Training In Occupational Medicine Research Articles

The Slow-Moving Crisis of Training in Occupational and Environmental Medicine.

The Slow-Moving Crisis of Training in Occupational and Environmental Medicine.

Integrating the Lifestyle Medicine Residency Curriculum into an Occupational Medicine Training Program.

Integrating the Lifestyle Medicine Residency Curriculum into an Occupational Medicine Training Program.

Zufriedenheit angehender Arbeits- und Betriebsmedizinerinnen und -mediziner mit der digitalen Lehre in arbeitsmedizinischen Weiterbildungskursen während der COVID-19-Pandemie

Satisfaction of prospective occupational and workplace physicians with digital training in postgraduate occupational medicine courses during COVID-19 pandemic – A quantitative survey in Germany Objective: The aim of this paper is to investigate the satisfaction of prospective occupational and workplace physicians with the mandatory postgraduate training in occupational medicine offered by academies in Germany, which had to be rapidly converted from face-to-face to digital training during the COVID-19 pandemic. Methods: Prospective occupational and workplace physicians in postgraduate medical education throughout Germany were asked about their needs and their satisfaction with digital training during the COVID-19 pandemic. The online survey took place from January to December 2021 and collected data were analysed descriptively. Results: Of the n=176 respondents, 48.0 % were satisfied with their academy‘s digital training in occupational medicine during the COVID-19 pandemic. The majority expressed a desire for further digital training in the future to complement face-to-face training (91.9 %). Different preferences for the use of both formats were identified. Conclusions: This study provides initial empirical evidence of the satisfaction and needs of prospective occupational and workplace physicians with the ad hoc digital training in occupational medicine offered by academies in Germany in the course of the COVID-19 pandemic. The study results provide a basis for the further development and implementation of blended learning programmes in postgraduate and continuing medical education. Future studies should longitudinally evaluate both qualitatively and quantitatively the implementation of blended learning programmes at academies of continuing medical education. Keywords: medical education – online learning – COVID-19 pandemic – e-learning – blended learning

Occupational lung disease: when should I think of it and why is it important?

Exposure to toxic inhalants in the workplace has the potential to cause (in susceptible individuals) almost any major type of lung disease, such as asthma, COPD and interstitial lung diseases. Patients with occupational lung disease will often present to or will be managed by respiratory specialists without training in occupational respiratory medicine, and patients (or their clinicians) may not identify a link between their disease and their current or a past job. Without an awareness of the range of different occupational lung diseases that exist, their similarity to their non-occupational counterparts, and without directed questioning, these conditions may go unidentified. Patients with occupational lung diseases are often in lower paid work and are disproportionally affected by health inequality. Both clinical and socioeconomic outcomes generally improve if cases are identified early. This allows appropriate advice to be given about the risks of ongoing exposure, clinical management, occupational mobility and, in some cases, eligibility for legal compensation. As respiratory professionals, it is important that these cases are not missed, and if needed, are discussed with a physician with specialised expertise. Here we describe some of the most common occupational lung diseases and outline the diagnostic and treatment approach.

A Proposed Two-Track Fellowship Training in Occupational and Environmental Medicine

Excerpts:
 "The new millennium, characterized by rapid industrialization, urbanization, environmental degradation, natural and man-made disasters, and newly emerging diseases affecting the working population and communities, is full of challenges which have to be addressed by policy makers of concerned government and non-government institutions. As of the present however, no formal specialty training program in Occupational and Environmental Medicine is being offered by any institution here in the Philippines.
 Occupational and Environmental Medicine: Scope and Relevance
 Occupational and Environmental Medicine (OEM) is perhaps the most comprehensive of all medical specialties. It is devoted to the prevention and management of occupational and environmental injury, illness and disability; as well as the promotion of health and productivity of workers, their families and communities.
 OEM is a discipline to pursue especially in a developing country like the Philippines, wherein a considerable number of workers and their families reside in agricultural and mining communities, and are therefore exposed to various occupational and environmental hazards..." 
 
 Read the full article in the attached pdf.

