Good morning. Thanks, everyone, for being with us here today. Really, we're very excited to get a chance to talk with you about where we are with the AECOM Ambassador Program and help hopefully get a lot of you signed up and we're also going to ask for a lot of input from you for how we can make this even better. So, hi. My name is Pam Kral. I'm the Residency Program Director at the Uniformed Services University. But I'm here as working on the AECOM Ambassador Workgroup. Yeah, and hi. My name is Dr. Captain Nate Jones. I'm on active duty at Robbins Air Force Base with the U.S. Air Force and the Occupational Medicine Clinic. Also been on the Ambassador Program Workgroup and, you know, specifically we fall under the Council on Membership and I've been on the Council on Membership for the last six years. Hi. I'm Nicolette Davis. I'm a PA and I am also in the Ambassador Workgroup but also served in the Future of OEM Workgroup as well and that's how I got connected with the Ambassador Workgroup. Did we lose our slides? Great. Great. I don't know that we can advance. Okay. One more. Should we just call out the advance? Did that go? Okay. So, as Dr. Kral had mentioned, essentially we'll be providing you an update of what the working group has been doing and I recognize that the Ambassador Program has essentially happened in previous iterations or other additions essentially and there may be some members of the audience here today who have contributed to that so definitely want to acknowledge and express gratitude to anyone who has pursued even something similar to this in the past but essentially the main problem that we're trying to get at is that there is a shortage of occupational medicine physicians, providers, and we're trying to raise awareness specifically among trainees and potentially mid-career physicians as well about this wonderful field that we all know and love. So, in doing so, we hope to highlight some of the advantages or benefits of occupational medicine that many of us are familiar with, specifically high satisfaction and low burnout. Those should be appealing characteristics, especially for today's trainees but there are still shortages both among active practitioners of occupational medicine as well as in the training pipeline. I think there have been a few presentations already at this meeting of AOHC that have highlighted not even all the residency slots are being filled and how are we going to fill them? How are we going to generate that interest among the trainees? And then obviously for our advanced practice providers, what is their pathway into occupational medicine? They don't necessarily have a residency like the physicians would and how are they going to first learn about occupational medicine but then also enter the field? Great. So, just to give a little bit more of the background here, counting how many of us there are has been a challenge. If you look, you can see there's a lot of overlap as we all know. There's kind of folks with board certification, folks who work in the area, people who are in both. And counting how many of us there are, it has always been a challenge. That's part of the new initiative for the ACGME to list occupational and environmental medicine separately from public health and general preventive medicine, separately from aerospace medicine. But regardless, generally you can see that about slightly less than half of those who self-designate don't have a board certification. And about 47% of active preventive medicine physicians are older than 59 years. So a lot of people are going to be retiring out of the specialty and there's just really a need to be bringing people in. I think you've probably been hearing this throughout the conference, kind of from beginning to end. But we need to sustain our field and so we need to bring folks in to do that. So if you look in 1999, we had about 2,400 board-certified ACMED docs and in 2019 we're up to 3,168 and now we're down to about 3,000. So we're not necessarily plunging but certainly with the impending retirements, that's a concern. And if you look, it also highlights the challenges of counting when people have the multiple certifications. It may artificially look like there's more if you just count certifications than there are actual people. So when we start to look at how many APPs are in OEM, so we look at the numbers and when we look at them, similar to what Dr. Kral was saying, it's really identifying those that say, yes, I'm in occupational medicine as my specialty. So when we look at PAs, it's about 0.4% of PAs identify themselves as occupational medicine providers. Now, we know that they're functioning in occupational medicine in some way, shape, or form through primary care, emergency medicine, urgent care, and so on, but these are the ones that specifically identify themselves as occupational medicine. When we look at our nurse practitioner counterparts, it's about 1.2% say that they identify themselves as occupational medicine providers. Now, of course, data can change based on what website you're looking at. This was from BLS.gov, but I think what it shows in the end is we truly have an opportunity to get into these schools and teach PAs and MPs what occupational medicine is, what quality of life it brings, and why we love what we do. So one contributor, as we've said, is just a lack of awareness, and that's what we're really trying to dig into with this program. So Dr. McKenzie did a survey of 247 medical students and 160 practicing OCMED physicians. 70% of med students said they'd had no more than one lecture, and 21% had no contact with the specialty at all during their training. And then, when asking those who are out in the field, you know, 21%, only 21% said that they heard about it during their initial training. And 38% thought that they might have moved into the field sooner, or it would have changed the path of their career had they known about the field sooner. So certainly, awareness is what we're talking about, and just trying to make students, APP and medical students, aware. And, you know, I can share my anecdotal personal experience that that was me in medical school. You know, my medical school official curriculum had no formal inclusion of occupational medicine. I kind of fell into it, actually, through the Air Force, attending an aerospace medicine training program as a medical student and was thankfully introduced to the field, and had a lot of great mentors, even as a medical student, that I can see some of them in the audience here, so really grateful for some of that input that was able to guide me into the field. But again, nothing against my medical