Occupational Medicine Residency Program

The goal of the Occupational Medicine Residency Program is to prepare residents for the comprehensive practice of occupational medicine in a variety of settings, including private clinical practices, managed health care organizations, corporate medical departments, public health programs and legal or regulatory authorities.

The residency addresses the competencies specified by the Accreditation Council for Graduate Medical Education (ACGME) for residency training in preventive medicine-occupational medicine, as well as core competencies identified by the American College of Occupational and Environmental Medicine. A list of competencies addressed by the program is available for review. Graduates of the program are well prepared to take the ABPM certification examination in preventive medicine-occupational medicine.

Specific educational objectives include:

• Enabling residents to acquire knowledge of and the ability to apply the core sciences of preventive medicine—epidemiology, biostatistics, health care organization and administration, occupational and environmental health, and behavioral sciences—in the identification and solution of health problems in occupational groups
• Helping residents acquire knowledge and skills in toxicology, environmental monitoring and safety evaluation as they apply to individuals and groups
• Enhancing residents' clinical knowledge in the care of people with occupational or environmental exposures and in the assessment of suitability for employment
• Teaching residents about planning, management and evaluation of occupational health programs in clinical practice and corporate settings
• Developing in residents an understanding of the policy-making process in occupational medicine with respect to law, regulation and workers' compensation
• Creating in residents an understanding of the roles and expertise of other occupational health professionals, and to collaborate with these professionals
• Providing an opportunity for residents to develop independent research skills and to be able to use appropriate analytical techniques in the prevention of occupational diseases and injuries and in the evaluation of occupational health care programs.

These aims are achieved through the graduate degree programs during the academic phase, the field site training during the practicum phase, clinical training at UC Irvine's Center for Occupational and Environmental Health (COEH), clinical case conferences, didactic seminars and the resident projects.

The academic and practicum phases of the Occupational Medicine Residency are functionally integrated because residents participate in occupational medicine clinical and core residency training activities while taking courses during the academic phase. Residents can tailor their training from a range of academic and practicum opportunities to meet their individual educational objectives while receiving solid training in the core areas of preventive medicine and occupational medicine.

The residency begins in August with a seven-week orientation and intensive introduction to the field of occupational health. Residents in the academic phase take courses for their master's of science degree programs during the fall, winter and spring terms, which last from late September to June. A practicum phase field site rotation follows from June until late-September.

Most residents then take one to two additional courses during the fall term of the second year while completing individual research projects for the master's thesis. The remainder of the residency is devoted to practicum training experiences. Residents finish the program at the end of July in the second year in order to qualify to take the occupational medicine board certification examination.

During an initial orientation period, residents develop individualized educational plans based on a self-assessment, prior training and experience as well as educational objectives. Residents begin to participate in the occupational and environmental medicine (OEM) clinics at the Center for Occupational and Environmental Health (COEH) and in core residency didactic seminars.

Residents also visit multiple worksites and occupational medicine programs in the region for an introduction to workplace assessment and to practice opportunities in occupational medicine. In addition, they complete courses on industrial hygiene, occupational safety and introduction to occupational and environmental health laws and regulations. This orientation period allows entering residents to interact with continuing residents and the program faculty in order to become thoroughly familiar with the educational opportunities and resources offered.

Throughout the two-year program, Occupational Medicine residents participate in core training activities that include participation in two COEH clinics, a weekly clinical case conference, the residency didactic seminar, journal club, worksite visits and monthly COEH grand rounds.

Occupational and Environmental Medicine Clinics

In addition to clinical training received in field-site rotations during the practicum phase, residents receive clinical training by  participating in two Occupational and Environmental Medicine clinics.

One clinic is based at the Center for Occupational and Environmental Health (COEH), which is located next to the School of Medicine on the UC Irvine campus. This clinic functions as a regional consulting and referral center. Appointments include pre-placement and surveillance examinations, fitness-for-duty evaluations,and "case evaluations," which can involve assessment of complex work or environment-related issues in persons referred by employers, other specialists, public health agencies, individuals or other sources. For case evaluations, residents interview and examine the patient; discuss the patient with faculty members assigned to the clinic session; direct the diagnostic work-up; arrive at a decision regarding the diagnosis, and provide the patient with a diagnosis, determine whether the condition is work-related and give a prognosis.

