Interest in Occupational Medicine

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C Chance

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Didn't know where this should go as there is no area for Occupational Med. Anyway, I'm going to do an IM residency and am interested in what path could give me the best lifestyle - M-F 8-5 and anything 130K and up is gravy. So I started to check out occupational medicine and it seemed like a nice deal - I was thinking after IM residency to do a 2 yr occupational med residency. I was wondering if anyone else has gone this route or can comment on the lifestyle and compensation of occupational medicine. Also if anyone can comment on how the job market is and how stable these things tend to be would be great. Thanks in advance.
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I am just starting training in occ med, but the graduating residents at my program have easily found jobs. Compensation is mostly from worker's comp and compared to other primary care like specialties, occ med physicians will get 95-97% reimbursed for what they bill compared to an internist who may only get 50%. I was told the salary will be about $150,000-$180,000 for the first couple of years and then after a few years experience, you can become a medical director and the pay will go up. People can go into occ med after one preliminary year or a residency or even in mid-career.
 
Several other questions

1. Are the residencies in occ med hard to get into?

2. What are the hours like for a practicing occ med doc? Is it M-F 8-5?

3. Is it relatively stress free?

Thanks for your reply, there seems to be very little info on this field
 
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I can only relay what I hear

1. Are the residencies in occ med hard to get into?

As of now, it is non-competitive because almost all of them are outside of the match. However, almost all programs will be using ERAS by next year and they may decide in the next few years to do a match for a residency or fellowship spot which may make it more competitive just due to increased advertising of a relatively poorly known field.

All programs are not the same, some programs require a completed 3 year residency, most do not. Nicer locations or well-known names may be a little more competitive. Also, you must get an MPH to complete the residency. Some programs subsidize the cost of this and a few will actually require you to pay tuition with relatively lower salary(which make them easier to get into). So naturally, the programs that pay regular PGY salary and subsidize tuition are sometimes more competitive.

2. What are the hours like for a practicing occ med doc? Is it M-F 8-5?

Yes, occ med docs follow the regular work schedule M-F 8-5 and if it is after that time the patients just go to the ER.

3. Is it relatively stress free?

YES, definitely, I remember when I interviewed, one of my interviewers specifically said that occ med is a more casual, laid back atmosphere and it is.

Hope that helps.
 
I find occ med pretty interesting, but my one concern are the job offers. I don't doubt that every grad is employed right after residency, but as someone who wants to return to my hometown to practice following residency, I worry about the lack of jobs in my area for occ med (even though it's a fairly large midwest city).

I know the specialty may not be in demand like primary care, but are the job offers coming from all over or mainly just in the area that the residency training was in?
 
Thanks for the replies, I really think this is a sweet field that goes overlooked or looked down upon. One other question is what is the average salary range? I thought it would be comparable to primary care doc - $150 to $180K.
 
Why isn't there a separate section in SDN forums for Occupational Medicine/Preventive Medicine residencies?
 
It may be beneficial to start a new section for occ med and pev medicine especially since they are joining eras, but again many people do them as fellowships as well. To answer the questions above, the salary range is $150,000-$180,000 the first few years and then it is usually $200,000+ following urgent care/emergency medicine type salaries depending on how little or how much you want to work.

The job market is pretty favorable right now and it is considered one of the specialties to be least affected by the new health care legislation. JObs can be found in big cities or even small towns. I wouldn't worry about finding a job in the midwest, many physicians will start their own occ med practice anywhere that people work(which really is everywhere). Of course, it may be easier to start your own practice if you do int med or another primary care residency and occ med as a fellowship. Many will start doing 50/50 general practice/occ med and as they become more well-known, they move to 20/80 or all occ med when they become established.

Hope this helps.
 
Also, I think an occ med/prev medicine thread would get more postings than the current community medicine or international and tropical medicine threads.
 
What exactly does an OCC med doc do on a daily basis? I have had a tough time finding info on specifics of practice.
 
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Practices in Occ med can vary widely, but usuallly a mixture of the following:

Health Evaluations for work(pre-work and getting back to work, fit for duty)

Occupational Injury and Disease Diagnosis and Treatment(usually about 90% is musculoskeletal,with frequent treatment of minor traumatic injuries, (aka lacerations, fractures)) also evaluation on whether it is caused by work or not

Disability Management(most docs will only spend one day a week or less doing this, but it is good to know)

Travel Medicine(in conjunction with infectious disease because you get certified in occupation and environmental medicine)

Many use their public health degrees to get a medical director job in which they also do health hazard evaluations, toxiologic assessments, healthy organization promotions(prev and wellness), education on environmental hazards, environmental protection programs, etc.

