Occupational and Environmental Medicine Residency

Visit program website.

Program Leadership:
Gina Solomon, MD, MPH, Program Director
Robert Harrison, MD MPH, Associate Program Director

Program Contact:
Lucia Wang, Program Administrator

Address:
Occupational and Environmental Medicine
University of California, San Francisco
Department of Medicine, UCSF
2540 23^rd Street, Rm. 2901
San Francisco, CA 94143

Phone:
(415) 763-7392

Program Description

Introduction

The Occupational and Environmental Medicine (OEM) residency program is a two-year ACGME-accredited program offered by the UCSF School of Medicine. The UCSF OEM program prepares physicians for Board certification in Preventive Medicine-OEM and for practice and leadership roles in clinical, academic, governmental, non-governmental, consulting, and corporate settings. The program provides academic instruction, clinical and non-clinical experiences, and research opportunities. A large core and affiliated faculty based at UCSF, together with extramural clinical faculty and other preceptors, provide this training. Graduates of the UCSF OEM program are currently leaders in academic medicine, government, and corporate medicine. Trainees will achieve competency in all core knowledge content areas in OEM and are encouraged to develop areas of special expertise. In keeping with this goal, the educational program is individually tailored to meet the needs of each trainee. Our program has a special emphasis on care to underserved workers and communities, especially including rural agricultural workers in the Salinas Valley and Central Valley of California. 

Educational Program (Basic Curriculum)

In the first year, trainees typically complete coursework to earn a Master of Public Health (MPH) from the UC Berkeley School of Public Health. Entering trainees who already have an MPH or an equivalent degree and who have already completed a primary residency may enter as a second-year resident. For entering residents who already have completed an MPH but no prior Board certification, the first-year curriculum will include a combination of clinical work (a minimum of 4 months) as well as other non-clinical rotations. The first year MPH residents enroll in the Interdisciplinary track, an accelerated, 9-month program. The program focuses on leadership development and successful interventions in public health. Core required coursework includes biostatistics, epidemiology, health services management and administration, environmental health, social and behavioral influences on health, and public health leadership. The Preventive Medicine Seminar includes quality improvement training.

Additional graduate-level content beyond the MPH addresses: Industrial hygiene (both years); clinical epidemiology (first year); An academic year-long (September-June) program of Grand Rounds and Journal Club; A year-long twice-weekly resident conference; toxicology (first year); and special workshops on topics such as emergency response, risk communication, and incident investigation. The annual UCSF Division of OEM CME, addresses a wide range of OEM content; Residents also get mentored, dedicated research time.

A month-long program (August each of two years) features industrial site visits. The trainees are expected to observe and record occupational and environmental hazards and the corresponding control measures. Each trainee is expected to complete weekly consultant write-ups after the site visits, identifying and recommending strategies to improve workplace safety and health. Site visits include a wide range of industries and environmental sites in the greater San Francisco Bay Area. Examples include: refineries, metals manufacturing, foundries, cement manufacturing, pharmaceutical and biotech facilities, research laboratories, sewage treatment facilities, waste handling facilities, food processing, dairies, farms, nail salons, and construction sites.

Types of Rotations and Educational Activities

The second year of residency training is devoted to a combination of clinical experience (minimum of four months), non-clinical rotations, and research. A typical breakdown of the trainees’ activities by year is shown below:

First Year

• 1 month of industrial hygiene course (August) including industry site visits and clinical work plus didactic training. 
• 8½ months UC Berkeley School of Public Health coursework
• Weekly half-day clinic throughout year
• 4-8 weeks of occupational clinical needlestick hotline coverage (nights and weekends)
• 2½ months of additional full-time clinical rotations (July; mid-May through June)

Second Year

• 1 month of industrial hygiene course (August) including industry site visits 
• Weekly half-day clinic throughout year
• 4-8 weeks of occupational clinical needlestick hotline coverage (nights and weekends)
• 3 to 4 months of additional full-time clinical rotations
• 2-4 months non-clinical rotations including corporate or consulting and public and environmental health
• 2 months of research

Instructors and Resources

The UCSF OEM Residency Program has a wealth of clinical and research faculty distributed throughout UCSF and its associated hospitals listed below. Education within the program and supervision of trainees are the focus of the majority of the faculty.

