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

描述（由申请人提供）：尽管几个世纪以来人们都认识到工作场所因素对人类健康、疾病、伤害、残疾和死亡的影响，但职业医学在卫生保健界仍然是一个鲜为人知的专业。很少强调在本科和研究生阶段对医生进行职业健康方面的教育。随着1970年《职业安全与健康法》的通过，职业医学领域获得认可的住院医师培训项目的数量有所增加，在90年代中期达到顶峰。从那时起，尽管在这一领域接受过正规培训的医生数量不足，但这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，也很少注意到非城市环境的特殊需要。小型雇主（例如，雇员少于100人的雇主）并非农村社区所独有。然而，农村社区往往缺乏基础设施，无法制定和维持预防职业病和伤害的办法，特别是在农业和建筑等特定工作部门，因为雇用和/或移徙劳动力可能构成雇员的大多数。

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.