Also, environmental medicine somewhat similiar to toxicology, such as a patient exposed to mold at home, etc.

Well, hope this helps.
 
Preventative/Occ med sounds really appealing. TooMuch ... what are these "med director" jobs??
 
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Does one need to complete a prior residency before Occupational Med residency? Thanks!
 
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Gracile said:
Does one need to do a prior residency before Occupational Med residency? Thanks!
Click to expand...


No, for most programs, you need to complete an intern year and then do an occ med residency OR you can treat it like a fellowship type deal and go into it after completing IM (at least that is what I have read so far)
 
bump ... anybody have any additional input??
 
a sample



The residency curriculum core consists of:

  • Fundamentals of Occupational Health (Dr. Schwartz)
  • Clinical Environmental and Occupational Toxicology (Dr. Weaver)
  • Occupational Health (worksite inspection) course (Drs. Agnew and Lees)
  • Principles Of Occupational and Environmental Hygiene (Dr. Lees)
  • Public Health Toxicology (Drs. Trush and Yager)
  • Environmental Health (Dr. Links)
  • Occupational Medicine Seminar series (Dr. Weaver)
There are also MPH required courses, for example in epidemiology, biostatistics and management. The epidemiology and biostatistics offerings in the School are particularly rich and residents are encouraged to complete as much of the five course epidemiology series and four course biostatistics series as possible, but a minimum of two courses in each. Fundamentals of Clinical Preventive Medicine is also required for the OEMR.

Required courses are augmented by a wide variety of attractive electives including:

  • Public Health Practice
  • Introduction to Ergonomics
  • Introduction to Radiation Health Sciences
  • Epidemiology of Injuries
  • Molecular Biology of Carcinogenesis
  • Toxicokinetics, Molecular Epidemiology and Biomarkers in Public Health
  • Noise and Other Physical Agents in the Environment
  • Health Effects of Indoor and Outdoor Air Pollution
  • International Health
  • Environmental and Occupational Health Law And Policy
  • The Global Environment and Public Health


http://www.jhsph.edu/omr/Prog_Overview_Pages/Sample_Curriculum.html
 
is it for sure that occ med will be entering the traditional match soon? This surprised me b/c I heard the funding for programs isn't really there right now and some programs would be closing. One of the UC campuses (san fran maybe?) closed for the upcoming yr I believe, or maybe for good.
 
it's not two residencies. it's a 4 year program where you get a MPH and preventive med training, as well as internal med training. what I would want to do is combination of clinical patient care + community health/international health. I'd like to work for the WHO for example.
 
startoverat40 said:
it's not two residencies. it's a 4 year program where you get a MPH and preventive med training, as well as internal med training. what I would want to do is combination of clinical patient care + community health/international health. I'd like to work for the WHO for example.
Click to expand...

I know it's not literally TWO residencies . . . :rolleyes:

Then it sounds like a good type of program for you.
 
jdh71 said:
Then it sounds like a good type of program for you.
Click to expand...

do you think that's a good career path? job prospects etc.? Which field are you in? thanks :)
 
Hi folks,
Great forum goin here.

So I'm trained/BC in Family Medicine -- can I get into occmed without doing an occmed residency/fellowship? at the medical system I work at there are a few occmed physicians who are only FM or IM trained.

any advice on how I can get into the field?

also, based on the description of the field, is it accurate to say that Occmed physicians don't manage a pt's HTN/DM/HLD / chronic diseases? do you have a lot of issues with pain-med seeking pt's given that you deal with workplace injuries?
thanks
 
Interesting thread. I wanted to do medicine because OccMed was research friendly even if unknown. Also, its incredibly DO friendly. One great area to look up information is the website:

http://www.aoec.org/training.htm

Click on the residency link and you can find numbers and contacts of current programs for individuals who will be willing to answer your questions. What I can tell you is that there are a few combined FM/OM and IM/OM residencies out there including one that encourages research at Harvard. Probably more competitive there.

You can also do interesting things like this:

http://www.cdc.gov/niosh/eis.html

Fellowships that are allowed with OccMed are pretty much toxicology. As a chemist its a great thing for me, but for others it could be to narrow of a focus.

For medical students, they can test out OccMed through this program:

http://www.aoec.org/OHIP/

For jobs on the market for this field check out this site (just one example but it gives you an idea):

http://www.healthecareers.com/acoem/search-jobs/

Sounds like a great field. I kind of want it to stay unknown.

