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

描述(由申请人提供)：尽管几个世纪以来，工作场所因素对人类健康、疾病、伤害、残疾和死亡的贡献得到了承认，但职业医学在卫生保健界仍然是一个鲜为人知的专业。对本科生和研究生阶段的医生职业健康教育重视不够。1970年《职业安全与健康法》通过后，经认可的职业医学住院医师培训方案的数量有所增加，在90年代中期达到顶峰。自那以后，尽管公认在这一领域接受过正规培训的医生短缺，但此类项目的数量迅速下降了35%。剩下的项目努力争取资金来维持他们的教育努力。在医疗实践的许多专业领域，对非城市环境的特殊需求也很少给予关注。小型雇主(例如，雇员不足100人的雇主)并非农村社区独有。然而，农村社区往往缺乏制定和维持预防职业病和伤害的方法的基础设施，特别是在农业和建筑业等特定工作部门，在这些部门，雇用和/或移徙劳动力可能占雇员的大多数。 该培训项目的具体目标是： 支持和增加合格职业医学住院医师的供应。 通过增加培养特定能力并接受农村/农业职业卫生教学培训的职业医学住院医师毕业生人数来扩大能力。 通过与NIOSH农业健康与安全中心的密切互动，提高职业医学驻地人员对有效的外展/教育以及负责任和文化上适当的研究活动的了解。 通过与国家农民工人健康中心(NCFH)的合作，在经认可的职业医学住院医生计划和移民/社区卫生中心之间培养跨学科临床经验的合作伙伴关系。 发展一系列农业部门的实地经验，通过这些经验，居民可以提高工作场所走访的技能。

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.