NIOSH Region II Educational resource Center: Occupation*

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DESCRIPTION (OM-Mt Sinai) The residency training program at Mt. Sinai School of Medicine, a full-time 2-year residency training program, is housed in the Division of Environmental and Occupational Medicine in the Department of Community and Preventive Medicine. The program has trained physicians in occupational medicine since 1973 and has received support from NIOSH since 1978. The Division of Environmental and Occupational Medicine includes over 20 full-time MD and PhD faculty. Additional faculty within the Department of Community and Preventive Medicine and other departments participate in the training program. Key faculty are clearly listed in the application. The occupational medicine residency training program is accredited from the American Council for Graduate Medical Education (2002-2007). The Mt Sinai occupational medicine residency has four essential components (1) a didactic academic program that leads to a Master in Public Health degree, (2) clinical training in occupational medicine, (3) field placement in diverse occupational settings and (4) research training, which are clearly and accurately described in the ERC grant application. Seven specific objects of the training program are listed. The most recent prior NIOSH review (2000) cited mainly strengths and a few weaknesses, which are addressed. The academic component, the MPH degree, requires 39 credits including 25 credits of required courses, 8 credits for completion of the master's thesis and 6 elective credits, fully detailed in the application. All required courses are taught by faculty in the Department of Community and Preventive Medicine, except the industrial hygiene course, which is taught at Hunter College, an ERC affiliated industrial hygiene program. Since the last NIOSH review the courses have been rescheduled to take place predominantly from 4-7pm to enable other students in the Department of Community and Preventive Medicine to jointly complete MPH courses, resulting in larger classes and a broader MPH academic experience. In response to a prior concern regarding the lack of a safety course, all residents now participate in the OSHA 10 hour safety course and a new one credit supplemental safety and ergonomic course was added. There is no specific course on research methodology but this topic is covered in several courses within the MPH program. The second component of the training program, clinical training in occupational and environmental medicine, is accomplished by a well-organized and supervised clinical experience for residents in the Irving J. Selikoff Center for Occupational and Environmental Medicine at Mount Sinai. This large active clinical center receives New York State funding, is the flagship of the statewide system, and has expanded substantially since the World Trade Center disaster. Residents attend 1 clinic session a week, evaluating 2-4 patients /session, under the direct supervision of a designated teaching attending physician. Patients are pre-selected from a larger number of patients being evaluated at the Selikoff Center to ensure exposure to a wide a wide spectrum of occupational and environmental problems. Residents participate in field surveys of groups of workers with common exposures, which provides experience with screening of exposed workers, field collection of data, and data analysis. The residents also rotate through the World Trade Center medical monitoring program. The third component of the training program involves field placement in different occupational health settings during the two year residency. A number of practicum experiences, outlined in the grant application and appendices are available, some mandatory and some elective, including OSHA, Consolidated Edison, New York City Department of Health, Exxon, and the Miller Health Institute for Performing Artists. These practicum / field rotations are focused more on governmental agencies, corporate occupational health facilities, and specialized clinical services, rather than industrial manufacturing sites (likely reflecting the New York City area economy). They appear to be well organized and provide a diverse and rich spectrum of practicum experiences. Sites are revised and changed in response to resident feedback and practical considerations. The fourth component of the training program is research training. A research project is required to complete the MPH degree, but a specific plan for research training is not described in detail in the Occupational medicine training program application. However, specific funding for research training is not requested and the separate Pilot Research Training Program provides a very effective means of fostering new investigators in the field. Importantly, the Mt. Sinai Division of Environmental and Occupational Medicine and other components of the ERC provide a strong productive research environment with substantial external funding and numerous opportunities for residents to gain research experience. Numerous educational conferences and seminars occur on a regular weekly or bi-monthly basis, including a clinical case conference, a clinical lecture, radiographic review session, a regular journal club, and research conferences. The weekly schedule is clearly outlined. The Mt. Sinai occupational medicine residency program currently has 5 residents and has graduated 12 residents in the past 5 years. The program is limited to 2 residents / year by the graduate division of Mt Sinai School of Medicine. The residency program attracts very well qualified applicants many of whom have completed three years of post graduate medical education in internal medicine or another primary care specialty prior to starting their residency in occupational medicine. There is a substantial national and regional need for physicians trained in occupational and environmental medicine, which has grown since 9/11/01. The Mount Sinai program is the only full time occupational medicine training program in New York State. There are more jobs available in the region than trained occupational medicine physicians.