One caveat though is that residency is NOT paid for by medicaid (I see this as a good and a bad thing). The residency program is funded through a NIOSH Training Project Grant. This grant is funded by the CDC specifically and may not cover all of a trainee's expenses. This is why some of the programs require the trainee to cover some of their own cost at least for living expenses. Most programs waive tuition though. The joint programs generally have you completely covered. The programs that see themselves as being in existence for 'career switchers' generally do not cover living expenses. There are programs that get the NIOSH grant and then subsidize living expenses through other grants and in house funding or fundraising. You have to figure out what programs you are willing to apply to.

Hope that helps.
 
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I've been doing Occ med for the past couple years and needless to say, it's nice! It's a Monday through Friday type job with NO call as we typically define it. Pay is extremely competitive and the problems you treat are relatively simple and straightforward. I feel that a primary care background is still essential since even though you don't regularly treat chronic conditions like diabetes and high blood pressure, you still need to take them into consideration when you are treating these patients. Granted it has its own unique challenges such as dealing with employers the same way you would with family members, keeping them informed. That can be tedious at times, but overall, very satisfying.
 
Many people do get into occ med without being residency/fellowship trained, it used to be easier to get board certified too, but unfortunately this is changing and more places prefer the board certified physician. Most people who do occ med will do the urgent care/ fitness for duty/ drug testing part of occ med if they are not residency trained. I see this even with the PM&R physicians who do occ med. More complicated cases that include IMEs, disability evaluations and environmental exposures will still go to the occmed physicians. Yes fellowships for occ med include another prev med specialty like aerospace, toxicology or undersea and hyperbaric medicine, sometimes acute pain.

A list of residencies/fellowships are listed on their website. Becoming an MRO and making agreements with a few local companies can help lead into an occ med practice, but more group practices are starting based on the combined PT/OT, Pain, Radiology and Physician practice model and then being bought out by larger hospital systems. MRO is becoming more National rather than local as well.

No occ med physicians currently do not manage htn/dm/HL often because it is a preventive medicine specialty so especially in the future more wellness/surveillance exams will be performed by the occ med doc staff which will follow prevention of these diseases and then referral to primary care if a disease presents itself. Occ Med is starting to add more wellness due to the problem with more and more non-communicable diseases that are causing lost work time rather than injuries alone.

Prev medicine in itself is a good residency, however, a majority of graduates will continue on to do an occ med residency or do occ med in their practice. Being dual boarded in occ med and prev med is not really necessary, but an initial occ med residency gives you more tools to develop a practice in the future.

Since occ med/prev med residencies include a public health degree and often at no cost, jobs with goverment and global health agencies go well with these residencies. I did an internship with the World Health Organization and the CDC/ATSDR during resideny so far and loved them.

Many Occ Med programs are funded by the NIOSH training grants, mine is funded by half GME/Medicare and half NIOSH which is a plus because it means that I was able to get the opportunity to rotate outside of my institution where as many residencies have more restraints. However, not all programs are funded by this grant, some are full GME and some are through a VA system or local businesses. NIOSH trainee grants are definitely still being funded for the next few years although there was a quesion about it earlier last year. Of course, this is the case for regular GME funding for all residency programs because they rely on the government working as well.


Ascultator said:
Hi folks,
Great forum goin here.

So I'm trained/BC in Family Medicine -- can I get into occmed without doing an occmed residency/fellowship? at the medical system I work at there are a few occmed physicians who are only FM or IM trained.

any advice on how I can get into the field?

also, based on the description of the field, is it accurate to say that Occmed physicians don't manage a pt's HTN/DM/HLD / chronic diseases? do you have a lot of issues with pain-med seeking pt's given that you deal with workplace injuries?
thanks
Click to expand...
 
C Chance said:
3. Is it relatively stress free?
Click to expand...

I would not call Occupational Medicine stress free. At least, it was somewhat stressful for me. I am a FM doc who is going back to residency to do Preventive Medicine. When I was working as a FM doc, I was working solo in an urgent care that is in-contract with a large national factory to do basic Occ Med for their employees. The stress from Occ Med that I encountered could be due to the fact that I am not specifically trained in Occ Med ( I am a FM doc), but that said, the stress from Occ Med that I witnessed came from:

-Filling out the tedious workman's comp forms (in addition to entering the info in the EMR)

-Trying to keep BOTH the factory administration (the boss) and the employee (the patient) "happy" .. That is not easy at it seems.

