Innovative Training for Occupational Med Residents in Non-Urban and Agr Settings

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DESCRIPTION (provided by applicant): Despite centuries of recognition of the contribution of workplace factors to human health, disease, injury, disability, and death, occupational medicine remains an obscure specialty within the health care community. Little emphasis is given to educating physicians at both the undergraduate and post-graduate levels concerning occupational health. Following passage of the Occupational Safety and Health Act of 1970, there was a rise in the number of accredited residency training programs in occupational medicine, reaching a peak in the mid-90s. Since then, the number of such programs has declined rapidly by 35 percent in spite of a recognized shortfall of physicians with formalized training in this area. Remaining programs struggle for funding to sustain their educational efforts. In many specialty areas of medical practice, there is also little attention given to the special needs of non- urban environments. Small employers (e.g., those with fewer than 100 employees) are not unique to rural communities. However, rural communities often lack the infrastructure for developing and sustaining a preventive approach to occupational disease and injury particularly for specific work sectors such as agriculture and construction where the hired and/or migrant workforce may constitute the majority of employees. Specific aims for this training project are to: Sustain and increase the supply of qualified occupational medicine residency trained physicians. Expand capacity by increasing the number of occupational medicine resident graduates who develop specific competencies and receive didactic training in rural/agricultural occupational health. Enhance occupational medicine resident understanding of effective outreach/education and responsible and culturally appropriate research activities through close interaction with a NIOSH Agricultural Health and Safety Center. Nurture partnerships for interdisciplinary clinical experience between an accredited occupational medicine residency program and migrant/community health centers through collaboration with the National Center for Farmworker Health (NCFH). Develop a range of field experiences in the agricultural sector through which residents can improve skills in worksite walk-through.