The University of Colorado at Denver and Health Sciences Center (UCDHSC) and National Jewish Medical and Research Center (NJMRC) residency program addresses two major NIOSH objectives: (1) introducing occupational and environmental knowledge to all MSPH students at our institution (including preventive medicine residents) and (2) increasing the number of residents with specific training in occupational safety and health. The residency grant, which operated from July 1, 2002, through June 30, 2006, supported five residents partially or full-time. During this time period we were able to graduate five residents. An additional resident will graduate September 30, 2006. The NIOSH grant allows this residency to continue training occupational and environmental medicine residents, who have all become active in their field in their post graduate roles, and also students in the Master's of Science in Public Health program at the UCDHSC. In addition, during this grant period we stared teaching in the training programs at Colorado State University involving occupational and environmental health. The residency has changed significantly through the last four years. We have broadened our mission to recruit regional practicing physicians as well as residents with a pulmonary background or other completed residency and interest in occupational medicine. Recognizing the increased need for training physicians already practicing in occupational medicine in Colorado, we increased the number of practicum year positions in the program from two to three. Our residency successfully recruited and graduated two practicum year only Colorado physicians and trained and graduated an additional practicing physician from the full, two year MSPH and practicum program. Multiple abstracts or posters were presented by residents during this time period at national and regional meetings covering the topics of: 1 ) Pediatric "hot tub lung"-- Environmental Exposures Causing Severe Lung Disease in Healthy Children A Case Series; 2) Stuck and Too Busy...Needlesticks in an Internal Medicine Training Program; 3) Fever, vomiting and headache in a 50-year old female-It's the water and 4) Symptoms Experienced by Law Enforcement Personnel in Association with Methamphetamine Lab Investigation. The last topic was accepted at the American Occupational Health Conference in May 2005 where the NIOSH supported resident competed with 15 other projects and received the Residents Award for high quality research. One paper and a book chapter were also completed and published by residents during this grant period. The grant relieves faculty from seeking further funding to support the residents and thus they are able to participate in multiple other training areas. The problem based occupational environmental health course offered through the UCDHSC MSPH program was increased in depth significantly during this time period. The year-long course now incorporates more toxicology, taught by two academic toxicologists who have an occupational and environmental medicine focused practice. The course reflects multiple disciplines through its inclusion of faculty industrial hygienists and OSHA regional directors and provides in-depth coverage of toxicology, industrial hygiene, and a broader spectrum of occupational diseases than was taught previously. This course is a popular elective for MSPH students and usually has between 10 and 14 students annually who are taking the course as an elective. All MSPH residents are required to take the year long course. In addition faculty and residents have lectured for the environmental health courses at Colorado State University, which trains industrial hygienists, ergonomists and other occupational health professionals. Similarly an exchange program has now been set up with Colorado State University faculty to teach in the MSPH program and to provide practicum lectures for the residents. The faculty also improved our training evaluations for residents by adding a 360 degree evaluation tool and a direct patient encounter evaluation. In the direct patient encounter faculty observe the full clinical evaluation of a patient and critique the resident's method as well as the medical record and treatment plan. This evaluation takes place at the beginning of the practicum year and near the end of the practicum year. We expect these tools to improve the residents' understanding of specific clinical areas needing improvement. Overall the NIOSH funding of this residency has supported five residents. All of our graduated residents have passed the occupational medicine boards on their first attempt. We are also pleased by the community leadership demonstrated by our graduates, as directors of clinical programs and participants in continuing education. The grant has also allowed faculty to improve not only the residency program but also the training program in occupational and environmental health for all of the students on the University of Colorado at Denver and Health Sciences Center campus as well as the Colorado State University campus.
Kathryn Mueller, MD, MPJH, Department of Preventive Medicine and Biometrics University of Colorado at Denver and Health Sciences Center, Aurora, CO 80045