school, but no thanks to them, essentially, that I'm in occupational medicine today. So, in 2020, Dr. Beth Baker, past president of ACOM, convened a presidential task force on the future of OEM that was led by Dr. McKenzie, who I also see, and you heard a little bit about this task force already during Dr. McKenzie's general session that she had given. So, one of the main topics that we were trying to address within that future of OEM work group was essentially the trainees. How are we going to increase awareness and draw in some of these trainees? We had a lot of Zoom meetings during 2020. It was one more Zoom meeting as we were all on, and I see some other members of the task force that were there as well. And we essentially started to rebuild this ACOM Ambassador Program, which, as I mentioned, Dr. Bob Bourgeois had been instrumental in creating a previous edition of this, but our task force was looking at trying to reinvigorate, recharge, and restart the program. And with that, we had also had some contact with the Council on External Relations and Communication, trying to create some synergy there to also not duplicate our efforts. And so, when that presidential task force had ended, the work was rolled back into the Council on Membership. And so, under the Council on Membership, a separate working group was created to continue the work of that presidential task force, and we started in July of 2021. And essentially, the main products so far have been presentations, which we'll run through quickly for you here in a minute, to essentially introduce the specialty of occupational medicine to trainees who may not have heard about it before. There have been some test runs of these presentations, and we've received some really good feedback. So, what we're still working on at this point are implementation plans, formal implementation program for the Ambassador Program. Later on, hopefully, we'll be able to solicit some great ideas from the audience here, and definitely looking also to expand this program into other modalities. You know, can we take advantage of some of the remote lecture opportunities, creating sound bites, branching out into podcasts, and definitely looking to spread the word in every possible way that we can. And I had already mentioned the Council on External Relations and Communication. Any of our colleagues who are here who are part of that group, definitely appreciate your collaboration and look to continue working with you in terms of spreading the word about occupational environmental medicine, especially perhaps among any mid-career physicians or practitioners who are looking to transition into our field from their current specialty. Alright, I'm going to stand up for this portion. So, what I'm going to show you is basically running through the slides, the presentation, what it would look like if you were standing in front of a medical school, a PA school, a nurse practitioner school of students. So, this is kind of how the presentation would go. So, we would begin with an introduction to occupational medicine. So, in this presentation, we'll run through these agenda items. We're going to talk about what is occupational medicine, who does this work, where do they do it, who do they interact with on a day-to-day basis, how did OEM even start from the very beginning, why would I choose this as a career path for myself, and then what is ACOM, and how could it support me in my journey as an OCMED provider. We go into what is occupational environmental medicine and we run through the different components of what this is and how it looks in the community and the people that you serve. So, it falls under preventative and clinical medicine under the American Board of Preventative Medicine. So, occupational medicine is in there, aerospace medicine is in there, and then general preventive and public health. This is truly workplace medicine. We are taking medicine either into someone's workplace or we're taking care of someone who works and then they come to us needing help. When we do that, we keep people well and working. That is our job, that is our passion, it's what we do. When we do that, there's a positive impact on not only our patient and their families, but also the employer in which they work and the communities in which they serve. Occupational injury and illness covers everything from head, shoulders, knees and toes, knees and toes, to everything in between, right? So, it could be neuropathy starting at your head, it could be musculoskeletal injuries, it could be things related to the skin, dermatitis, lacerations, foreign body removals, it could be hearing loss due to a work-related exposure, it could be cancers, lung disease, kidney and liver problems, all of those can be affected, as well as mental health. That is a huge push right now. When we think about mental health in the worker, if they spend 33% of their life in their workforce, where do you think their identity lies? In their job and career, right? So, if they get injured or they have an illness that came from their work environment, what do you think that does to their mental health, right? It declines, because their identity is in their workplace. That's why we have to keep people well and working, and that's why we're passionate about our working population. You also need to have a very great knowledge of where these people work and play. Also, how is their work directly impacting their health, and how can we protect them and keep them safe? We also look for patterns and prevention strategies. These are through epidemiologic trends, right? So, when COVID hit the United States, what were all of you all doing? Hitting the refresh button on the CDC website to figure out, okay, where is this and how is it impacting my community? We also look at exposure measurements. What are they exposed to in the work environment? What are those levels, and at what level does it become unsafe for the worker? We also look at protective measures. What kind of PPE do they need? What respirator do they need? How do I fit test them to that respirator to make sure that it truly works and protects the worker? We focus on function. So, we look at what can the worker do in their work environment and what can they not do? If they can't do their normal job in their work environment, how do I connect them and be a connector to rehabilitative services or to adaptive options? We also want to prevent needless disability. That is why we do the work that we do. We don't want people to move on to disability. We know how that affects not only our patients, their families, their employer, and again, our communities. We also have to look