-Arguing with the employee about their ability and/or inability to return to work.

-Accurately determining the level of disability of the employee...keeping in mind it that can significantly affect the employee's livelihood or the factory's bottom-line.

-Dealing/managing chronic workman's comp disabilities that are not improving.

-Dealing with malingering employees and pain med seekers.

-Dealing with angry employees who either demand to return to work despite their disability, or do not want to return to work beacuse they are lazy.

-Dealing with the pressure and the liability of making in-accurate return-to-work capabilities and timeline.

-Dealing with the pressure of having to keep costs under control when ordering tests on patients so as to not make the employers mad.

For all the above reasons, I decided to do a General Preventive Medicine residency as opposed to an Occ Med residency...but that is a personal preference. I just wanted to point out that Occ Med is not entiely stress free.

Good Luck.
 
This is a great thread. Does one apply to these programs after they have completed an ACGME internship, or can they apply before they are completed the internship with the knowledge that they will complete the internship before starting the Occ Med residency?

I guess a better way to put this is: do you apply for Occ Med residencies as an MS4?
 
CrileDO said:
This is a great thread. Does one apply to these programs after they have completed an ACGME internship, or can they apply before they are completed the internship with the knowledge that they will complete the internship before starting the Occ Med residency?

I guess a better way to put this is: do you apply for Occ Med residencies as an MS4?
Click to expand...
Most if not all programs require you to have already completed an intern year before you apply. Many programs also give preference to people who have completed an entire residency, often in a primary care specialty like IM. So no, as an MS4, you need to apply to internships and/or clinical residencies.

You can find a list of programs here: http://www.aoec.org/training.htm
Go to each program's site for specific requirements.
 
Hello,
I'm a PGY2 in an internal medicine residency program in Northern CA. I was thinking of moonlighting at an urgent care that does mostly occupational medicine, such as US Healthworks, or something similar. I do not have any specific previous experience in OccMed though, and so I have a few questions:

1. What exactly does one do at an OccMed urgent care? I know obviously we would see work related injuries, but to what extent? Would I be treating serious injuries (my guess is not, they'd have to go to the ER, right?)

2. What kind of procedures should I know how to do? Wrap a joint, dress a wound, suture lacs? (I suppose an even more pertinent question would be, what should I not do!?

3. Can you recommend a text or reference, of common diagnoses and procedures seen in a OccMed Urgent care setting, so I can read and get smart on the matter?

Thanks in advance for any advice.
 
LeemerDO said:
I've been doing Occ med for the past couple years and needless to say, it's nice! It's a Monday through Friday type job with NO call as we typically define it. Pay is extremely competitive and the problems you treat are relatively simple and straightforward. I feel that a primary care background is still essential since even though you don't regularly treat chronic conditions like diabetes and high blood pressure, you still need to take them into consideration when you are treating these patients. Granted it has its own unique challenges such as dealing with employers the same way you would with family members, keeping them informed. That can be tedious at times, but overall, very satisfying.
Click to expand...

Are you board certified in IM or FM in addition to occ med?
 
Hello, I have recently begun to take an interest in occupational medicine very late into the residency application season. I am currently applying to Physical Medicine and Rehabilitation residencies. Is PM&R a good field to get into occupational medicine and/or occupational medicine residencies? I would generally think that it would be a good point of entry, but the more that I read about the field, it seems that Family Medicine or Internal Medicine is a more common precursor.

Also, I've read that some believe that completion of a full residency is more advantageous to get into an Occupational Medicine residency where others do not really see a need past finishing a preliminary year of internal medicine (or whatever).

Any help would be appreciated, thank you. Also, apologies for some slight thread necromancy. (3 months)
 
Hi- I'm new to SDN so I'm not sure if I'm posting this in the right place.... I'm an FP doc looking into several options (not entirely in love with FP at the moment)... Among the things I'm considering is doing a fellowship in Environmental /Occupational Medicine. I'm not a big fan of the Occupational Med part (work health / work injury stuff) and am wondering if anyone is aware of jobs that exist in Environmental Medicine?
 
Hello,

I am currently a PGY2 resident and I have been interested in Occ Med since my PGY1 year and I am ready to apply this year for a spot in 2016. I have finished an internal medicine preliminary year. I want to know how competitive it really is and what my job prospects are as I will be applying to occupational medicine and environmental rather than preventive medicine. I like to think I got a well rounded internship but very little clinic but I am doing clinic this year. My concern is not having enough clinic experience for after residency. I would like to do more administrative jobs like medical director or employee health.
 
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