Learning experience in occupational medicine

Introduction

This page has been written in support of the learning experience in Occupational Medicine (and environmental health) and the associated clinical and epidemiologic concepts (notably causality, risk and the methods for determining these and for reducing risk).

Based on the recommendations of the Faculty of Occupational Medicine, by the end of the MB ChB programme, one would expect that students would have achieved the objectives listed hereunder.

By the end of the course students should:

Attitudes

  • Have accepted the physician's responsibility for recognising occupationally and environmentally related ill health and the physician's contribution to prevention and, where appropriate, notification and compensation,
  • Have accepted their responsibilities as health care workers towards their health and safety at work and that of others.

Core learning: Responsibilities of General Practitioners, Hospital Doctors, Doctors as Employers and Employees, Societal attitudes,

Extended learning: In-depth appreciation of attitudes of above and of employers, workers and other stakeholders.

Skills

  • Be able to take a good occupational history and consider the relevance of exposure in the workplace, as well as elsewhere to the patient's health problems,
  • Be able to pursue ways in which work can be modified to support less fit or handicapped people, and to rehabilitate patients back to work.

Core learning: Basic occupational history taking, hazard identification, semi-quantitative assessment of exposure, ways of identifying sources of further advice, elements of fitness for work, basic techniques for workplace rehabilitation.

Extended learning: Quantitative assessment of exposure to examples of physical, chemical and biological hazards, sources of further advice, skills for assessing and advising on fitness for work and on sickness absence and for implementation of workplace rehabilitation.

Knowledge

  • Be able to define the major occupational and environmental health risks in modern Britain in terms of clinical features, epidemiology and exposures that result in these risks,
  • Be able to discuss the concepts of occupational and environmental epidemiology, biological and environmental monitoring of workplace hazards and measures that can be taken to control these hazards,
  • Be able to outline the functions and responsibilities of occupational physicians, the Health and Safety Executive, other occupational health practitioners such as nurses, hygienists and safety practitioners, Environmental Health Officers and other relevant agencies and practitioners.

Core learning: Outline of hazards and diseases of occupation, frequency of work-related ill-health, understanding of discrepancy between official data on occupational ill-health and that derived from epidemiology or self-reporting. Outline knowledge of function of enforcing authorities and of basic strategies for risk assessment and control. Outline understanding of responsibilities of Occupational Physicians, Occupational Hygienists and other health and Safety Practitioners.

Extended learning: Description of techniques for reducing risks to health from work (elimination, substitution, changes in work practice and organisation, segregation, enclosure, personal protection etc). Strategies and techniques for Health Surveillance. Knowledge of basic legislative framework for prevention, e.g. for Control of Substances Hazardous to Health, for rehabilitation, for reporting and for compensation (statutory and common law). In-depth appreciation of responsibilities of Occupational Physicians, Occupational Hygienists and other Health and Safety Practitioners.

Assessment

Objective assessment of clinical skills should include basic elements such as history taking relevant to Occupational Medicine. Moreover, within the portfolio reports, students will be expected to address, where relevant, concepts such as risk and how it relates to health at work, methods of its control and rehabilitation.

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