It's a wonderful day to be here in Philadelphia at the AOHC, so thank you so much for attending. We are going to be talking about a day in the life of an OCDoc. So your panelists are Dr. Fayyaz Bojani, he's going to represent corporate occupational medicine, Dr. Saaj Sabool from academic and medical center occupational medicine, Dr. Alia Khan from academic OEM, and my name is Anna Novus, I represent medical center occupational medicine. So no disclosures, no conflicts of interest, and our goal today is just to briefly touch on the different pathways, different opportunities open to you going into OEM or who are exploring OEM, and just talking about kind of our own stories and answering your questions about our paths, the challenges, what we like about the job. So quick question, if you guys can by show of hands, how many of you are residents? Great, okay, wonderful. How about recent grads, any recent grads? Okay, thank you. And how about mid-career practitioners that are maybe thinking about changing to OEM? Okay, wonderful, thank you. What are you guys practicing right now? Okay, wonderful. Maybe, wonderful, okay, thank you for sharing. All right, so I'm going to pass it over to Dr. Khan to get us started. So I'm actually going to come down so I can talk to you guys more informally. I hate being behind the desk and everything like that. So thank you, Anna, for the introductions. So I'm basically going to be taking the next few minutes to share some information that you can take in terms of understanding how you can get into OEM, especially board certification, understanding the residency pathways, especially of those of you interested in transferring or transitioning into occupational environmental medicine. And we have some residents here, so some of this information may be known to you or maybe something that you should be aware of in the future. So this is from the ABPM website, the American Board of Preventive Medicine. So in order to be board certified in occupational and environmental medicine, there are various pathways to get into or obtain board certification. And the most common way is the residency pathway, an ACGME-accredited residency pathway that I'll be discussing more in the next slide. There is also the option of a complementary pathway whereby someone may have had two or more years of another residency than do a year in the specific field of occupational environmental medicine, fulfill their MPH or equivalent master's degree requirements and some other requirements that the ABPM has, and then they can become board eligible by ABPM. And then there's a special pathway. So for example, let's say you're already certified by the ABPM in another specialty and you want to get board certification in another ABPM specialty. So for example, you're already board certified in general preventive medicine, you want to become board certified in occupational environmental medicine. That would be another pathway for you to obtain that. And if you go to the ABPM website, abpm.org, they list out all the requirements there, which is really nice. They have a tool that says, am I eligible quiz? So I've encouraged my residents as well, just go on there, you can see, you know, what you have to do in order to make sure you check all the boxes and that you're actually eligible to get board certification. So I mentioned the residency pathway, which is the most common pathway. I am a residency program director. And so currently we have 23 active OEM residency programs. Two of them are military programs. So we've got 21 civilian programs. The residency program is essentially a two-year program, but it requires at least one year of clinical accredited, ACGME accredited residency. And this residency program also requires a completion of an MPH or an equivalent master's degree. So I'm going to skip the next bullet and go to primary versus secondary residency. Essentially what that means is, yes, you can have someone who does, for example, a transitional year, an internal medicine year, and then go directly into occupational environmental medicine, and then they become board eligible. But you can also have those who have done another residency. So I did internal medicine prior to occupational environmental medicine. So OEM ended up being a secondary residency or like a fellowship, a fellow status for myself. So you can see that there's some flexibility in how people can enter OEM. And I'm sure as you're networking and meeting people here at the ACOM conference, you can see that everyone took a different trajectory to get to that point. You're going to hear that later today and how that's reflected even in the residency programs. The application process and the match timeline is set as unique because we do not currently participate in the NRMP match, which is the National Residency Matching Program. Let me backtrack here. So most of the residency programs accept applications through the Electronic Residency Application System or ERAS, as most other residency programs in medicine do. And that timeline usually follows the fall. So around September, the programs are then able to review the applicants, and then they conduct their interviews. And we have our match in about mid-January. And because we don't have currently a computerized standardized match, it is a direct offer on a specific date and time that is set for that year. We notify applicants of