Teaching Faculty

• Rahmat Balogun, DO, MPH, Associate Clinical Professor, UCSF , Medical Director, UCSF Occupational Health
• Max Blumberg, MD, MPH, Associate Medical Director, UCSF Occupational Health
• Timur Durrani, MD, MBA, MPH, Professor of Medicine UCSF, Associate Chief for Clinical Services, Division of Occupational, Environmental and Climate Medicine; Medical Director, ZSFG Occupational Health Services
• Sheiphali Gandhi, MD MPH, Assistant Clinical Professor of Medicine, UCSF; Director, Northern California Silicosis Network
• Matt Gribble, PhD, DABT, Professor of Medicine, UCSF; Associate Chief for Research, Division of Occupational, Environmental and Climate Medicine
• Sandeep Guntur, MBBS, MD, MPH, Associate Clinical Professor, Director, Employee Health, SF Veterans Administration Health Center
• Carisa Harris, PhD, CPE, PT, Professor of Medicine, UCSF; Director, Ergonomics Program; Director, Northern California Center for Occupational and Environmental Health    
• Robert Harrison, MD, MPH, Clinical Professor of Medicine, UCSF; Public Health Medical Officer, California Department of Public Health; Associate Program Director, OEM Residency
• Sarah Janssen, MD, PhD, MPH, Associate Clinical Professor of Medicine, UCSF; Staff Physician, Kaiser Permanente Medical Group, San Francisco Opera Plaza 
• Gina Solomon, MD, MPH, Professor of Medicine, UCSF; Chief, Division of Occupational, Environmental and Climate Medicine; Program Director, OEM Residency

Instructional Facilities

Examples of our rotations include:

Entrance Requirements

In accordance with ACGME requirements for graduate medical education, the UCSF School of Medicine GME eligibility policy applies to all residency and fellowship programs and may be found in the Housestaff Information Booklet.

The program specific policies may be found at: https://oecm.ucsf.edu/residency-and-other-education/residency-program

Policies

Enrollment Policy

In accordance with ACGME requirements for graduate medical education, UCSF School of Medicine GME policies apply to all residency and fellowship programs and may be found in the Housestaff Information Booklet.

Credit Evaluation Policy

In accordance with ACGME requirements for graduate medical education, the UCSF School of Medicine GME supervision, evaluation, and other policies apply to all residency and fellowship programs and may be found in the Housestaff Information Booklet.

The program specific supervision, communication/escalation, and evaluation policies address the different levels of training and may be found at: https://oecm.ucsf.edu/residency-and-other-education/residency-program. Each program has a multisource learner assessment program in accordance with ACGME, UCSF GME, and program policies and requirements.

All faculty and trainees are educated about fatigue in GME training and adept at recognizing fatigue in themselves and others. In accordance with ACGME requirements for graduate medical education, the UCSF School of Medicine GME fatigue mitigation policy applies to all residency and fellowship programs and may be found in the Housestaff Information Booklet.

Attendance Policy

In accordance with ACGME requirements for graduate medical education, the UCSF School of Medicine GME leave policy, which addresses vacation, sick, parental, and other leave, applies to all residency and fellowship programs and may be found in the Housestaff Information Booklet.

• Absence: Refer to the GME leave policy in the Housestaff Information Booklet.
• Tardiness: Fellows are expected to contact their site preceptor by 8:30 a.m. to indicate if they will be late or absent that day for any reason, notify the Chief resident, and to document absence in the MedHub system.
• Interruption for Unsatisfactory Attendance: Interruption for unsatisfactory attendance is address through the established UCSF GME disciplinary mechanisms noted elsewhere in this document. Fellows taking more than the allowed vacation/sick time may be required to extend their fellowship past the normal graduation date.
• Cutting Classes: Fellows must attend a minimum of 70% of conferences during their fellowship and unsatisfactory attendance will be reviewed at the semi-annual Clinical Competency Committee. If needed the fellow will be put on a remediation plan until the situation is rectified.
• Make-up Work: Missed conferences that have been recorded will be available for later viewing. Other missed conferences are made up at the discretion of the program director.
• Leave of Absence: Refer to the GME leave policy in the Housestaff Information Booklet.

