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EXECUTIVE SUMMARY Occupational and environmental diseases encompass a broad range of human illness, and give rise to the disciplines of occupational and environmental medicine. Occupational medicine addresses the relation between workplace factors tincturing physical, chemical, biological, social, and psychological factors) and health. Environmental medicine includes most aspects of occupational medicine, and encompasses conditions related to environmental exposure to chemical, physical, and biological agents. Estimates of physician supply in these fields are derived from several sources, largely se~f- reporting by physicians, and have deliberately not included the newer and less-defined field of environmental medicine. A 1989 estimate commissioned by the Institute of Medicine indicates an additional need for 3,100 to 5,500 physicians, including primary care physicians with special

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2 competence in occupational and environmental medicine. For fulI-fIedged specialists.alone, the deficit is estimated to range between 1,600 and 3,500. The fOM offers six specific measures to alleviate the shortage of physicians in occupational and environmental medicine: (i) increase interest in the field of occupational and environmental medicine among students and trainees; (ii) establish a cohort of centers of excellence to train future teachers, researchers, and leaders; (iii) integrate environmental medicine with occupational medicine training and research programs; (iv) increase funding for faculty clevelopment; (v) support residency and fellowship training; and (vi) explore, refine, and adopt new pathways to certification and accreditation in occupational and environmental medicine.