at environmental impacts. Where do the patients live? So, I have a little story about this. So, when COVID hit 2020, we had a registration staff, female, excellent worker. She contracted COVID. She ended up in our virtual hospital and we were taking care of her virtually. A nurse was reaching out daily. What we found out about this registration worker, not only did she have very complicated COVID symptoms, she was homeless. We had no idea. We were able to get social work involved. We were able to get her home environment to where she could get back on her feet. Know where your people live, work, and play because it can directly impact how your treatment plan is going to work for them. We also look at pollution and climate change. You all have heard a lot about that during the lectures over the past few days. We look at their workplace environment. That may mean that you go out as an occupational medicine provider and you tour a plant. You look at what are they doing, how much are they lifting, what resources are in place to keep them safe, and what is the education around their job duties. We look at social justice. How do we serve underserved populations? We have a plant right now that I just put a nurse in. The majority of the population are Burmese speaking. So, what do we have to do? We had to pivot, right? We had to make sure that we could constantly be able to communicate with them easily, safely, and quickly. So, we put an interpreter on a stick. iPad has wheels. We run it around the plant and we have conversations with these people. You have to be able to know who you're serving and meet them where they are. We also look at public policy and law and fair compensation for our workers. So, where do OEM physicians and APPs work? Everywhere. They work in hospitals and clinics. They work in private practice. They work in theme parks and resorts. They can work for the government and the military. Large corporations, factories and industries, and also professional sports teams. So, here we go through alright, well these are the places where different OEM physicians and APPs work. These are varied options. So, one is academics. And what we do is we run through why did they want to come to occupational medicine? What drew them in to this being the specialty that they want to serve? One of the ones I like to highlight is Dr. Melanie Hayes, nurse practitioner. What she has said is that occupational medicine has opened her eyes to the new option and consideration about workforce hazards and exposures that affect our individual health. It has allowed her to expand her work as a clinician, leader, educator, and advocate for individual workers to improve their health and safety. So, who does OEM, who do OEM providers work with? Again, everyone. They will interact with almost every specialty. They interact with primary care. They interact with businesses and law, engineering, public health and government. So, even if a student decides down the road, hey I don't want to do OEM but I'm going to go into primary care. What you have to understand is whether or not you go into OEM, you will interact with an OEM provider probably in some way, shape, or form. And if you don't, you're going to interact with someone who works or a family member of someone who works. So, it's very important that we understand OEM providers are the master connectors. So, how did OEM even begin? I think there was a great lecture on this as well. So, a couple examples of where OEM started was Hippocrates in 400 BC. He was looking at lead poisoning in some minors. They were having colic abdominal pain and they were able to create a correlation between the lead exposure and the symptoms. Bernardino Ramazzani, he wrote the dissertation on worker disease. And what he is is a father of occupational medicine. So, what he actually wrote down was exposure then leads to symptoms. So, he said lead exposure leads to symptoms of headache or certain exposures lead to symptoms of headache. He actually put that in writing. Dr. Alice Hamilton was a first female faculty at Harvard University and her focus was actually on industrial toxicology. What she looked at was how does heavy metal exposure then create symptoms in workers? So why would you choose a career in occupational medicine? Like Dr. Jones was saying, you know, there's high satisfaction and low burnout. If you look at these graphs, what it shows is that providers in occupational medicine do really enjoy their work and actually fall at the very bottom of that burnout rate. Again we look at, yes, not only do providers in OEM have high satisfaction and low burnout, they also have, and have expressed, a work-life balance. So in the one graph you see that OEM is in the top left, and what that shows is providers were saying, yes, I truly do feel like I have a work-life balance in this profession. In the graph over to your right, what it shows is that OEM, the providers that do it said, yes, when I work I enjoy it, but I also have time with my family. So why choose a career path in OEM? Well, it gives you variety. I'm sure providers in the room would say you're never bored, and if you get bored you can find something else to do that's also in occupational medicine. There's a mix of administrative, clinical, research policy. And then you can take all of those and you can mix them up and do them all at the same time. There is a high demand for occupational medicine providers. As you can see in the graph, it falls within the top 10 of the highest demand specialties in the United States. There are 50 jobs for every one graduating resident. There's also multiple leadership opportunities for both physicians and APPs in this world. When we look at OEM physician compensation, as you can see, AECOM actually provides all of this to you as part of your membership. They did a survey of about 322 physicians and where they were able to pull out these compensation ranges. So you have access to this. I highly encourage you to take a look. OEM PA compensation, so when you look at this graph, PAs are compensated the highest in the specialty. So this is with about a median of 15 years of experience. They get a base of about 124,000, and that is before any benefits packages or bonus structures, such as quality, and that's what I do for my APPs. They get a quality bonus. They also get a modified productivity bonus based on our primary care numbers. OEM NP compensation, again, these graphs can vary based on where you're pulling them from, but from the 25th percentile to the 75th percentile, NPs can make around $122,000 base salary without benefits or any bonus structures. So how would I enter occupational