Online-Befragung der Ärzteschaft zu Kenntnissen über Berufskrankheiten

ZusammenfassungHintergrundBasiswissen über Berufskrankheiten (BK) ist für jeden Arzt erforderlich. BK dürfen nicht übersehen werden. Hauptziel dieser Studie war es, das selbsteingeschätzte Wissen zum Thema arbeitsbedingte Erkrankungen (aE) und BK sowie das Handeln bei begründetem Verdacht auf eine BK bei Ärzten verschiedener Fachgebiete zu erfassen und Ärzte verschiedener Fachrichtungen in Bezug auf dieses Thema zu sensibilisieren, insbesondere für die berufsbedingten Krebserkrankungen.MethodikIm Zeitraum von 11/2014 bis 5/2015 erfolgte eine Online-Befragung unter Ärzten verschiedener Fachrichtungen.ErgebnisseEs nahmen 254 in Sachsen-Anhalt registrierte Ärzte/innen, die ihr Studium in verschiedenen Bundesländern absolviert haben, an der Befragung teil. Der größte Anteil der Ärzte/innen (69,7 %) war zwischen 40 und 59 Jahre alt. Der überwiegende Teil der Ärzteschaft verfügte über 16 bis 30 Berufsjahre. Knapp ein Viertel aller Befragten schätzte den eigenen Kenntnisstand zu diesem Thema als mangelhaft/ungenügend ein. Die Hälfte der Befragten gab eine nicht ausreichende Vorbereitung zu dieser Problematik, während des Studiums oder während der Facharztausbildung, in ihrem Fach an. 91,1 % der Befragten unterschätzten die Wichtigkeit der arbeitsmedizinischen Kenntnisse auf diesem Gebiet während des Studiums teilweise oder komplett. Knapp drei Viertel der Befragten haben während ihrer beruflichen Tätigkeit noch keine Fortbildungsangebote zu dieser Thematik wahrgenommen.DiskussionEs bestehen hohe fachliche und ethische Anforderungen an den Arzt, BK frühzeitig zu erkennen und der Anzeigepflicht bei BK nachzugehen. Die Befragung diente u. a. auch dem Ziel, die Wege der Qualitätssicherung der universitären Lehre sowie von Fort- und Weiterbildungen mit einem interdisziplinären Charakter aufzuzeigen. Gemeinsame Fortbildungen zur Vermittlung der arbeitsmedizinischen Kompetenz zum Thema Berufskrankheiten sollten vermehrt angeboten werden. Die Kommunikation in der Lehre soll aufzeigen, wie wichtig die arbeitsmedizinischen Kenntnisse für jeden Arzt sind.

Occupational health

We spend the majority of our healthy years in employment. With retirement ages increasing and a reduction in healthy lifespan, the interactions of work and health are growing ever more complex. This article serves as an introduction to occupational medicine for GPs supporting patients’ healthy working lives. As well as looking at some common occupational conditions, this article will explore avenues to further training in occupational medicine.

Occupational health within the bounds of primary care: Factors shaping the health of Latina/o immigrant workers in federally qualified health centers.

Many workers seek care for work-related medical conditions in primary care settings. Additionally, occupational medicine training is not consistently addressed in primary care professional training. These patterns raise concerns about the health outcomes of low-wage Latina/o immigrant workers who make use of primary care settings to obtain care for work-related injuries and illnesses. The objective of this qualitative study was to investigate how primary care clinicians assessed and addressed the role of occupational exposures on the health and well-being of Latina/o immigrant workers. We conducted semistructured in-depth interviews with 17 primary care clinicians (physicians, resident physicians, and nurse practitioners) employed in an urban federally qualified health center (FQHC) with two sites located in Orange County, CA. Using a constructivist grounded theory approach, we determined that primary care clinicians had a general understanding that employment influenced the health and well-being of their Latina/o immigrant patients. Clinicians delivered care to Latina/o immigrant workers who feared reporting their injury to their employer and to Latina/o immigrants whose workers' compensation claim was terminated before making a full recovery. Clinicians were responsive to patients' work-related concerns and leveraged the resources available within the FQHC. Although some clinicians offered suggestions to improve occupational health in the FQHC, a few clinicians raised concerns about the feasibility of additional health screenings and clinic-based interventions, and pointed to the importance of interventions outside of the healthcare system. This study underscores the complexities of addressing occupational health concerns in urban FQHCs.

Occupational medicine training in Korea

Occupational medicine training in Korea

Outcomes of an Intervention to Increase Physicians Underrepresented in Medicine in Occupational Medicine Training.

Diversity in the US physician workforce is important. Physicians Underrepresented in Medicine (UIM) are more likely to serve poor, uninsured, and vulnerable populations. To increase the number of UIM physicians in Occupational Medicine. An Inclusion and Diversity Committee, consisting of the program director, trainees, and graduates, was created with the goal of recruiting and developing UIM residents and increasing Occupational and Environmental Medicine awareness. Outreach to UIM residents and medical students at local, regional, and national meetings, creation and distribution of descriptive brochures, and supervised 1-day observerships were some of the interventions. Only 4 Underrepresented Minorities physicians out of 65 (6%) graduated during the first decade of the program 1997-2007; this increased to (16/70) 23% during the following decade subsequent to establishing the Inclusion and Diversity Committee. A multifaceted strategic approach can help increase UIM physician participation in graduate training programs, helping address health equity.

