The Occupational Medicine Pipeline: Report on the Results of a Survey of International Occupational Medicine Society Collaborative (IOMSC) Member Countries.

OBJECTIVE: To learn how occupational and environmental medicine (OEM) expertise is developed and maintained around the world and to inform strategies for further international development of OEM. METHODS: An anonymous survey was conducted of leaders of the 48 member societies (from 43 countries) of the International Occupational Medicine Society Collaborative (IOMSC) to evaluate OEM training, certification, maintenance, and recertification requirements. RESULTS: OEM physician leaders representing 46 of the 48 IOMSC member societies (95.8%) completed the survey between December 2019 and February 2020. Academic post-graduate and on-the-job training were the most frequent methods for developing OEM expertise, with little use of online coursework and minimal OEM content in medical school in most countries. Occupational medicine board certification usually required graduate specialty training and passing a certification examination, while occupational medicine recertification requirements were uncommon. CONCLUSION: The IOMSC is positioned to support the international development of OEM expertise by sharing information on competencies, best practices in medical education curriculum content and examples of OEM specialty certification pathways from different countries.

Back injuries--getting injured workers back to work.

BACKGROUND: Back problems are the seventh most common reason for seeking care in general practice in Australia. Despite medical advances, chronic disability from back pain is a major contributor to the burden of disease in society today. OBJECTIVE: This article provides an overview of evidence based management for workers presenting with acute low back pain, with the aim of minimising the risk of chronic disability. DISCUSSION: Approximately 95% of cases of acute low back pain are nonspecific. Serious spinal conditions are rare and can be identified by triaging for 'red flags'. A modern biopsychosocial approach does not require a specific patho-anatomic diagnosis for effective management. It is essential to reassure patients to stay active and to resume normal activities quickly--including return to work. Screening for environmental and psychosocial 'yellow flags' can identify patients at risk of poorer outcomes so that additional early intervention can commence.