medicine as a physician? So I think most of us in here would know, but for the students who are going to be hearing this presentation, the idea is to give them a roadmap of how, if they're interested, great, how are you going to enter this specialty? And I think many of us recognize that it is a rather unique pathway compared to many other specialties. We've worked with Kathy Kirkland from AOEC to try to keep an updated list of the OEM residency programs that are available. But we also try to highlight, you know, that there are different ways that they can actually get involved in OEM even before they enter residency, where they can seek out clinical elective rotations, go to conferences such as the one which we're attending right now, and also highlight that this training pathway gives some benefit, you know, Dr. Jung's presentation about how many students currently want to pursue second degrees. This is a great opportunity for them as well. So in turn, how would an APP enter occupational medicine? I don't know. I have no idea. They don't. So they actually learn on the job. So it's because of physicians and APPs who know and have experience in occupational medicine, and they take students under their wing, and they teach them. It's because of people like you that APPs can come in right out of school and learn what occupational medicine is. There are no postgraduate residencies. Now at Atrium Health, what I've done so far is we have an APP Urgent Care Fellowship. So I teach a module on occupational medicine. And when they graduate, they are required before graduation to have their FMCSA medical examiner certificate. So as they enter the workforce, they are already a step above their competition. So the next part of the ambassador presentation would be for you all to put in your personal journey in occupational medicine. So this slide would be dedicated to you to talk about your journey. So for me, I came out of PA school, fresh, bright. I was a military spouse. I moved from Charlotte, North Carolina to San Diego, California. Knew nobody. Got a job with an old school family practice doc. So I go in on my first day. I sit down in his office. I'm so excited. I'm going to learn all of his knowledge, right? He's going to give me everything that he knows. During that first meeting with him, he said, I have three other businesses. This one's yours. You can get me by phone. So he left me with a five-day-a-week family medicine practice. Out of this practice, he did not only family medicine, urgent care, occupational medicine, pediatrics and obstetrics. So it was quite interesting. What it gave me though, not only was it the two best years of my career, it's probably the two worst years of my career. I was scared to death. But what it taught me was I had to find out where my resources were and find them quickly. And that's where ACOM stepped in. I was able to find CME. I was able to make connections with physicians that I still have very close relationships to date. And they taught me what they knew. And that's how I became and had the love for occupational medicine that I continue today in an administrative role for a healthcare system. So what is ACOM and what will it do for me, right? American College of Occupational Environmental Medicine is an OEM professional society. What it does is it promotes optimal health and safety for workers who are your patients. It also provides safety in the workplaces and environments. It educates health professionals like yourselves, as well as the public. It stimulates research and advocates for specialties. It produces and promotes evidence-based treatment guidelines, which is going to be so important to you as a student. It also guides workplace and public policy. And as a student, you can have free membership, whether you're a medical student or an APP into ACOM, you would be able to scan this QR code right now, fill out a very quick application and you will have access to all of these benefits. So you'd have electronic access to the Journal of Occupational Environmental Medicine, free access to the MD guidelines, which I feel like is one of the most invaluable resources that ACOM provides to us, minus our networking, and networking and educational opportunities. You can go to conferences, you can network with other people in your specialty, and you can create lifelong friendships. These are the different ways that you can access ACOM, websites, phone numbers, as well as their social platforms. Oh, and that cool new member kit, they get that too, so you can tell them that as well. So try and draw them in. So how are we trying to do, thanks, and this gives you a sense of kind of what that presentation is. It runs about 15 minutes or so, so a chance to kind of make it your own and give your own spin on it, tries to hit on all of the key things, a chance to hit on some of the environmental and social justice issues that are so important, as we heard, to the younger folks coming into the profession. So anyway, that's that. So in terms of doing the in-person lunch and learn implementations, we're really looking at trying to target the 10 largest medical schools, specifically to try and get a foot in the door there. But we're happy to get anybody who has a way to get into any other schools, certainly not going to rule any of those out. And then also, we're working with medical student organizations as well. So we were out at the AMSA conference just a couple, was it three weeks ago, I guess now. And then also, ACOM had a presenter on a panel for the Student National Medical Association as well. They had their Sowing the Seeds series. One thing that we ran into in terms of incorporating the APP aspect of this was that there was no membership category for students who are PA or MP students. So that has now been created as a pilot program for a student membership for PAs and MPs that they can also get the free access just as medical students can. So that should be great for that. And then we want to make this sustainable. We have some funds to get things going in terms of doing Lunch and Learns, but we're going to need to generate ideas on how to keep this going moving forward. This is just the listing of those 10 largest medical schools. So if anybody has any ins with any of those as an alum, has a point of contact, yeah, there's one. Yeah, we'll definitely take you up on it and try and get in there. But that would encompass 15% of all U.S. medical students. And again, we're just trying to give at least some awareness. I hope many of you who are interested saw the great session on the medical student curriculum efforts that are being done at several places. That's