Orientation Period

During this period, residents receive orientation and develop their individualized educational plan based on their self-assessment, prior training and experience, and educational objectives. The residents begin to participate in the COEH occupational and environmental medicine (OEM) clinics and the core residency didactic seminars. They visit multiple worksites and occupational medicine programs in the region for an introduction to workplace assessment and to practice opportunities in occupational medicine. They also complete courses on industrial hygiene, occupational safety, and introduction to occupational and environmental health laws and regulations. This period allows time for entering residents to interact with continuing residents and the program faculty so they can become thoroughly familiar with the educational opportunities and resources.

Core Residency Training

Throughout the two year residency, the occupational medicine residents participate in core residency training activities based at the UCI Center for Occupational and Environmental Health. These training activities include participation in the two COEH occupational and environmental medicine 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 the field site rotations during the practicum phase, residents receive clinical training through their participation in the COEH occupational and environmental medicine (OEM) clinics. The COEH operates two full-time clinics. One clinic is based at the Center, located next to the College of Medicine on the UCI campus. This clinic functions as a regional consulting and referral center for occupational and environmental medicine clinic. 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 communicate with the patient regarding diagnosis, work-relatedness of the condition, and prognosis.

The other OEM clinic is based at the UCI Medical Center in Orange, CA. This clinic is the employee health service for the UCI Medical Center and it provides comprehensive workers compensation and employer services for a range of work places in the area. Under supervision of the attending faculty, 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 COEH clinics throughout the residency program, although residents may do a longer rotation in the UCI Medical Center clinic during the practicum phase. Residents are supervised, but they are given progressive responsibility for patient care.

Clinical case conference. The COEH has a weekly clinical case conference held in conjunction with the required residency didactic sessions. This conference serves as the attending rounds for the COEM clinic in which residents discuss case issues, case management strategies, clinical toxicology, and occupational medicine principles. The role of the COEH 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 COEH faculty provide continuity for the residents.

Residency didactic seminar. The residency program sponsors a bi-weekly occupational medicine didactic seminar. Residents are required to participate in the seminar during the practicum phase. We make this possible by arranging for the "full-time" field site rotations to be four days per week so that residents spend one day a week at the COEH.

Topics for the seminar are taken from the 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.

Journal club. The other required seminar is a bi-weekly residency journal club. The purpose of the journal club 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 an important, recent article. The resident then reads the article and other relevant citations and prepares 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. The following are examples of sites visited recently by the residents: Allergan Pharmaceuticals, Exxon-Mobil Refinery; Exide-GNB Industrial Power; Steelcase Manufacturing; Toyota Car Manufacturing; Kimberly Clark Paper Mill; Mansfield Plumbing; Hunting Beach School District; Orange County Health Department; San Diego Poison Control Center; and the UCI Environmental Health and Safety Facility. Residents also visit work sites during the Cal-OSHA rotation.

Grand Rounds. The COEH sponsors a monthly grand rounds designed as a Continuing Medical Education program for practicing physicians. The program invites regional and national speakers to present at the rounds. This seminar increases the visibility of the COEH and maintains good collaboration with the professional community which ultimately enhances the residents training opportunities. Residents are expected to attend the Grand Rounds whenever their academic and practicum training schedules permit.

In addition, residents may attend other seminars in the College of Medicine - for example, the Department of Medicine Grand Rounds and noon conferences, as well as seminars of the Epidemiology and the Environmental Toxicology programs. The UCI Medical Center sponsors a range of residencies and fellowships. These programs provide substantial opportunity for residents to participate in research and clinical seminars.