Successful practice of Occupational and Environmental Medicine (OEM) requires attainment of a specific set of knowledge, skills, behaviors, and attitudes. These are established by the Accreditation Council of Graduate Medical Education's (ACGME) Residency Review Committee for Preventive Medicine. They are collectively referred to as the "competencies" of OEM. You can see a detailed description of the competencies by clicking on the link (insert link). The USUHS OEM Residency Program ensures that its graduates are thoroughly versed in the competencies of the specialty by providing extensive didactic learning experiences in Public Health and Clinical OEM combined with supervised application of the knowledge, skills, behaviors and attitudes taught in the didactic setting. The residency is a two year program open to physicians who have completed a clinical internship (Post Graduate Year 1).
For the purposes of board certification in OEM, the American Board of Preventive Medicine requires physicians to complete Masters level courses in epidemiology, biostatistics, health services administration, environmental health, and behavioral health. USUHS OEM Residents fulfill this requirement by obtaining a Master of Public Health (MPH) Degree during their residency. The majority of the required classroom instruction is provided during the first 8 months of the PGY2 year. During this period, residents are full-time students in the USUHS Department of Preventive Medicine and Biometrics. You can click on the following link to see the list of required and elective courses (insert link). In order to receive an MPH degree, a resident must also complete an independent project and a 108 hour practicum experience. These requirements are met in the last 4 months of the PGY2 year and the 1st 6 months of the PGY3 year.
The object of the practicum year is to complete the training of the resident by giving him/her a variety of opportunities to apply the 'book knowledge' of the didactic experience to real world occupational medicine practice situations. The challenge of occupational medicine is to make rational, evidenced-based decisions utilizing sound data and science in the face of uncertainty, inadequate information, politics, economics, and other confounders. Each resident is provided with a variety of direct patient care, administrative, and policy making experiences and will be expected to demonstrate progressively increasing levels of responsibility for patient care and population management. The residency staff will track the progression in level of responsibility and attainment of proficiency in the competencies.
The practicum year is structured as a series of rotations, typically lasting 8-12 weeks each. Each rotation is built around ACGME competencies, and each rotation has a designated preceptor who supervises and guides the resident. The resident is expected to fully participate in a "hands-on" mode during practicum rotations, assuming significant responsibilities. Usually, in addition to dealing with the day-to-day work at the rotation site, the preceptor will assign a specific project or series of projects for the resident to complete.
Because of the unique circumstances of the USU OEM residency (robust support for the Residency, fully funded and salaried residents, and a prime location in Washington, DC), a large number of practicum rotations are possible. Doing a variety of rotations is desirable because it allows the resident to experience a wide range of occupational medicine practice situations.
The practicum experiences will be tailored to the needs of the individual and his/her sponsoring service. Specific residency educational goals and objectives for each practicum rotation are expressed in clear behavioral and measurable terms in the letter of agreement between the residency and the practicum site and in the resident rotation evaluation.
Military Unique Competencies
The National Capital Consortium requires that all resident be trained in militarily unique competencies so the program emphasizes population medicine problem-solving that focuses on military groups. Thus, in addition to mastering the generic occupational medicine competencies, USUHS OEM residents are expected to understand and analyze:
- Epidemiology and control of infectious and tropical diseases of military significance
- Health aspects of rapid mobilization (medical threat assessment, immunization and chemoprophylaxis policy, etc.)
- Humanitarian assistance
- Organization and function of military preventive medicine and occupational medicine in garrison and on deployment
- Military-unique occupational and environmental health concerns
- Health concerns peculiar to basic training (acute respiratory infections, barracks design)
- Legal requirements of local, state, and federal regulations as they apply to military posts and personnel.
- Medical Surveillance of workers with potential exposures to nuclear, biological, and chemical agents.
- Medical response to nuclear, biological, and chemical incidents.