a long and ongoing process, but this is just at least to give some basic level awareness at places where there hasn't been the chance to progress into the curriculum. And for the largest PA schools, this is the listing of those. So we're going to take the same approach, yep. And then for the nurse practitioner schools, we're finding it a little bit more challenging. They're more diffuse, some combination of online and person, but we're working with the NP section to try and figure out the best approach there moving forward. So our next steps, we're going to try and figure out how to do virtual Lunch and Learns, maybe get food delivered by Grubhub or something in that way to get people to do it. Looking at social media engagement, there were suggestions that there are apps for being able to quickly reshare posts. Some other members of our working group who are social media gurus are going to be working toward that, as well as the short videos, all TikTok kind of things to get things out there. And then last, we're going to try and build a network of clinical and non-clinical experiences that's more readily available. So when a student has that interest, you can just plug them right in and get them engaged. All right, so here's the interactive part. Oh, yes, sir. They want us to, for the recording, do it this way. We used to hold sessions 20 years back together, which is kind of nice, I thought. Oh, I'm Fred Amell. I'm in private practice at Albuquerque, New Mexico, 32 years Air Force retired, board certified in emergency trauma, aerospace, and occupational medicine. Not only in my last few years, but I feel like contributing to the new generation, and I think this is a great session. Question I have, and I have under my hire any number of mid-level providers in particular, let alone physicians, but is the American Association of Occupational Health Nurses was our nursing counterpart. We used to hold conventions together back 20 some odd years ago. They were great, I thought, and built kind of a camaraderie, but what did they have? My question is, what did they have in terms of career enhancement for their group? How many nurse practitioners are represented by them, and how are they promoting them, and is there any opportunity there to work with them? Were you wanting to jump in on that? No, no, no, here, here, here. No, no. Hi. Oh, do you want me to walk up this way? Fine. I'm Maria Lonzi. I am a nurse practitioner from the Philadelphia VA. Love occupational environmental medicine, best specialty there ever was, and lead the nurse practitioner section. We have, over the number of five years, worked strongly to develop competencies for entry-level APPAs into occupational environmental medicine. I'm happy to announce that we have completed that. We have objectives. We have about 20 hours of continuing medical education for baseline critical competencies and about 20 CME hours for electives, and we are hoping to partner with our counterparts at the American APANPV, the American Nurses Practitioner Association. And the suggestion is that we open up this very practical CME bundle of competencies to all entry-level OEMs. And so I'm looking for partners. We're going to be doing a formal presentation to the board here at ACOM in July, and it's been a long time coming, but we're very, very proud of it, and we mimicked the ACOM competencies. And this year we have a number of nurse practitioners who came to ACOM, including people that were going to leave ACOM and not only remained but are volunteering for many of the committees that ACOM has. So we're looking to a really future of collaborative practice and team approach to OEM. Thank you. Judith McKenzie, Johns Hopkins. I just have a quick question. Will this be available for use by anyone, or do you have to sign up and, like, what's the process? Is it easy, or is it? That's where we're getting next. Okay, so I promise we're going there. Yeah, sure. So I have a little bit of experience in engaging medical students in my new elective, and the way that I did it, I think that it may be a tactical error to say learn about occupational environmental medicine because it's, like, bleh. It's not attractive. Maybe saying something about a top secret specialty or something kind of funny. When I posted the information about my elective in their catalog, I started it with questions, and that might be a way to pull them in. So, like, I think my work caused my cancer. Would you please sign this disability paperwork? You know, I got lead poisoning at work. Could my child be at risk? So the kind of questions that they might have to deal with clinically to help make it kind of more real. I think that the idea of telling your personal story is great. I think it belongs in the beginning. It belongs up front, and I think anybody delivering this should probably go through the teaching videos, the ACOM Teaching Academy, to learn how to present and pull people in. In fact, we were going to, yeah. We were kind of heading out. I completely agree with you. You know, we have, like, a big image of people working on a ship in full-on PPE. Like, can you find, you know, how many hazards can you find? And that's what we use, you know. I would definitely do something like that, something fun and engaging to pull people in. And you may want to also, I'm sorry, I didn't introduce myself. I'm Marianne Cloran from the University of Maryland. You may also want to segregate the presentations for the different audiences. We have it that way. We just tried to condense it for this session. So it's actually two separate presentations. And I will say, when I dry ran it, I definitely moved the my story up. Yeah. Hey, thanks. I'm Ross Mullinax. I'm actually the chair of the RG section, and this is a topic that's very near and dear to our hearts. And we had a substantial discussion after our section meeting last night on this topic. So my particular question was, you said that there was ACOM had some sort of visit to the SNMA conference and the AMSA conference. Yeah. What was that contact? It was like a lunch and learn or, like, what was the? It was on a specialty panel. It was actually with Family Medicine and with He-Monk. It was a very shortened version of this. We had, like, a very brief part, but then there was a question and answer period. Yeah. I guess one thing to consider then, I don't know if ACOM has done this, but to rent a booth in, like, the exhibition hall. There was. There was. And then do we also do that not just for medical students, but also for, like, maybe the AFP conference and, you know, other organizations? Yeah. So I know we have a few of our leadership from the Council on Membership. And absolutely, there's a whole trade show list that they visit and address. I don't know, Dr. Littow, if you have anything. So, yeah, good morning. I'm Francesca Littow. I'm the rising chair of the Council on Membership. And thank you all so much for attending. I hope we are enlisting you in the Army or for people who know me in the Navy and for the Air Force. But, yeah, thank you, thank you. And, yes, so one of our strategic items is that we do identify meetings and opportunities where we would most align. Sometimes they overlap. So right now the urgent care meeting is going on and we're here. So, you know, unfortunately we were not able to send staff there. But, yes. And the other thing, shamelessly, is that if you are a member of another organization, as many of our members are, and you're attending anyway, and we have a booth there, wouldn't it be lovely for you to help, you know, as sort of a, hey, I do this type person. So if you're interested in doing that or if you know that you also go to, say, some other meeting, I'm probably the only Littow in the app and probably the only Littow on LinkedIn. So please do connect with me. And I think you had one more question. Do you have time? It very much overlaps with these last two comments, so thank you. I'm Dr. Rosandra Day Walker. And thank you so much for this presentation. You've pretty much created a standard pack so we can all go around and share how much we love ACOM and what we do. I actually wanted to say that I sort of serve as a de facto ambassador. And I actually went two weeks ago in person to the Student National Medical Association meeting. I understand that the point of contact, or the contact we had with them previously, was probably that virtual presentation. I'm part of, I'm also part of the leadership of the RRG. We actually dedicate funds for a representative to go to AMSA. And I'm wondering if there is room, or how we can maybe, if we are interested in increasing diversity through the pipeline, in putting support, putting our money where our mouth is, towards supporting similar initiatives within the Student National Medical Association, the Latino Medical Student Association, and the Asian Pacific American Student Medical Association. Absolutely. To put it in a word, yeah. Yeah, we'd love to hear more about some of those. And yeah, the Council on Membership is obviously very happy to engage on that. And just highlighting traditionally underrepresented groups in medicine, and probably in our group as well. Thank you. Absolutely. Oh, good morning. Thanks for the presentation. Laura Bain, Raytheon Premise Health. So I had a quick question about the logistics of this program. I don't know if you're gonna get into that, so real quick apology. Okay, then I'll step back. No, no, no worries. So yeah, the people who are gonna go out and deliver this are gonna be the heart of this program, right? And I think our main goal out of this was to kind of introduce it to you, and try and, yes, sign people up to try and do this. You know, we're not trying to place barriers in terms of having people formally sign up, but do want to kind of track how much we're getting out there, trying to show that we're able to be making a difference, right? And then also, you know, to make sure to give everybody the opportunity to kind of tune up their presentation skills before you go out there and do it, so we can make a great first impression. So we wanna give, you know, tools for folks in that regard. So, you know, we're not limiting this to just Lunch and Learns. If you aren't a stand-up-there-and-do-a-presentation kind of person, then, you know, if you would rather hit it on social media, great. You know, if you wanna try and say, hey, I'd love to have med students come join me doing X, Y, Z, great, let us know, because we wanna build a pool of resources to be able to go out and do this sort of outreach. And if you have some other idea that we haven't thought about and that you wanna offer that you think would be engaging, you know, let us know, right? So I guess the next we wanted to ask you, what would, you know, most encourage you to do this? Ha ha. Ha ha. So this is an opportunity to engage, if any of you have used Poll Everywhere before. The med students have. Ha ha. But it has the instructions up there. Oh, is it showing it live? Okay. But essentially, another thing that we've been considering is not only, you know, so we have, we have kind of the traditional Lunch and Learn and we want ambassadors to go out to these schools and actually give these presentations to medical students, but like Dr. Kral was mentioning, there are other opportunities to engage as well, but we realize time is limited. Not everyone necessarily has a lot of disposable time that they could engage with this. So what are some ways that we could incentivize our wonderful ACOM members to participate and to help give back to this awesome specialty that we all know and love? Some ideas that are currently being kicked around, you can see here, we're looking for some feedback to see what people find appealing. And we do have some on the chat. There were questions about how to become an ambassador and we're working our way there. I promise. We have another question about, is there any point person or people that I can talk to to transition into OEM mid-career? Oh, well, yeah. We can absolutely plug you in with any of us here on the panel. We'd be happy to chat with you. Anyone on the Council on Membership would be very happy to engage with anyone. And we regularly do. Sometimes ACOM staff will reach out and say, oh, we've had a question from someone who is not familiar with the field and wants to get into it. Can I connect them with one of the members of the Council on Membership? And we do that on a regular basis. One more from the chat here. How do you address the constraints of prelim and transitional programs with the stiff competition for more attractive programs with medical students? So as a, what's that? Perceived. Perceived. Correct, because they don't know about occupational medicine. So as a fairly recent-ish medical student, I can say that is a barrier, where it's a non-traditional pathway that you're going to be entering into residency. Even some of my advisors, assistant deans within my medical school are trying to dissuade me from pursuing this because they just weren't familiar with it. It's the classic, well, you're a doctor, what about, what's this occupational therapy that you're interested in? And it's amazing, even in academic medicine, a strong word maybe, but the ignorance surrounding our field that there is. And so