A short review of undergraduate occupational medicine training.

Medical schools worldwide allocate little time and utilize varying formats in the teaching of occupational medicine (OM) to undergraduate medical students. To identify undergraduate OM teaching formats and highlight key findings in these different methods. A limited literature search conducted on PubMed and Scopus identified relevant articles published in English and between the years 2009 and 2018. Our inclusion criteria were papers containing the key words ('occupational medicine' AND ('medical students' OR 'undergraduate medical')) OR ('occupational medicine' AND ('training' OR 'education' OR 'teaching')) in the title or abstract and those that specifically discussed OM education. The literature search yielded 1479 papers. Seven of them fulfilled the inclusion criteria and were reviewed in full. Formats in OM education of undergraduate medical students include, either singly or in combination, the use of case studies, didactic sessions, workplace visits, text-based readings and pro forma. OM education has a very small footprint in most undergraduate medical curricula. The studies show that different teaching formats are utilized, often in combination. Case-based discussions and workplace visits are frequently used with good qualitative results. Text-based readings will serve well to build good foundational knowledge, though there is no conclusive evidence that students will perform better.

New approaches to professional training in occupational medicine

The authors presented new forms of professional training for specialists in occupational medicine (network type of running educational programs, electronic education and distant training technologies, etc.), based on continuous training concept with module system and creation of competency approach.

Two decades’ contribution of occupational medicine training in Thailand: experience from the foundation with a view toward the future

Abstract For 2 decades, the Department of Preventive and Social Medicine, Faculty of Medicine, Chulalongkorn University, has served the Occupational Medicine Residency training program in Thailand. Graduates of this program undertake to work in occupational medicine to promote health and prevent morbidity and mortality in the workplace and provide occupational medical services for the working population in Thailand. Qualifying for a Postgraduate Diploma in Occupational Medicine in Thailand can be achieved in 2 ways: through a 3-year residency training or 5 years of working experience in the field of occupational medicine combined with an elective 2-month short course. There are currently 159 Thai board-certified occupational medicine physicians. Occupational medicine physicians in Thailand work in both public and private healthcare facilities. A number of certified occupational physicians occupy leading national health positions in various government and academic organizations. Knowledge of occupational medicine is currently essential for undergraduate medical students as specified in the medical competency assessment criteria of the Thai Medical Council. Updating content and incorporating needs of employers are keys to success for Thailand, as a country with an occupational medicine training program in its initial stages. In Thailand, the supply of occupational medicine physicians is still less than the increasing demand. Advancement of health research schemes would contribute to the curriculum. Occupational medicine development in Thailand needs to address challenges in local issues including work in the informal sector, particularly in agriculture, and incorporate standardization and international consistency into the training curriculum and qualifying management.

Specialty training in Occupational Medicine

Specialty training in Occupational Medicine

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

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. We evaluated educational outcomes from a novel residency program for midcareer physicians seeking formal training and board certification in occupational medicine. 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. 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. 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.

EELAB: an innovative educational resource in occupational medicine.

Postgraduate education, training and clinical governance in occupational medicine (OM) require easily accessible yet rigorous, research and evidence-based tools based on actual clinical practice. To develop and evaluate an online resource helping physicians develop their OM skills using their own cases of work-related ill-health (WRIH). WRIH data reported by general practitioners (GPs) to The Health and Occupation Research (THOR) network were used to identify common OM clinical problems, their reported causes and management. Searches were undertaken for corresponding evidence-based and audit guidelines. A web portal entitled Electronic, Experiential, Learning, Audit and Benchmarking (EELAB) was designed to enable access to interactive resources preferably by entering data about actual cases. EELAB offered disease-specific online learning and self-assessment, self-audit of clinical management against external standards and benchmarking against their peers' practices as recorded in the research database. The resource was made available to 250 GPs and 224 occupational physicians in UK as well as postgraduate OM students for evaluation. Feedback was generally very favourable with physicians reporting their EELAB use for case-based assignments. Comments such as those suggesting a wider range of clinical conditions have guided further improvement. External peer-reviewed evaluation resulted in accreditation by the Royal College of GPs and by the Faculties of OM (FOM) of London and of Ireland. This innovative resource has been shown to achieve education, self-audit and benchmarking objectives, based on the participants' clinical practice and an extensive research database.

Training in Occupational Medicine: Jurisprudential Malfunctions in the Italian System and European Perspectives.

