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Innovative training experiences for occupational medicine residents in non-urban and agricultural settings
Investigator (PI): Nessim, Dalia Ezzat
Performing Organization (PO): (Current): University of Texas Health Science Center at Tyler / (903) 877-4673
Supporting Agency (SA): Centers for Disease Control and Prevention (CDC), National Institute for Occupational Safety and Health (NIOSH)
Initial Year: 2007
Final Year: 2025
Record Source/Award ID: RePorter/T03OH009221
Funding: 2007 Award Amount: $148,000
2008 Award Amount: $148,000
2009 Award Amount: $148,000
2010 Award Amount: $175,606
2011 Award Amount: $189,998
2012 Award Amount: $182,866
2013 Award Amount: $175,480
2014 Award Amount: $175,480
2015 Award Amount: $174,131
2016 Award Amount: $174,131
2017 Award Amount: $174,131
2018 Award Amount: $174,131
2019 Award Amount: $174,131
2020 Award Amount: $249,834
Award Type: Grant
Award Information: Reports resulting from this project
Abstract: Non-urban populations are given little attention in many aspects of medical practice. Rural communities often lack the infrastructure for developing and sustaining a preventive approach to occupational disease and injury, particularly for specific work sectors such as agriculture, where the hired and/or migrant workforce may constitute the majority. Northeast Texas, home to about 1.5 million people spanning 35 counties, is considered the largest rurally distributed population in the state, and is also one of the unhealthiest. There is a considerable need to train medical students and graduates in general, and occupational medicine residents in particular, to be competent in knowledge and skills pertaining to rural and migrant populations, who have special cultural needs and considerations. As the region's only university medical center, the University of Texas Health Science Center at Tyler (UTHSCT) is home to some of the latest developments in patient care and community health, medical and health education, and biomedical and clinical research. There is a physician shortage in rural counties throughout Northeast Texas, and UTHSCT has the responsibility of training the future generation of physicians. The occupational medicine residency program at Tyler (OMR) is one of seven Accreditation Council for Graduate Medical Education (ACGME)-accredited graduate medical education (GME) programs sponsored by the institution. The overall objective and mission of the program is "to increase the number of occupational medicine physicians who have adequate experience and sufficient competence to enter the practice without direct supervision, while adding a special focus on training in the occupational health needs of the rural workforce, to help serve the population of Northeast Texas and beyond." This is in alignment with the overall mission of the institution. Specific aims of the program are to 1. increase the number of board-certified occupational medicine graduates able to engage in evidence-based and independent practice in various settings including the proportion remaining in Texas and rural areas; and 2. enhance a robust residency experience in rural/agricultural occupational health, safety, protection and promotion. There remains a recognized burden of occupational injury and illness in general and in agriculture specifically. This proposal is considered responsive to the Funding Opportunity Announcement PAR-15-352 by addressing a critical gap in Occupational Medicine Residency (OMR) trained physician workforce needs (core discipline). The proposed program will integrate agricultural safety and health by implementing a multi-faceted training approach that relies upon an inter-professional educational team effort, while also leveraging the strengths of the NIOSH-supported Southwest Center for Agricultural Health, Injury Prevention and Education to achieve a significant impact on continued workforce expansion.
Abstract Archived: Despite centuries of recognition of the contribution of workplace factors to human health, disease, injury, disability, and death, occupational medicine remains an obscure specialty within the health care community. Little emphasis is given to educating physicians at both the undergraduate and post-graduate levels concerning occupational history-taking and little focus is placed in clinical encounters on discerning and reducing work-related risk factors. Since the mid-1990s, the number of accredited occupational medicine residency (OMR) programs has declined steadily (35%) in spite of a recognized shortfall of physicians with formalized training in this area. Remaining programs struggle for funding to sustain their educational efforts. In many specialty areas of medical practice, there is also little attention given to the special needs of non-urban populations. However, rural communities often lack the infrastructure for developing and sustaining a preventive approach to occupational disease and injury, particularly for specific work sectors such as agriculture where the hired and/or migrant workforce may constitute the majority of employees. One main objective of this proposal is to seek support for sustaining and increasing the number of occupational medicine trained physicians who have broad experience and sufficient competence to enter practice without direct supervision. The second main objective is to bring a dimension of training that emphasizes the occupational health needs of the rural workforce with special attention to agriculture. This proposal is in keeping with the Centers for Disease Control and Prevention Healthy People 2020 and the National Institute for Occupational Safety and Health (NIOSH) mandate to provide an adequate supply of qualified personnel to carry out the purposes of the Occupational Safety & Health Act. The proposal is considered responsive to the Funding Opportunity Announcement PAR-10-288 by addressing a critical gap in OMR trained physician workforce needs (core discipline), and will integrate agricultural safety and health. Specific aims for this training project are to 1. sustain and increase the supply of qualified occupational medicine residency trained physicians, particularly in U.S. Public Health Region 6; 2. expand service capacity by increasing the number of occupational medicine resident graduates who develop knowledge and awareness of rural/agricultural occupational health, through a range of didactic, experiential, and practicum learning activities; and 3. nurture interdisciplinary collaborations between an accredited occupational medicine residency program, the Southwest Center for Agricultural Health, Injury Prevention, and Education, and multiple other regional stakeholders, including the Southwest Center for Occupational and Environmental Health NIOSH ERC located in Houston at the University of Texas School of Public Health.

MeSH Terms:
  • Agriculture
  • Centers for Disease Control and Prevention, U.S.
  • Education, Medical, Graduate
  • Health Care Costs
  • Humans
  • Internship and Residency
  • Occupational Health
  • Occupational Medicine /*education
  • Program Development
  • Public Health
  • Risk Factors
  • Rural Health Services /*organization & administration
  • Rural Population
  • Texas
  • Transients and Migrants
  • United States
  • United States Occupational Safety and Health Administration
  • Universities
Country: United States
State: Texas
Zip Code: 75708
UI: 20174279
Project Status: Ongoing
Record History: ('2020: Abstract archived and replaced; Project extended to 2025',)