Supervised Practicum-Year Residency in Occupational Medicine
University of Pennsylvania Health System
External Track
Overview
This NIOSH-supported, ACGME accredited, practicum year residency program is designed to provide structured supervised training and experiences to ensure that the resident has achieved competency in all areas required for the American Board of Preventive Medicine Examination in Occupational Medicine and for the specialist practice of Occupational and Environmental Medicine. There is also emphasis on the acquisition of knowledge, skills, and attitudes in leadership and organizational management. Strong clinical skills, beyond those that would be expected to be acquired from the minimal one required year, are necessary for admission to the program. The program consists of two interrelated components, a didactic component and an applied component.
The external track is designed to train clinical and professional leaders in occupational and environmental medicine. The program takes advantage, not only of the superb resources of one of the nation’s top five Schools of Medicine, but also of other schools such as the Wharton School of Business and the School of Engineering and Applied Science at the University Of Pennsylvania.
An obligatory, structured, didactic component requires three full-days of participation in Philadelphia (Thursday, Friday, and Saturday) once a month. The program is designed in modular form so that it may be completed over more than one calendar year. Certain general objectives including clinical judgment and skills, critical thinking and analysis, effective communication and professional development are addressed throughout the year. Nested within the program are five didactic rotations or clusters around the themes of organizational management; the workplace (hazard recognition evaluation and control); the worker, disability and work fitness; environmental health, risk assessment and risk communication; and population based occupational medicine. Each resident must satisfactorily complete and present a meaningful project in each module or cluster area.
An appropriately qualified physician in full-time employment may participate in the external track of the residency provided that a practicum experience can be arranged with the employer which meets University of Pennsylvania program requirements including satisfactory supervision of the resident's clinical work. The external track requires a comprehensive written understanding with the employer, and time release analogous to that necessary for executive development programs. Depending on the experience available through employment additional arrangements may be necessary to provide sufficient breadth of experience, including experiences at the University of Pennsylvania Health System. University of Pennsylvania Occupational Residency program faulty also make four visits to each resident's worksite over the course of the year.
Successful completion of the practicum year requires the active demonstration of competency in didactic and applied components including through practical demonstration of required skills and completion of required reports and projects.
Admission Requirements
All residency candidates will generally be expected to have strong clinical skills prior to admission such as those obtained from training and experience in family practice, internal medicine, or emergency medicine. Candidates with clinical training in other specialties will also be considered for admission, however they may be required to gain additional experience in clinical areas that directly impact on occupational medicine practice. These clinical areas may include outpatient orthopedics, sports medicine, dermatology, pulmonary diseases, and ambulatory care.
All resident candidates will be expected to possess a Masters in Public Health degree or an equivalent masters degree. The completion of business courses prior to admission is encouraged.
Individuals who do not meet this requirement will be expected to be actively enrolled and to have almost completed such a program, including having successfully completed all the core courses required by the American Board of Preventive Medicine (Biostatistics; Epidemiology; Environmental and Occupational Health; Health Services Organization and Administration and a course on Social and Behavioral Influences on Health. Completion of all academic-year requirements is required before completion of the practicum-year can be certified.
Candidates for the external track will generally be employed full-time in an occupational medicine practice in a clinical, corporate, military, or governmental setting as a staff physician, assistant medical director, associate medical director, or equivalent and will have continuing access to one or more senior physicians who can act as site supervisors for the purpose of the training.
Prior to admission applicants will need to establish and document that there are sufficient resources and variety of work to ensure the quality and comprehensiveness of the learning experience at their work location. The resources evaluated will include the:
· Number of employees and variety of jobs and job-settings.
· Medical facilities
· Caseloads
· Type of patients
· Opportunities for collaboration with industrial hygienists, nurses, safety personnel, counselors and/or others concerned with psychosocial issues.
· Opportunities to deal with clinical, scientific, social, legal and administrative issues.
· Opportunities to deal with issues from the perspectives of workers and their representatives and of regulatory or legal authorities, as well as from the employers' perspective.
· Opportunities to interact with workers, human resources personnel, industrial relations personnel, line supervisors, worker representatives, and the outside medical community.
· Opportunities for experience in the clinical and administrative aspects of direct worker care and job assignment, medical screening and surveillance, health conservation and promotion, environmental assessment, employee assistance and relevant regulatory compliance.
The prospective resident will also need to demonstrate that he or she has a suitably qualified, board-certified physician who will be an on-site mentor.
Educational Plan
By the commencement of the practicum-year each resident will be assigned a faculty preceptor (the residency program director or a key faculty member). On the basis of an initial competency assessment against the required competencies the resident, together with the faculty preceptor, will develop a plan to acquire the required competencies over the year. This plan will incorporate the projects and other requirements of the didactic program. The plan will need approval by the residency director.
On the basis of the plan a learning contract will be established with the resident, and the responsible person at the worksite (the in-house person to whom the resident is responsible). An affiliation agreement will be necessary between the residents’ worksite and the University of Pennsylvania Medical Center.
The preceptor will visit the site approximately quarterly and will include a meeting with the resident and the responsible person at these times. At these visits the preceptor will review relevant aspects of the quality of the program, quality of the residents work and progress against objectives.
In addition the resident may participate in supplementary experiences to round out the experience available at the primary workplace. The need for these will be determined on an individual basis, by the preceptor, resident and/or program director with input from the responsible person.
Successful completion of the applied component of the externally employed resident track will require the equivalent of one year full-time effort and successful attainment of the required competencies including satisfying completion of the five competency blocks. Where completion of these requirements within the allowed time is not possible, the supervised-practicum year may take more than one year to complete. Generally we would require the supervised-practicum year requirement to be completed within two years. Residents are encouraged to complete requirements in one year, but not at the cost of stress to the degree that it might inhibit performance or learning.
Tuition
The cost of tuition for the 2012-2013 has been set at $32,500, however, where residents work more than 200 miles from Philadelphia there is an additional charge of $2000 to partially offset the cost of faculty travel/time for site visits. Residents outside the contiguous 48 states should contact the Program Director regarding the applicable travel/time supplement.
We have received funding through a training grant from NIOSH to help pay for part of the tuition and some required travel costs for attending the program in Philadelphia. Some funds may be available to reduce the costs for a small number of needy trainees. Awards will be available on a competitive basis and will be based on criteria of community need in addition to the usual criteria of merit. Criteria of community need for this purpose include: service to underserved population(s); difficulty in accessing a training program (remote location, location where there is no training); family responsibilities; specific regional workforce need (lack of occupational medicine specialists in area, other regional needs, etc.); and service to special populations at risk, including minority and disadvantaged workers.
Further Information
Further information and application materials may be obtained from:
Judith McKenzie, MD, MPH
Occupational Medicine Residency Director
University of Pennsylvania Medical Center
One Convention Boulevard, Penn Tower 4th Floor
Philadelphia, PA 19104-4283
Telephone: 215-662-4439
Facsimile: 215-662-4430
E-mail: