Be certified by an American Board of Medical Specialties (ABMS) Member Board or the American Osteopathic Board of Emergency Medicine (AOBEM)
- Actively participate in the continuing certification process for their primary Board.
- Successfully complete the pre-approved training pathway as specified in the eligibility criteria
- Apply through their home board, whether ABEM, ABP, or ABPM
- Fulfill the ABEM Policy on Medical Licensure
- Comply with the ABEM Policy on Board Eligibility for Subspecialty Certification
As a physician, if you are seeking access to the Medical Toxicology application, first check your ABEM Portal to see if your eligibility has been pre-established and you already have access to apply.
If you do not currently have application access or you do not have an ABEM account, and believe you are eligible to pursue certification, you can request application access using the form below.
Exam Process
The Medical Toxicology Certification Examination is offered every other year, in even numbered years.
Apply
To apply, physicians must complete the current-year application form available on their
ABEM Portal once eligibility is established. Complete application submissions include:
- Completed Medical Toxicology certification application
- Application fee paid through the ABEM Portal
The application fee covers the cost of processing the application only and cannot be refunded.
A final review of an application will be completed when all information is received. Applications that are incomplete will be closed by February of the following year. Physicians with closed applications who want to take the exam must submit new applications and meet all requirements in place at the time the new application is submitted.
Timing Considerations
Physicians can submit their application before their Medical Toxicology training is completed. However, all steps of the application, including verification of the successful completion of training, must be completed before scores will be released.
Physicians can sit for subspecialty exams before obtaining Emergency Medicine certification. However, they are not considered certified in a subspecialty until they become certified in Emergency Medicine.
If a physician chooses to take a subspecialty exam before becoming certified in Emergency Medicine, they will be asked to sign a form acknowledging the following:
- If the results of the Oral Exam are a pass, in which case the physician is certified in Emergency Medicine and will meet the eligibility criteria for certification in the subspecialty, the application for certification in the subspecialty will be approved and scores will be released.
- If the physician does not pass the Oral Exam, they are not certified in Emergency Medicine and will not meet the eligibility criteria for certification in a subspecialty; the subspecialty examination results will be held for 12 months. If the physician does not pass the Oral Exam and become certified within that time, the subspecialty scores are nullified and the examination fees are not refunded. Scores will not be released.
Register
Physicians who apply through ABEM will receive information about how to register for the exam once their application is approved. After registration is completed, physicians will be notified how to schedule an appointment at a Pearson VUE testing center.
Physicians who apply through the ABP and ABPM will be registered by ABEM and notified when they can schedule an appointment to take the examination.
Taking the Exam
The Medical Toxicology Certification Examination is approximately eight hours, with six hours and twenty minutes devoted to actual testing time. This criterion-referenced exam has 300, single-best-answer, multiple choice questions, and 10-15 percent of questions will have an image. The examination is administered at over 200 Pearson VUE professional computer-based testing centers throughout the United States.
Sample Exam Questions
Content Specifications
The 2021 Core Content of Medical Toxicology is the basis for all Medical Toxicology examination content.
Core Content of Medical Toxicology
It is published in the Journal of Medical Toxicology. Hendrickson RG, Bania TC, Baum CR, Greenberg MI, Joldersma KB, Keehbauch JN. The 2021 core content of medical toxicology. J Med Toxicol 2021 Jun 29. doi: 10.1007/s13181-021-00844-5. Online ahead of print.
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Exam Question Distribution
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Principles of Toxicology (1.0)
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14%
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Principles of Pharmacology/Toxicology (1.1)
Principles of Molecular Components/Mechanisms (1.2)
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10%
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Principles of Radiation (1.3)
Mutagenesis and Carcinogenesis (1.4)
Principles of Epigenetics (1.5)
Mechanisms of Reproductive and Developmental Toxicology (1.6)
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4% |
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Toxicants and Toxins (2.0)
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38%
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Medications and Drugs (2.1)
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16%
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Household Items (2.2)
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4%
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Supplements (2.3)
Food Poisoning (2.4)
Fungi (2.5)
Plants (2.6)
Envenomations (2.7)
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10%
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Agents of Warfare/Terrorism (2.8)
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5%
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Radiological (2.9)
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3%
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Clinical Assessment (3.0)
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11%
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Therapeutics (4.0)
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11%
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Assessment and Population Health (5.0)
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3%
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Analytical and Forensic Toxicology and Workplace
Drug Testing (6.0)
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5%
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Environmental Toxicology (7.0)
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5% |
Addiction Toxicology and Substance Use (8.0)
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8% |
Occupational Toxicology (9.0)
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5% |
Passing Criterion and Scoring
The Medical Toxicology Certification Exam is criterion referenced. A criterion-referenced exam uses a predetermined passing score, which is adopted by the Subboard as reflecting its performance standards (The Core Content of Medical Toxicology). All candidates meeting the standard will pass the exam. Quotas or required percentages of candidates passing are not used to determine the passing score.
All candidates achieving a final score of 64 or greater will pass the examination. The score on the exam is a scaled score that ranges from 0 to 100 and does not include field test items. In addition to the field-testing process, each question receives a thorough review before it is used in scoring the examination. Questions that do not meet Subboard’s quality standards are not used in determining candidates’ final scores.
Determining a Passing Score
The passing score was last evaluated in 2022. Best practice in testing suggests that the passing score for an examination be substantially connected to the content and performance standards defined by The Core Content of Medical Toxicology.
In order to maintain this connection, the passing score is typically reviewed every five to seven years, or when the format or content of the exam changes significantly (such as when the Core Content is revised). The process involves a representative panel of clinically active, Medical Toxicology–certified physicians who are trained in a process called “standard setting.” This process requires the participating physicians to thoroughly understand The Core Content of Medical Toxicology. The panelists then evaluate each test question and assess how a candidate who meets the Subboard’s standard would perform. The panel then recommends a passing standard (score) to the Subboard, which weighs this recommendation and uses it to determine a final passing score.
2022 MedTox Certification Exam Scoring FAQs
Results
Exam results are posted on a physician's ABEM Portal within 90 days of the date of the examination. Physicians are notified via email when results are available.