Learning

OEM Competencies

To assist practicing physicians to keep current and to serve as knowledgeable representatives of the specialty, ACOEM has identified these 10 core competencies for occupational and environmental medicine (OEM):
1) Clinical Occupational and Environmental Medicine 

The OEM physician should have the knowledge and skills to provide evidence-based clinical evaluation and treatment of injuries and illnesses that are occupationally or environmentally related. The OEM physician’s expertise is also applied to evaluating the impact of personal medical conditions on the ability to perform work tasks. Throughout the course of care, the physician should seek to maximize the patient’s functional recovery. Clinical expertise is applied in face-to-face care of patients, as well as in activities such as case management and peer-to-peer discussions. (ACGME core competencies addressed: ACGME Patient Care, Medical Knowledge, Interpersonal and Communication Skills, and Professionalism.)

2) OEM Related Law and Regulations 

The OEM physician should have the knowledge and skills necessary to comply with regulations important to occupational and environmental health, as well as the wide range of laws and regulations related to the interactions between work and health. As recognized experts on issues relating to the causation of occupational and environmental injuries and illnesses, as well as ability to perform work with or without reasonable accommodations, OEM physicians are frequently called on to provide expert testimony, write expert opinion reports, and provide peer review. The OEM physician needs to interact knowledgeably with nonmedical professionals, including human resources managers, operations managers, safety professionals, union leaders, government officials, and legal professionals, and should understand the rules of these worlds. (ACGME core competencies addressed: ACGME Practice-Based Learning and Improvement, Interpersonal and Communication Skills, Professionalism, and Systems-Based Practice.)

3) Environmental Health 

The OEM physician should have the knowledge and skills necessary to recognize potential environmental causes of concern to the individual, as well as to community health. Environmental issues most often include air, water, or ground contamination by natural or artificial pollutants. The physician should know about the health effects of the broad physical and social environment, which includes housing, urban development, land use and transportation, industry, and agriculture. (ACGME core competencies addressed: ACGME Patient Care, Medical Knowledge, Interpersonal and Communication Skills, Professionalism, and Systems-Based Practice.)

4) Work Fitness and Disability Management 

The OEM physician should have the knowledge and skills to determine whether a worker can safely be at work and complete required job tasks. The physician should be able to assist the patient in identifying personal functional goals, and develop a treatment or management plan that attempts to align the patient’s goals with the job requirements. The physician should have the knowledge and skills necessary to provide guidance to the employee and employer when there is a need for integration of an employee with a disability into the workplace, or when there is a need to pursue other avenues such as vocational rehabilitation or disability benefits. (ACGME core competencies addressed: ACGME Patient Care, Medical Knowledge, Interpersonal and Communication Skills, Professionalism, and Systems-Based Practice.)

5) Toxicology 

The OEM physician should have the knowledge and skills to recognize, evaluate, and treat health effects of exposures to toxic agents at work or in the general environment. The physician should also have the knowledge and skill to develop, evaluate, and manage medical surveillance and biological monitoring programs for toxicological exposures. (ACGME core competencies addressed: ACGME Patient Care, Medical Knowledge, Practice-Based Learning and Improvement, Professionalism, and Systems-Based Practice.)

6) Hazard Recognition, Evaluation, and Control 

The OEM physician should have the knowledge and skills necessary to assess whether there is risk of an adverse event from exposure to physical, chemical, biological, ergonomic, or psychological hazards in the workplace or environment. The OEM physician should be prepared to collaborate with industrial hygienists or other qualified safety and health care professionals and interpret measurements and reports from such professionals in context. If there is a risk with exposure, then that risk can be characterized with recommendations for control measures or medical surveillance. The OEM physician should demonstrate an understanding of the core principles of industrial hygiene, ergonomics, occupational safety and risk/hazard control, and communication, and apply the principles of the Hierarchy of Controls to protect the health of individual workers, patients, and the public from the range of known chemical, physical, biological, and radiological hazards. (ACGME core competencies addressed: ACGME Medical Knowledge, Practice-Based Learning and Improvement, Interpersonal and Communication Skills, and Systems-Based Practice.)

7) Disaster Preparedness and Emergency Management 

The OEM physician has a critical role in emergency preparedness and emergency management, with responsibility for protect- ing employed individuals and the national workforce from health and economic con- sequences of disasters. The OEM physician should have the knowledge and skills to collaborate with the employer management team to plan for workplace response to natural or man-made disasters. Emergency management planning includes resource mobilization, worker population tracking, communication contingency planning, and collaboration with local, state, or federal agencies. (ACGME core competencies addressed: ACGME Patient Care, Medical Knowledge, Practice-Based Learning and Improvement, Interpersonal and Communication Skills, and Systems-Based Practice.)

8) Health and Productivity 

The OEM physician should be able to identify and address individual and workplace organizational factors to optimize the health of the worker and enhance productivity. These issues most often include absenteeism, presenteeism, health enhancement, and population health management. (ACGME core competencies addressed: ACGME Patient Care, Medical Knowledge, Practice-Based Learning and Improvement, Interpersonal and Communication Skills, and Systems-Based Practice.)

9) Public Health, Surveillance, and Disease Prevention 

The OEM physician should have the knowledge and skills to develop, evaluate, and manage medical surveillance programs for the workplace, as well as the general public. The physician should be able to apply primary, secondary, and tertiary preventive methods. (ACGME core competencies addressed: ACGME Patient Care, Medical Knowledge, Practice-Based Learning and Improvement, Interpersonal and Communication Skills, Professionalism and Systems-Based Practice.)

10) OEM Related Management and Administration

The OEM physician should have the administrative and management knowledge and skills to plan, design, implement, manage, and evaluate comprehensive occupational and environmental health programs and projects. OEM physicians need an understanding of health care benefits, workers’ compensation systems, and electronic health records and knowledge of the laws and regulations applicable to the jurisdiction, industry, and population of interest. OEM physicians in all practice settings are expected to be sensitive to the diverse needs and cultural backgrounds of those they serve, and anticipate meeting diverse needs in setting up their practices. (ACGME core competencies addressed: ACGME Practice-Based Learning and Improvement, Interpersonal and Communication Skills, Professionalism, and Systems-Based Practice.)


View the complete OEM Competencies Statement which defines and expands each competency.