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Medicine and Public Policy |

Physician Shortage in Occupational and Environmental Medicine

Joseph S. Castorina, MD, MPH; and Linda Rosenstock, MD, MPH
[+] Article and Author Information

Grant Support: By the Agency for Toxic Substances and Disease Registry, Atlanta, GA; and the Committee on Enhancing the Practice of Occupational and Environmental Medicine, Institute of Medicine, National Academy of Sciences.

Requests for Reprints: Joseph S. Castorina, MD, MPH, Occupational Medicine Program, University of Washington, ZA-66, 325 Ninth Avenue, Seattle, WA 98104.

Current Author Addresses: Drs. Castorina and Rosenstock: 325 Ninth Avenue, ZA-66, Seattle, WA 98104.


© 1990 American College of PhysiciansAmerican College of Physicians


Ann Intern Med. 1990;113(12):983-986. doi:10.7326/0003-4819-113-12-983
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Objective: To determine future training needs for physicians in occupational and environmental medicine based on goals established by the Institute of Medicine (IOM) for clinical practice in the field.

Design: A critical review of previously published estimates of the need and supply of physicians with clinical training in occupational and environmental medicine with the application of currently available data to produce revised estimates.

Measurements and Main Results: Need estimates reviewed from the National Institute for Occupational Safety and Health, the Graduate Medical Education National Advisory Committee (GMENAC), and the Bureau of Health Professions. Supply figures reviewed from GMENAC, the American Medical Association, the American College of Occupational Medicine, and the American Board of Preventive Medicine. Revised need figures are based on the estimated number of occupational and environmental physicians needed to provide adequate nationwide coverage as full-time academic faculty, community-based specialists, and public health physicians in state and local agencies. Revised supply estimates are based on review of available data. Need is estimated at 4600 to 6700 physicians (board-certified or eligible or with special competence in occupational and environmental medicine). Supply is estimated at 1200 to 1500.

Conclusions: This review identified a deficit of 3100 to 5500 physicians in this newly evolving specialty. In order to address this shortfall in the next decade, graduate specialty training would need to be increased to about 3 to 5 times the current maximum capacity.

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