The other OEM clinic is at UC Irvine Medical Center, Orange County's only university hospital. This clinic is the employee health service for the medical center and provides comprehensive workers compensation and employer services for a range of work places in the area. Under the supervision of attending faculty members, residents manage workplace injuries and illness, as well as return-to-work determinations and medical surveillance examinations.

Residents attend one clinic session per week in either of the clinics throughout the residency program. Residents may also do a longer rotation at the medical center clinic during the practicum phase. Residents are supervised, but they are given progressive responsibility for patient care.

Residency Didactic Seminar

The OEM residency program sponsors a weekly didactic seminar in which residents are required to participate during the practicum phase. This is possible because "full-time" field-site rotations are four days per week, allowing residents to spend one day a week at the program.

Seminar topics are taken from ACGME requirements for residency training in occupational medicine, with additional consideration to topics presented in major textbooks on occupational and environmental medicine and to recommendations on core competencies defined by the American College of Occupational and Environmental Medicine. The residency program identifies a systematic list of topics and then identifies program faculty, clinical faculty and guest speakers to present the topics for the residents.

Clinical Case Conference

The OEM residency program holds a bi-weekly clinical case conference. This conference serves as the attending rounds for the COEM clinic and allows residents to discuss case issues, case management strategies, clinical toxicology and occupational medicine principles. The role of the clinical training and case conference is to provide a continuous clinical training experience for the residents over both the academic and practicum phases. We have found that the weekly contact with OEM faculty members provides continuity for the residents.

Journal Club

Also required is a bi-weekly residency journal club. Its purpose is to teach the residents how to critically read the scientific literature and to provide a mechanism for reviewing current issues in occupational and environmental medicine. Under faculty supervision, each resident in turn is required to identify a recent important article and other relevant citations then prepare a critique. The critique is presented in journal club to the faculty and other residents. All program faculty regularly attend the journal club and participate in the teaching. Principles of study design, epidemiology, clinical toxicology and data analysis are emphasized in the discussions.

Work-Site Visits

The core training includes work-site visits with program faculty. Examples of recent work-site visits include Allergan Pharmaceuticals, an Exxon-Mobil refinery, Exide-GNB Industrial Power, Steelcase Manufacturing, Toyota Car Manufacturing, Kimberly Clark Paper Mill, Mansfield Plumbing, a Huntington Beach school district, the Orange County Health Care Agency, the San Diego Poison Control Center and UC Irvines' Environmental Health and Safety facility. Residents also visit work sites during the Cal-OSHA rotation.

Grand Rounds

The OEM sponsors a monthly grand rounds designed as a Continuing Medical Education program for practicing physicians. Regional and national speakers are invited to present at the rounds. This seminar increases the visibility of the OEM and reinforces professional collaborations that enhance resident training opportunities. Residents are expected to attend the Grand Rounds whenever their academic and practicum training schedules permit.

Residents also may attend other School of Medicine seminars, including the Department of Medicine Grand Rounds and noon conferences, as well as those presented by the Department of Epidemiology and the Environmental Health Sciences program. The Department of Medicine and the school sponsors a range of residencies and fellowships that offer OEM residents substantial opportunities to participate in research and clinical seminars.

The principal objective of the academic phase is to provide didactic and research training in the core areas of preventive medicine and occupational and environmental medicine, while providing in-depth training in an area of greatest relevance to the resident's educational objectives.

During the academic phase, residents enroll in the master of science degree program in Environmental Health Sciences based in UC Irvine's School of Medicine. Residents must complete the degree program as part of the academic phase of the residency program.

Master of Science in Environmental Health Sciences

This degree program is offered by the Division of Occupational and Environmental Medicine to provide in-depth training in toxicology while satisfying course requirements for preventive medicine. Residents complete required courses in toxicology and conduct an individual research project that leads to a master's thesis.

