Occ Med and Prev Med can be great options for those who have not yet found a specialty and may have an interest in population health, policy, environmental health, or administration. This post is more focused on Occ Med as that is what I know best, but there is a lot of overlap with Prev Med. I know there are a couple of Occ Med and Prev Med folks on SDN, so hopefully they can chime in as well with additional insights.
(All this to say that it is a legitimate medical residency, similar to Internal Medicine, Dermatology, Neurology, etc.)
It is also not an either/or. A lot of people go into Occ Med after completing a prior specialty.
Advanced positions follow the same timeline as things like Dermatology, Radiology, etc. Let's say you are graduating med school in 2026:
Do keep in mind that a few programs run this as a fellowship rather than a residency, meaning that they require you to have finished a full residency prior to starting Occ Med.
Most clinical occupational medicine staff physician jobs will take people from any medical field (IM, FM, EM, PM&R are the common ones).
However, these are not the most interesting jobs in the field. If you want to open up the directorship positions, government roles, or private industry work, you'll want to be board-certified in Occ Med, or alternatively, be board-certified in something else and have a lot of Occ Med experience.
Occupational Medicine is also so flexible that you can do a lot of stuff on the side, if you so choose.
What is an "Occupational Medicine Residency"?
Occupational and Environmental Medicine is an ACGME-accredited residency that leads to board eligibility in Occupational and Environmental Medicine through the American Board of Preventive Medicine, one of the member boards of the American Board of Medical Specialties.(All this to say that it is a legitimate medical residency, similar to Internal Medicine, Dermatology, Neurology, etc.)
What do you actually do?
In residency, you focus on a few areas:- Clinical occupational medicine: treating occupational injuries (workers' compensation). This is typically musculoskeletal injuries, bloodborne pathogen exposures, lacerations, eye injuries, etc.
- Non-clinical occupational issues: this includes things like surveillance exams (e.g. asbestos, lead, benzene), pre-employment clearances, returns to work, regulated exams (e.g., DOT, TSA), etc.
- Environmental medicine: This is similar to toxicology, but usually less acute poisonings and often more chronic exposures (heavy metals, etc.).
- Public Health: This will take the form of academic coursework and rotations with public health agencies.
This sounds like it could be done by anyone from Internal Medicine or Family Medicine, why shouldn't I just do that?
From a purely clinical standpoint, there is little you can do in Occ Med that you can't do from Internal Medicine or Family Medicine. In fact, this is kind of a given assumption, as you can only start Occ Med after doing some other clinical training first (at least an intern year). The main unique clinical aspect is the evaluation and management of environmental exposures. What makes Occ Med really unique, though, is all the non-clinical experience you get.It is also not an either/or. A lot of people go into Occ Med after completing a prior specialty.
What else makes these residencies unique?
- They are two-year programs. You enter after completing an intern year in any other clinical field.
- During the first year of Occ Med, residents primarily work on getting an MPH (or another Master's degree at some programs).
- Hours during residency are typically Monday to Friday, 9 to 5 (sometimes better). No nights, weekends, holidays, or call.
Why have I never heard about this?
Likely one of two reasons:- It is not a commonly-offered clerkship, as there are only 24 residency programs nationwide.
- Even at those places with Occ Med programs, they are more closely associated with the school of public health rather than the school of medicine, so med students don't get exposed to people in the field.
They are not in the match.Update: As of the 2024-2025 cycle, (almost all) Occ Med and Prev Med residencies are part of the NRMP match
How do I apply?
Occ Med requires at least a full (clinical) PGY-1 year prior to officially joining a program in the PGY-2 year. Now that (most) Occ Med programs are in the match, there are two main types of spots: Advanced positions and Reserved positions. As of writing, I believe only Loma Linda offers Categorical positions (starting with an integrated PGY-1).Advanced positions follow the same timeline as things like Dermatology, Radiology, etc. Let's say you are graduating med school in 2026:
- In the summer of 2025 (one year prior to graduation), you will apply to intern years (TY, prelim IM/surgery/etc.) as well as Advanced Occ Med positions
- In late 2025 to early 2026 you interview for intern years and Occ Med residencies at the same time
- In March of 2026, you will match to both an intern year and an Advanced Occ Med residency position
- Your intern year will run from July 2026 to June 2027
- Your Advanced Occ Med residency will run from July 2027 to June 2029.
- In the summer of 2025, you start your intern year and soon afterwards start the application process for Occ Med
- In late 2025 to early 2026 you interview with Occ Med programs
- In March 2026 you match a Reserved Occ Med position
- You complete your intern year June 2026 and will join an Occ Med residency from July 2026 to June 2028.
Do keep in mind that a few programs run this as a fellowship rather than a residency, meaning that they require you to have finished a full residency prior to starting Occ Med.
What kind of jobs can I get after graduating?
Jobs for board-certified Occupational Medicine physicians will usually fall in a few categories:- Clinical Occupational Medicine: typically occupational health director positions, but also staff physician positions.
- Academia: often with a focus on public health or environmental health research.
- Government agencies: NIOSH, OSHA, CDC, etc. or similar state-level equivalents.
- Military: A lot of trainees are active-duty military and go back to practice in the military.
- Private Industry/Consulting: This is the most varied and can range from performing independent medical exams, to being an advisor to a corporation on Occupational/Environmental Health issues, to being a chief medical officer at a tech company and many other things in between.
Again, couldn't I do that stuff from Internal Medicine or Family Medicine?
Yes/maybe.Most clinical occupational medicine staff physician jobs will take people from any medical field (IM, FM, EM, PM&R are the common ones).
However, these are not the most interesting jobs in the field. If you want to open up the directorship positions, government roles, or private industry work, you'll want to be board-certified in Occ Med, or alternatively, be board-certified in something else and have a lot of Occ Med experience.
What kind of salary can I expect?
For clinical occupational medicine, you can probably expect something in the $240,000-$260,000 range (typically for Monday to Friday, 9 to 5, without nights, weekends, holidays, or call). Government work will be less than that. Academia likely similar. Private industry is the big wildcard, and you can probably earn a lot more depending on what you do.Occupational Medicine is also so flexible that you can do a lot of stuff on the side, if you so choose.
Where can I learn more?
- ACOEM | Learn about occupational and environmental medicine -- Information from the American College of Occupational and Environmental Medicine
- Occupational and Environmental Medicine – American Board of Preventive Medicine -- More information on board certification.
- AOEC - OEM Training and Education -- A list of Occ Med residency programs.
- https://www.acpm.org/getmedia/00bc7...220ac45/pmrresidencydirectoryaug2021.pdf.aspx -- A slightly more comprehensive list of Occ Med programs, in addition to Prev Med and Aerospace programs
Wait, what's this about Preventive Medicine and Aerospace Medicine?
Public Health and General Preventive Medicine (PH/GPM) and Aerospace Medicine (AM) are essentially sister specialties to Occ Med. They have the same parent board (ABPM) and the residency set-up is almost identical:- In Prev Med there is less clinical time and more public health rotations
- In Aerospace medicine your clinical experience will be in flight surgery. This field is almost exclusively for military flight docs.
Where do I learn more about those fields?
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