Policy on Academic Progress

The medical education of physicians to practice independently is experiential and necessarily occurs within the context of the health care delivery system. Developing the skills, knowledge and attitudes leading to proficiency in all the domains of clinical competency requires the resident and fellow physician to assume personal responsibility for the care of individual patients. For the resident and fellow, the essential learning activity is interaction with patients under guidance and supervision of faculty members who give value, context, and meaning to those interactions. As residents and fellows gain experience and demonstrate growth in their ability to care for patients, they assume roles that permit them to exercise those skills with greater independence. This concept – graded and progressive responsibility – is one of the core tenets of American GME. Supervision in the GME setting has the goals of assuring the provision of safe and effective care to the individual patient; assuring each resident or fellow’s development of the skills, knowledge, and attitudes required to enter the unsupervised practice of medicine; and establishing a foundation for continued professional growth.

The program director is responsible for the content and conduct of all educational activities at all teaching sites.

Trainee performance and progress are evaluated by program faculty verbally and in writing with progression consistent with ACGME milestones assessed twice yearly by the Clinical Competency Committee and further reviewed by the Residency Advisory Committee. These formal mechanisms are in place for monitoring and documenting each trainee’s acquisition of fundamental knowledge and clinical skills and overall performance throughout the academic year.

Trainees are supervised by faculty and given regular feedback on their performance in real-time and at regular intervals from the program director or associate program director with input from the Clinical Competency Committee (CCC), as noted. If a trainee is not meeting expectations or experiencing difficulties, the program director will determine if remediation is needed.

In the event academic action is necessary, policies and procedures must follow the UCSF GME academic due process policy.

Trainee Responsibilities

UCSF residents and fellows are expected to:

• Develop a personal program of self-study and professional growth with guidance from the faculty
• Participate in safe, effective, and compassionate patient care under supervision commensurate with their level of advancement and responsibility;
• Participate fully in the educational and scholarly activities of their program and as required, assume responsibility for teaching and supervising other residents, fellows, and students
• Participate in institutional programs and activities involving the medical staff and adhere to established practices, procedures, and policies of the institution
• Participate in institutional committees and councils, especially those that relate to patient care activities; Participate in evaluation of the quality of education provided by the program;
• Develop an understanding of ethical, socioeconomic, and medical/legal issues that affect graduate medical education and how to apply cost containment measures in the provision of patient care;
• Comply with established ethical behavior and practices
• Adhere to federal, state, and campus deadlines and requirements regarding licensure and registration for the practice of medicine;
• Respond to the Office of GME (OGME) and the home program/department for information related to position/rank and function; Adhere to all departmental, School of Medicine, GME, and ACGME policies and procedures.

Benefits/Leave

UCSF residents and fellows are entitled to four (4) work weeks of vacation, 12 sick days, and (4) work weeks of paid parental leave annually. Find more information about trainee leaves.

Time spent away from the program may impact program completion per American Board requirements. Programs are required to provide timely notice of the effect of leave(s) on the ability of trainees to satisfy requirements for completion.

UCSF Hospital System Responsibilities

• Sleep rooms and lounges: Sleep rooms and lounges for residents and fellows are provided at rotation sites. They may use for overnight call and napping.
• Uniforms: One long white coat is issued to new residents.
• Work Hours: UCSF GME work hour policy applies to all residents and fellows and may be found in the Housestaff Information Booklet.
• Communication: email addresses, and access to the UCSF network are provided to all residents and fellows when they start their training.
• Library: All trainees have access to the UCSF library, both in-person and online. They also have access to libraries at the sites in which they rotate.

Salaries

Trainee salaries are determined through collective bargaining with CIR-SEIU Healthcare, the exclusive representative of UCSF residents and fellows. If program policy allows, trainees may elect to moonlight. Find the UCSF GME moonlighting policy in the Housestaff Information Booklet.