Elective courses in the program allow residents to complete the required course work for the preventive medicine program. Required or commonly taken elective courses include: Principles of Toxicology, Target Organ Toxicology (2 courses), Experimental Design and Interpretation of Toxicology Studies, Neurotoxicology, Inhalation Toxicology, Environmental Toxicology, Industrial Toxicology, Toxicology Seminar, Data Analysis (statistics), Epidemiology and Biostatistics, Management of Health Care Organizations or Public Health Cost-Effectiveness Analysis, Health Psychology, and Environmental Epidemiology.

Learn more about the master's program in Environmental Health Sciences.»

The practicum phase, a recognized strength of the Occupational Medicine residency program, provides opportunities for residents to assume progressive responsibility for the practice of occupational medicine in a range of settings, while achieving each resident's individual educational objectives.

The excellent facility and resources of the Center for Occupational and Environmental Health (COEH) provide an outstanding setting for clinical and didactic training, and close collaboration with occupational medicine programs in the region makes available a range of outstanding practicum training experiences.

The major components of the practicum phase include field site placements, COEH clinical training, COEH didactics and the individual research experience. Conceptually, the program divides the field-site rotations into three types of experiences: corporate or worksite-based occupational medicine programs; regulatory or public health agencies, and comprehensive occupational medicine clinical practices. Residents complete at least one rotation in each setting. Residents also may undertake clinical training at UC Irvine in areas relevant to occupational medicine practice.

During the practicum phase, residents spend most of their time in field-site rotations which reflect the broad range of "real world" practice opportunities. Within these rotations, the residents are exposed to all aspects of practice including clinical care and evaluation of workers; medical surveillance; organization and management of occupational medicine programs; work place exposure assessment and control methods, and collection and analysis of health data.

Meanwhile, residents also receive clinical, didactic and research training through interaction with the OEM program faculty, which provides continuity for the residents' other training experiences.

Field-site rotations are divided into three types of experiences: corporate or worksite-based occupational medicine programs; regulatory or public health agencies, and comprehensive occupational medicine clinical practices.

Residents are expected to complete at least one rotation in each setting. Residents also may undertake clinical training at UC Irvine Medical Center in areas relevant to occupational medicine practice, such as dermatology, radiology and physical medicine/rehabilitation.

The first rotation provides full-time training at major industrial corporations, including Exxon-Mobil. Residents participate in the full range of occupational medicine activities that occur in these corporations. Rotations with the U.S. Postal Service and the County of Orange's Employee Health Service also provide a comprehensive range of learning experiences in occupational medicine programs. These rotations provide training experiences in the industrial and service sectors to complement the other rotations.

The field-site placement with Cal-OSHA is an interesting and valuable component of the practicum training since it affords an opportunity for residents to view many work places and to become involved in issues related to occupational health law and regulation. This rotation's emphasis is on work place exposure evaluation and regulatory compliance. It takes place two days a week over several months so that residents have meaningful participation in work place evaluation and possible resultant regulatory actions. Under supervision, residents assume increasing responsibility for performing work-place evaluations, doing research and writing reports to be approved by the Cal-OSHA staff.

The third rotation involves training sites that include the Kaiser Occupational Medicine Program or Sharp Rees-Stealy Medical Group. Residents obtain comprehensive clinical training including experience in performing pre-placement examinations, fitness-for-duty examinations and OSHA-mandated surveillance exams. They also evaluate and treat occupational injuries and illnesses and  care for employees under workers' compensation. These rotations provide residents an opportunity to understand the comprehensive practice of occupational medicine in a group medical practice setting. Residents may also do a full-time rotation at the UC Irvine Medical Center's Occupational Health clinic.

In addition, the residency program offers rotations with UC San Diego's Toxicology and Poison Control Center and its Center for Occupational and Environmental Medicine (COEM), providing valuable clinical and field training experiences in San Diego. The poison control center rotation is full-time for one month, including an evening on-call schedule. The COEM rotation can be taken for two to four days a week. This rotation emphasizes management of the university's employee health service. The number of patients is determined by the resident's educational objectives. The rotation can be structured to function as a corporate, work-site based rotation.