that issue of actually how does a student get from being a student into occupational medicine residency, that is a challenge and it's a barrier. It's not something that we're trying to fix within this ambassador program working group, but definitely agree. And I know that that is being discussed among residency program directors and in other groups within ACOM as well. Jeff, yeah. Hi, Jeff Singh. So first of all, this is really fantastic. My comments are kind of tangentially related, so nothing to take away from the ambassador program. So I spent a few years on the membership committee and the struggle was always like a mathematical struggle. So you have to think about what the goals are. So is our goal to expand occupational medicine in general? So that's basically any all comers can be part of that group. So that's different. And then there should be a subset of our goal, which is we actually actually increase membership within our college. That's a much more narrow, but that goes to the business pipeline of this particular college, which is really, really vital. That's essential. Especially the college's numbers are dwindling for a host of reasons. So that macro trend is really pressing on us. And we have an aging specialty population. So the comment you made, Nate, is really what I was thinking about is the ambassador program is one subset. The sell cycle, for lack of a better term, is really long to get into this field. To be a full member and then eventually a fellow of this college, you have to have made a decision in medical school, probably even before third year, and you have to finish medical school and then get into residency and go through all this. So this is a five, six, seven year pipeline just to get here. And my concern is as a member of the college, that's a really, really long time to wait. And if you look at the number of residency spots, even if they're all full and oversubscribed, that won't actually plug the number of people retiring over the next five or 10 years. So the other option, not addressing here, but I hope that the college is thinking about is what are the alternate pathways to recognize, train, and include ancillary specialties because that math problem is the only way I think it can get fixed. And let me be specific. I am only PM and OM certified. I don't have any other specialty. This was my chosen path as a second career in life. I land upon this a little too late, like many of us did. So for me, I guess it's a comment, not really a question, is that part is really, really important because we can get more providers. We have a lot of family docs and internists that they do this on the side and many of them are actually probably quite talented. I've seen many medical notes and some are good and some are not good. So again, I apologize, but as the leader of the council, I would love to listen to you separately, but I also know that we have 15 minutes, so I want you know, to continue. Yeah, we appreciate it and the point's well taken. And I would say, you know, the council on membership does have a few initiatives that look at that and even the ambassador program, you know, we hope to have opportunities to branch this out, to give presentations to, say, current residents in other fields and also to the point on conferences that are being attended. You know, asthma, for example, is definitely a highlight of where ACOM tries to go and recruit and advertise. So definitely, yeah, mid-career physicians, they're kind of an immediate shot of adrenaline into ACOM. We realize this is more of a long-term. Yep. There was one comment from the chat that there should be a dedicated webpage with information specifically for med students, so thanks for that. So, and thanks for all this input here. You know, we want to be sure and make it, you know, beneficial for everyone. Oh, Dr. Soury. I'm Mike Soury. I'm in private occupational medicine and in 1976, I was the first resident chair for OCMED and it's because we knew nothing about OCMED, so we were all getting together and the person that put us together was Kent Peterson. So this process has been going on for a long time and it's a struggle and I think you've made really great progress here and I'd like you to sign me up for the PA version and the reason is because I work with PAs in the military as well as on the outside, surgical, OB, medicine, and I think they're underrepresented. I'm from Rockville, Maryland, but I think it's a great program. Great, thank you. All right, and this is what everybody was waiting for. Become, oh, and the K stayed there. Okay, the QR code will work. The link has an extra K in it, so anyway. For those who look on there, just delete the K out and the link is otherwise all right, but the QR code will work. And the slides are uploaded, but again, just for everyone here and everyone listening, the link does not take you to the webpage. You have to scan the QR code. Oops, sorry. And just while everyone's got their phones out looking at that, do want to thank everyone for attending. We appreciate all the feedback in the comments and we have some time for a few more questions and so forth, but again, appreciate everyone attending and appreciate the enthusiasm for trying to promote and spread the word about occupational medicine. Thanks so much. So coming back to the logistics question, so if we're interested in speaking to a med school in terms of a lunch and learn, will there be guidance given on like who to contact? Do you go straight to the Dean of Admissions or are you all facilitating that? If I say, hey, I'm in Tucson, there's the U of A, do you kind of foster that relationship? Can you give me some guidance on that? It's a little bit of both. So if you have an in with a specific med school, that's great because sometimes that's the hardest part is finding a way, a foot in the door. But if you don't, we'll still work to try and get there. So it's a little bit of both. The other thing that we're gonna do that we didn't really put on the slide there is once we get kind of the pool of folks signed up, we are gonna, like I said, get together the training to get everybody feeling comfortable with it and whatever you need to be able to be ready to go. Thanks. Yep. So to answer that question from a PA perspective as well, so I'm working with AAPA, our national organization, to get a list of all the PA schools and the contact. So initially we were going after the director of the program and then I think more what I'm leaning towards is towards their educator contact. And then I leveraged relationships that I had from PA schools. So I have a couple PA, directors of our programs, so I actually