Outcomes of a Survey-Based Approach to Determine Factors Contributing to the Shortage of Occupational Medicine Physicians in the United States.

CONTEXT: There is a long-standing shortage of formally trained Occupational & Environmental Medicine (OEM) physicians despite OEM practitioners experiencing high satisfaction and low burnout. OBJECTIVE: To explore the root causes of this shortage and suggest potential remedies. METHODS: Cross-sectional surveys were administered to medical students queried regarding OEM training, practicing OEM physicians queried regarding timing of specialty choice, and OEM Train-in-Place (TIP) program graduates queried regarding satisfaction with training. RESULTS: Of 247 medical student respondents, 70% had heard of OEM, 60% through one lecture. Of the 160 OEM physicians, 17% first became aware of OEM as medical students, and most would have chosen a different path had they heard sooner. Most TIP program trainees reported that they would not have undertaken specialty training without a TIP program (89%). CONCLUSIONS: Strategies to introduce OEM earlier in medical education and TIP programs for mid-career physicians may help overcome persistent shortages of OEM specialists.

Fitness-for-Duty Assessments of Industrial Firefighters: Guidance for Occupational Medicine Physicians.

: Industrial firefighters share many characteristics with municipal firefighters; however, employers frequently have not addressed or characterized the unique job duties, hazards, and specific physical/mental demands associated with industrial firefighting. In addition, gaps exist in the medical literature with regard to industrial firefighter demographics, behavioral risk factors, and chronic diseases. Finally, the proper methodologies for fitness-for-duty assessment of employees acting in this capacity are lacking. To address these gaps, the American College of Occupational and Environmental Medicine (ACOEM) convened a Task Force in 2014, to develop fitness-for-duty guidance for industrial firefighters. This document highlights these gaps and suggests research opportunities to enhance the health and safety of this population. While an extensive literature review found a lack of studies for this population-thus excluding the development of an evidence-based document-sufficient materials were available from which to draw preliminary conclusions, considerations for best practices, and recommendations for future studies.

Characteristics and Outcomes of an Innovative Train-in-Place Residency Program.

BACKGROUND: Physicians who make a midcareer specialty change may find their options for formal training are limited. Here, we describe a train-in-place program, with measureable outcomes, created to train midcareer physicians who desire formal training in occupational medicine. OBJECTIVE: We evaluated educational outcomes from a novel residency program for midcareer physicians seeking formal training and board certification in occupational medicine. METHODS: Physicians train in place at selected clinical training sites where they practice, and participate in 18 visits to the primary training site over a 2-year period. Program components include competency-based training structured around rotations, mentored projects, and periodic auditing visits to train-in-site locations by program faculty. Main outcome measures are achievement of Accreditation Council for Graduate Medical Education Occupational Medicine Milestones, American College of Occupational and Environmental Medicine competencies, performance on the American College of Preventive Medicine examinations, diversity in selection, placement of graduates, and the number of graduates who remain in the field. RESULTS: Since inception of this program in 1997, there have been 109 graduates who comprise 7.2% of new American Board of Preventive Medicine diplomates over the past decade. Graduates scored competitively on the certifying examination, achieved all milestones, expressed satisfaction with training, and are geographically dispersed, representing every US region. Most practice outside the 25 largest standard metropolitan statistical areas. More than 95% have remained in the field. CONCLUSIONS: Training in place is an effective approach to provide midcareer physicians seeking comprehensive skills and board certification in occupational medicine formal training, and may be adaptable to other specialties.

Occupational medicine residency graduate survey: assessment of training programs and core competencies.

OBJECTIVE: This study provides insight into Occupational Medicine (OM) residency graduates and how residency programs are meeting their education goals. METHODS: A survey of graduates from nine OM residency program was performed to evaluate the effectiveness of OM residency training in the United States and Canada. RESULTS: Eighty percent of the OM residency graduates were currently practicing OM. Three-quarters worked in clinical practice for a mean of 20 hr/wk. Other activities varied and included management, teaching and consulting. Ninety-five percent were satisfied with their OM residency training. The competencies acquired were mostly ranked highly as practice requisites, although preparation in clinical OM might be better emphasized in training. Recent OM residency graduates were more likely to be board-certified in OM than other American College of Occupational and Environmental Medicine physician members (73% vs 41%). CONCLUSIONS: OM residency graduates over the past 10 years were highly satisfied with OM residency training, with the training generally meeting practice needs.

Outcomes from the occupational physicians scholarship fund: private support for physician residency training.

The Occupational Physicians Scholarship Fund (OPSF) was established 20 years ago with the goal of helping to address the critical shortage of qualified physicians entering occupational and environmental medicine (OEM). We examined descriptive and outcome measures to evaluate its success. Information was obtained from members of the original board of directors, the OPSF office, and the American Board of Preventive Medicine (ABPM). Most of the scholars (88%) are diplomats of the ABPM, certified in OEM. Scholars represent 6% of board-certified OEM physicians, score higher on the certifying examination than other examinees, practice in all regions of the United States, and are represented in diverse practice settings. The OPSF has achieved its objectives, producing well-trained physicians who contribute to the growth and vitality of the specialty improving worker health, business productivity, and the environment.