Residents who desire more specialized clinical training may do ambulatory rotations with UC Irvine Medical Center clinical programs, such as dermatology, pulmonary, radiology, physical medicine and rehabilitation.

Although the goal of the residency program is to prepare physicians for the comprehensive practice of occupational medicine, research is an integral component of the program in that the academic degree programs require research leading to a thesis. The residency program endorses the academic rigor of this approach by requiring that residents satisfy the thesis degree requirements in order to complete the residency. The Division of Occupational and Environmental Medicine and the School of Medicine provide a rich environment for residents to undertake a full range of research activities.

The program director and faculty members guide residents in selecting their research topics for the master's degree thesis. In many instances, residents perform their research under the supervision of a division faculty member, many of whom have joint appointments with participating academic institutions.

During the program's practicum phase, residents may extend the research they began in the academic phase or they may undertake new projects. These projects often develop from field-site rotations. The research experience is designed to provide knowledge, skills and an appreciation of research without materially detracting from the residents' core training in comprehensive occupational and environmental medicine practice.

Here are some examples of research projects undertaken by our residents:

• Anthony Biascan, MD, MS, “Cardiovascular Plaque Associated with Exposure to 2.5 ppm,” July 2013.

• Mahdy Flores, DO, MS, "Cardiac Toxicity of Wild Land Fire Generated Ultrafine Particles in Rats," July 2014.

• Derek Gagnon, MD, MS, "Brain and Other Nervous System Tumor Risk Among Workers at the Long Beach Naval Shipyard: A Retrospective Cohort Study," July 2014.

• Michael Sracic, MD, MS, "Modeled Deposition of Inhaled Particulate Matter in Athletes at Exertion," July 2014.
  
  
• Lynn Flowers, DO, MS, “The Effect of Polycyclic Aromatic Hydrocarbon on Ovulatory Status in Women,” August 2015.
  
  
• Sanjiwani Meharda, MD, MS, “In Utero Exposure to Benzo(a)Pyrene Results in Ovarian Follicular Depletion in F1 Muta TM Mouse,” July 2016.
  
  
• Gillian Nelson, MD, MS, “Is There a Relationship Between Polycyclic Aromatic Hydrocarbon Exposure and Ovarian Reserve Markers in Humans?” July 2016.
  
  
• Joseph Vo, MD, MS, “The Effects of Ozone on Atherosclerosis in Predisposed Mice,” July 2017.
  
  
• Samir Mukherjee, MD, MS, “Clinical Predictors of Metabolic Syndrome," June 2018.
  
  
  

Applications can be submitted via the Electronic Residency Application Service (ERAS). This program is listed under Preventive Medicine residencies in ERAS.

The required documents for applications are:

• An “original” Dean’s letter from your medical school.
  
  
• An “original” letter from your PGY-1 Program Director to include previous educational experiences and summative competency-based performance evaluation.
  
  
• Three “original” letters of recommendation. Letters of reference are required to be “originals” and “current” 12 month period prior to start date.
  
  
• “Original” undergraduate, graduate and medical school transcripts. Sent directly from school.
  
  
• Part 1 & 2 of National Board or Flex scores, MCAT, USMLE, COMLEX scores “originals”.
  
  
• “Statement of interest” concerning your interest in Occupational Health.
  
  
• Copy of Medical License
  
  
• Copy of Medical License Diploma.
  
  
• Copy of DEA License.
  
  
• Copy of NPI Number.
  
  
• Copy of all Certificates of Residency (include all PGY’s) and Board certification(s).
  
  
• CV (Please account for all periods of time chronologically since High School (Pre-med, post-med, leave of absences, residency).

Interviews begin in October. Application materials must be posted to ERAS by October 1st. It is recommended that applicants submit all of their materials well before the October 1 deadline to secure a timely interview slot. Applicants will be notified no later than December 15.

For questions about the application process please contact the program coordinator, Barbara Scarpine, at bscarpin@uci.edu. For questions about the residency program, please contact our Residency Program Director, Dr. Alya Khan, at alyak@uci.edu.