went to them first and said, hey, can I be part of your curriculum in second year PA school? And they were more than happy after they reviewed the presentation to figure out how to incorporate me into the curriculum annually. So I think both, for sure. And don't forget about your own alma mater too, even if that's not represented on one of the 10 largest. I had reached out to my medical school and they were ecstatic to hear from someone who wanted to come back and share their experience and to hear from someone who wanted to come back and share some information about the specialty that I'd gone into. And it was a great experience for me too. Hi, Claudia Hicks. I'm a op doc in Connecticut. But this is gonna be a little out there. But I've long had the suspicion that we gotta start even earlier and we gotta start with high school kids who are interested in going into medicine or PA or nursing or whatever. And we gotta start at the pre-med level because our track is long. And if they don't know about us beforehand, they're not gonna even think about looking at our specialty. But that's my two cents. Yeah, I don't disagree with you. I think for now we're focusing essentially on the trainees and trying to expand it to the mid-career practitioners as well. But yeah, I mean, obviously the earlier you can get someone focused on something, hopefully the more likely the desired outcome will be. Yeah, and I agree. I would go and speak with the Naval Academy. I'm a Naval Academy grad with the midshipmen who are going into medicine and always give them a pitch long before this. I know of at least one that's doing it. Yeah. Dr. Buckta. Hi, I'm Bill Buckta. I hope this, I'll disclose. I'm a shareholder and a board member of CB Academics, which a neuroradiologist at Medical College of Wisconsin started this, it's kind of an IT company. It's a service to reach out to medical, to start high school students to get them interest in healthcare fields. And you can look it up, CV Academics, C-V-A-C-A-D-E-M-A dot org. Anyway, we're trying to build this platform up and get it going viral. It's a little tough getting it off the ground, but it's exactly right. We need to start earlier. And basically it's a product we hope to sell to parents and their kids to get them interested in healthcare fields. So those platforms are out there. If it's active, we're just haven't gotten it, haven't monetized it yet. To keep it going, because it's a shoestring organization. But those kind of things do exist. I would say, you know, if you have an opportunity and wanted to do this, you know, as an ambassador and you have an in at an undergraduate, go for it, right? I mean, that's, I wouldn't. Oh yeah, no. And I think this program is not meant to like constrain people into what we're trying to do formally with the program. You know, obviously informal opportunities abound and definitely encourage everyone to participate in those. But the ambassador program here, we're looking to, you know, essentially have people flow through the council on membership so that we can, you know, track some kind of metric outcome of this, you know, essentially membership attendees at these presentations so that we can show some of the impact that's happening. And, you know, again, to how early are we gonna start? You know, we recognize that at each, it is a long training process. We've all been through it. And we recognize that at each step, there is attrition, you know, at each stage where maybe a high school student was convinced they were gonna go into medicine. And then, you know, they ended up doing engineering, which is great, you know, or a pre-med student in college, who, again, was convinced they were gonna go into medicine, but then decided to do a PhD program and went in that direction. And same thing, even in medical school, to residency and so forth. So there is gonna be attrition at every step. You know, so we tried to focus on people who are at least a few steps down the right path to then decrease some of that potential loss from the information that we're sharing with them at the stage of medical training. Looks like maybe another question. Morning. Wonderful talk. Reflecting back on my own journey, one of the barriers, or maybe false barriers, I was given advice that, before you go into Occ Med or aerospace medicine, you should complete a primary residency. And it sounds like that's probably a paradigm that we're shifting away towards. But in that, then, since it's still a PGY, PG-2 and 3 program, what do we advise people to do for their first year? Is it a surgery, medicine, prelim? Or do they go into whatever specialty they're interested and see how far they make it? What's the general recommendation to anyone or in the crowd? Well, yeah, I think you would, how many people are in here? I think you'd probably hear that many responses to that question. I know when, I can only speak for myself, and I did go straight from my intern year into occupational medicine training. And I received a lot of people who recommended that I not do that, that I pursue a clinical residency first and there were pros and cons to both. And I had a lot of good advice, I think, given by people that I really respect on both sides of that. I don't know that there's gonna be one right answer for everyone, but I encourage people who are asking me to reach out to as many people as they can and gain some of that insight. And just one other thing to note, there has been a change through the ACGME that programs can structure themselves to be 36 months and include an internship. None have done that yet. I know we're gonna work toward doing that. But there may be changes coming, I think, in the near future in terms of the ability to select training and go straight on through without having to do a two-step process, because I know that could be daunting. Tony Alamo of Memphis. So in talking with some of the ACOM leaders, they're considering developing an occupational medicine-specific first year. In other words, leave out the OB, leave out the pediatrics, and concentrate more on dermatology, ophthalmology, those kind of things that would be applicable to an occupational medicine doctor. Okay, thanks. And I know we're at time, so thank you again all for participating and for the collaboration. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you.

AECOM Ambassador Program

occupational medicine

medical students

physician assistants

nurse practitioners

benefits of occupational medicine

shortage of occupational medicine physicians

APPs challenges

AECOM Ambassador Program activities

collaboration with American Association of Occupational Health Nurses