Free ResourcesRelated Titles |
||||||||||||||||
|
||||||||||||||||
|
||||||||||||||||
|
| ||||||||||||||||||||||||||||||||
|
||||||||||||||||||||||||||||||||
Below are the first 10 and last 10 pages of uncorrected machine-read text (when available) of this chapter, followed by the top 30 algorithmically extracted key phrases from the chapter as a whole.
Intended to provide our own search engines and external engines with highly rich, chapter-representative searchable text on the opening pages of each chapter.
Because it is UNCORRECTED material, please consider the following text as a useful but insufficient proxy for the authoritative book pages.
Do not use for reproduction, copying, pasting, or reading; exclusively for search engines.
OCR for page 14
14
CURRENT EDUCATION AND TRAINING
The earlier lOM committee concluded that (~) the care
of inclividuals with occupationally and environmentally-
relatecl exposures ancl/or conditions requires mastery of a
special body of knowledge, skills, and attitudes by the
primary care or other first contact physician, and (2) all
levels of medical education -- undergracluate, graduate,
and continuing education -- are currently deficient in OEM
training. Only 66 percent of U.S. medical schools
specifically teach occupational medicine as part of the
required curriculum; among schools that require such
teaching (about hale, the mean required curriculum time
over 4 years is 4 hours. A 1987 Association of American
Medical Colleges (MMC) survey of medical school
gracluates found that occupational medicine was taken as
an elective by only 1.4 percent, the least frequently
selected elective reported.79 An MMC survey in 1988
found that only one of 127 medical schools reported
having a required course in environmental health, although
100 schools reported that environmental health concepts
OCR for page 15
15
were taught in other courses.20 A survey of 89
departments of internal medicine with divisions of general
internal medicine found that only 20 programs (22
percent) offered clinical occupational medicine experience
to medicine residents, elective in almost all cases.27
, , ad, ~
~ · ~e ~
The deficiency in numbers of academic faculty in
occupational and environmental medicine is
well-documented. In one survey of 102 medical schools,
only 59 percent reported having even a single faculty
member with special interests in occupational medicine.22
In another survey of 127 medical
schools only 37 faculty
were identified as specializing in occupational medicine.
Specialty training in occupational medicine at the
graduate level is largely confined to the 29 occupational
medicine residency training programs approved by the
Accreditation Council for Graduate Medical Education
(ACGME). Most residency programs are based in either
schools of public health or medicine, although some are
jointly sponsored by schools of public health and
medicine. In some instances trainees have dual status as
occupational medicine residents and department of
medicine fellows. The ACGME does not accredit any
occupational and environmental medicine training as a
clinical medical subspecialty. lt is estimated that about 70
resident physicians are produced each year who are
deemed eligible to sit for the certification examination in
occupational medicine by the only extant certifying bocly,
the American Board of Preventive Medicine.
The Subcommittee conceives three levels of specially
prepared specialists and clinicians to provide needed OEM
OCR for page 16
16
training and care (Figure 2~. As is described further in the
following sections, different levels of certification will
recognize their competencies.
Figure 2. Levels of OEM Physician Expertise
Domain I Certification
OEM Specialist
OEM Clinician
Primary Care
Physician
public health agency
full-time faculty
research
consultation
industry
clinical faculty
consultation
community hospital
industry
practitioner
ABPM (OEM)
ABIM or ABFP
ABIM or ABFP
CAQ in OEM
ABIM or ABFP
OEM = occupational and environmental medicine
ABPM = American Board of Preventive Medicine
ABIM = American Board of Internal Medicine
ABFP = American Board of Family Practice
CAQ = Certificate of Added Qualifications
Representative terms from entire chapter:
american board
