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.
You’ll want to start your application around one year prior to your intended start date. You then interview like usual, and then there is a uniform decision date after which programs can contact you to offer you a position (it can get a little hectic).
As an example, let's say you are a med student graduating in 2024 and want to just do 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.
Why aren't they in the match?
To be totally honest, I don't have a good simple or succinct answer to this one.If they're not in the match, how do I apply?
You apply individually to each program during, or after completion of a PGY-1 year. Some programs are fully on ERAS, some programs are fully on SOPHAS (MPH application system), and some programs make you apply through both systems. Because of this, you will need to look at the process for each program you're interested in.You’ll want to start your application around one year prior to your intended start date. You then interview like usual, and then there is a uniform decision date after which programs can contact you to offer you a position (it can get a little hectic).
As an example, let's say you are a med student graduating in 2024 and want to just do Occ Med:
- In the summer of 2023, just like all your other classmates, you will apply on ERAS, but only to prelim or transitional-year positions.
- You will start that prelim/transitional program in July 2024.
- Soon afterwards, you start your Occ Med applications (they are often due in September or October).
- You interview in October-December 2024.
- You hear back from programs on the uniform admission date (December 2024 or January 2025).
- You will finish your prelim/transitional year on June 30th, 2025 and start Occ Med on July 1st, 2025.
- You will graduate from your Occ Med program on June 30th, 2027.
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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