November 1988

The Challenge of Teaching Occupational and Environmental Medicine in Internal Medicine Residencies

Author Affiliations

From the Yale—New Haven Occupational Medicine Program, Department of Internal Medicine, Yale University School of Medicine, New Haven, Conn (Dr Cullen), and the Occupational Medicine Program, Department of Medicine, University of Washington, Seattle (Dr Rosenstock).

Arch Intern Med. 1988;148(11):2401-2404. doi:10.1001/archinte.1988.00380110055011

• Using a mailed survey questionnaire directed toward division chiefs of general internal medicine, we have confirmed that despite increased interest among faculty, few medical residents currently receive required or elective training in occupational medicine. However, recent changes in societal perceptions about environmental risks, corporate health care practices, and medical reimbursement patterns favoring provision by hospitals of contractual outpatient services to healthy workers all portend expanded involvement of residents in certain occupational medicine activities in the future, in response to economic pressures on both consumers and providers. These same forces may, unfortunately, undermine the scientific and ethical quality of such training experiences, compared with emerging, more academically motivated approaches. The implications of these prospects are analyzed in the hope that a proper balance can ultimately be struck between economic and academic imperatives.

(Arch Intern Med 1988;148:2401-2404)