National Grand Rounds - December 2024

John W. Downs, MD MPH, is a graduate of the Virginia Military Institute and served two years as a US Army infantry officer, prior to attending medical school at the Uniformed Services University of the Health Sciences (USU). Dr. Downs completed residency training in internal medicine at Tripler Army Medical Center, Honolulu, Hawaii, and in occupational & environmental medicine at USU, where he also completed a Master of Public Health degree. Dr. Downs later completed a fellowship in medical toxicology at the Virginia Commonwealth University (VCU) Health System. Prior to his recent arrival as medical toxicology faculty at VCU in summer 2024, Dr. Downs was a US Army officer for more than 20 years. His final active-duty tour was at the Uniformed Services University where he was an Associate Professor and the Associate Program Director for the Occupational and Environmental Medicine residency, and an attending physician at Walter Reed National Military Medical Center. 

His military medical experience includes multiple tours as senior medical officer to special operations and light infantry units to include deployments to operations in Iraq and Afghanistan. Dr. Downs’s public health experience includes service as Chief of the Department of Preventive Medicine at Fort Campbell, Kentucky, and Chief, Occupational & Environmental Medicine Service, Walter Reed National Military Medical Center during the COVID-19 pandemic. Dr. Downs is board certified as a physician in internal medicine, occupational & environmental medicine, and medical toxicology. Dr. Downs also holds allied health certifications as a certified public health professional (CPH), and Diplomate of the American Board of Toxicology (DABT). Dr. Downs is a recipient of the Army Surgeon General’s 9A Proficiency Designation in occupational and environmental medicine. He has authored more than 25 peer-reviewed publications. He is a Fellow of the American College of Physicians, and the American College of Occupational and Environmental Medicine.

Nicholas E. Nacca, MD, FACMT is an Assistant Professor of Emergency Medicine, Director of Medical Toxicology, and Associate Fellowship Director of the Medical Toxicology Fellowship Program at the University of Rochester Medical Center (URMC). In addition to his role within the Department of Emergency Medicine, Dr. Nacca holds a secondary appointment in the Department of Environmental Medicine. As Director of Medical Toxicology, Dr. Nacca oversees the educational and clinical operations of the medical toxicology consultation service, where he is actively involved in training medical toxicology fellows, as well as mentoring multidisciplinary teams that include medical residents, pharmacy residents, and medical students. He also staffs and directs a referral-based outpatient Medical Toxicology Clinic, where he provides specialized care to patients requiring toxicological evaluation and treatment. Dr. Nacca’s work bridges clinical practice and education, emphasizing the development of the next generation of toxicology professionals while providing expert consultation in both inpatient and outpatient settings.