To practice occupational health in Europe, a medical doctor must qualify in occupational medicine. This requires a period of postgraduate specialist medical training lasting a minimum of four years, in conformity with European regulations, to obtain a certificate of completion of training which is then mutually recognized within the entire European Union. In 2002 an Italian law allowed doctors specialized in public health medicine and legal/forensic medicine to also practice as consultants in occupational medicine in the country. However a subsequent law in 2008 determined that only physicians specialized in occupational medicine could freely practice as consultants in this discipline. The other two categories (consultants in public health medicine and consultants in legal/forensic medicine) were required to undertake additional training (a Master course) to qualify as consultants in occupational medicine. Doctors who entered postgraduate training in public health or legal/forensic medicine before 2008, with the option to practice also as consultants in occupational medicine upon completion of their training, suffered an unprecedented and legally questionable retroactive application of this new law which stripped them of previously acquired rights. Moreover, even after qualifying by undertaking this extra training in occupational medicine, the latter two categories of doctors do not have their training recognized in other member states of the European Union. To disallow the rights of doctors qualified in occupational medicine to work as consultants in the latter medical discipline elsewhere within the European Union seems a clear violation of professional rights and, as such, legal action could be taken to submit this issue to European attention.

The influence of prior training on GPs' attitudes to sickness absence certification post-fit note.

Aim To investigate the attitudes to health and work of general practitioners (GPs) with training in occupational medicine (OM) compared with non-OM trained GPs, since the introduction of the fit note. Changes to the UK sickness certification system since 2010 and the introduction of the fit note required GPs to change their focus to what patients can do, rather than what they cannot do in relation to work. In an effort to reduce the UK sickness absence burden, GPs completion of the fit note should help to keep people in work, or assist patients to return to work as quickly as possible after a period of absence. Questionnaire data were collected via the 7th National General Practitioner Worklife Survey. Findings Results indicate that responses from GPs who had undertaken training in OM, and GPs having received some form of work and health training in the 12-month period before the study were associated with significantly more positive attitudes to patients' returning to work and to the fit note. This study reveals evidence of a difference between trained and non-trained GPs in their attitude to the fit note, and to work and health generally. Further work investigating the effect of specific training in OM on the management and recognition of ill-health by GPs is recommended.

Do GPs record the occupation of their patients?

General practitioners (GPs) have a central role in providing advice about fitness for work, yet there are concerns about their understanding of the relationship between work and health. To assess whether GPs in one Cornish practice record the occupation of patients of working age and to quantify how important GPs in Cornwall consider recording of occupation in working-age patients. An audit of the notes of 300 working-age patients in one practice, a search of the computer records at a different practice and a questionnaire survey of 202 GPs in practices in Cornwall. Occupation was recorded in 50 (17%) of the 300 patient notes audited. The questionnaire response rate was 31%. Few (8%) respondents reported training in occupational medicine. Most (65%) of GPs recorded their patients' occupation some of the time. A third (32%) of GPs did not consider it important to record patients' occupations. GPs in two Cornish practices recorded the occupation of working-age patients infrequently, but over two-thirds of GPs in Cornwall believe it is important to do so. If these results reflect the practice of UK GPs, the new 'e-fit note' may be of limited value in monitoring and analysing sickness absence.

Work-related sickness absence as reported by UK general practitioners

Issues surrounding sickness absence are of interest due to growing awareness of the costs to employers and the UK economy, a greater understanding of the interaction between health and work, and increasing evidence that work is beneficial to physical and mental well-being. The Health & Occupation Reporting network in General Practice (THOR-GP) is a national source of information on work-related sickness absence. To assess the factors influencing work-related sickness absence in the UK. General practitioners (GPs) report cases of work-related ill-health via an online web form. Sickness absence information reported with each case was compared by demographic information, diagnosis/symptom and employment factors. Between 2006 and 2009, THOR-GP received 5683 case reports of work-related ill-health; 53% were musculoskeletal diagnoses and 31% were mental ill-health diagnoses. Over half (56%) of cases reported had associated sickness absence. Diagnosis had a highly significant influence on the occurrence of any associated sickness absence. Eighty-one per cent of mental ill-health cases were reported to result in sickness absence compared to 50% of musculoskeletal cases. Public sector employees incurred sickness absence more frequently than those from the private sector. Industries with the highest mental ill-health incidence rates had sickness absence episodes most frequently. Within employment groups, levels of sickness absence were inversely proportional to the level of self-employment. These data reported by GPs with vocational training in occupational medicine may help to inform policy decisions targeting work-related exposures and the management of sickness absence, thereby reducing the UK burden of work-related sickness absence.