that specific time, and they are notified of whether they've been accepted into a program. So for the residents in this program, you've gone through that process. I'm sure you're aware, and there's a certain timeline that you can then either accept or decline the offer. We are planning to hopefully move into a more standardized computerized process. So there'll be more information available hopefully later this year on that process. And again, here's a list of all the residency programs here. So where do OEM physicians work? And as you're probably aware, and as you're networking here at AOHC, you can see that there is such a variety of different settings that our physicians work in, right? So that really makes it unique compared to other specialties. And one of the reasons that I got interested in transitioning into OEM after internal medicine was because of this flexibility, this variety. So you'll meet a lot of physicians that are working in a clinical setting. They're working for hospitals, medical practices, health care systems, but they're also working for corporations and industries, serving as medical directors, CMOs, overseeing their medical surveillance programs or worker injury prevention programs, those kinds of things. They're working for government agencies, regulatory agencies. So you'll meet people who are working for OSHAs, the state OSHAs, or NIOSH, public health departments, and so on and so forth. You'll find physicians working for insurance companies, working on the payer side, trying to mitigate worker injury and illness. And then, you know, there are a lot of physicians who are doing consulting, independent type of work. And you'll find that some of the physicians are just doing a mixture of all of these things, right? Like one or two days they're working in a clinic, another day they're working for an insurance company, and that this field really gives you that flexibility to make your schedule the way you want it. And that's one of the reasons that I really got interested in it, was having that ability to have variety in my career, especially as my career moves on and seeing the different areas that I want to explore. So why choose a career in OEM? There are so many reasons to choose a career in OEM that you're going to be hearing from us, and you probably have your own reasons why you even came to this session in AUHC today. But we hear a lot about physician burnout, moral injury. And especially in the House of Medicine, right? So where does public health and preventive medicine in general, which OEM is under, fall in terms of burnout? And you'll see that we're at the lowest compared to our colleagues in other specialties and here as well. And you know, in terms of satisfaction, there's this, you know, we talk a lot about work-life balance. I don't really like that term, just because I feel like it's really hard to actually have a balance in life from personal experience. But we can see that, again, preventive medicine has the highest satisfaction in our career. And again, with the low physician burnout. And we just know from, you know, with low burnout, higher satisfaction, these are all positive things when it comes to our mental health and well-being. So before I click on the next slide, we're going to get to the fun part, okay? So I share, like, the boring, you know, logical stuff here. But we're going to be really talking about what it is like in the day-to-day life of an occupational medicine physician. And as you can tell, each day is going to be very different for each and every person. So I hope you enjoy the video. Good morning. Good morning. Today is Monday, beginning of the week. And where are you all going today? School. School. Box. Daddy's going to work. I'm going to school. She's going to school. She's going to school. I'm going to school. I'm going to school. I'm going to school. I'm going to school. I'm going to school. I'm going to school. I'm going to school. I'm going to school. I'm going to school. I'm going to school. I'm going to school. I'm going to school. I'm going to school. I'm going to school. I'm going to school. I'm going to school. I'm going to school. I'm going to school. I'm going to school. I'm going to school. I'm going to school. I'm going to school. I'm going to school. I'm going to school. I'm going to school. I'm going to school. I'm going to school. I'm going to school. I'm going to school. I'm going to school. I'm going to school. I'm going to school. I'm going to school. I'm going to school. I'm going to school. I'm going to school. I'm going to school. I'm going to school. I'm going to school. I'm going to school. I'm going to school. I'm going to school. I'm going to school. I'm going to school. I'm going to school. For example, today we had an employee who requested exemption from TDAP because of encephalopathy as a child after receiving DTAP. So we did approve that just because of the similar formulation and encephalopathy is a contraindication to future vaccination. And then after that, I've been reviewing a red cap survey from students who work in labs. And we review what kind of bacteria or toxins or other materials they're working with. And we make sure we have them in the appropriate surveillance. This is my wonderful crew here at Vanderbilt. Everybody here is so special, every single person here. Look at this smorgasbord they've prepared. And we're just so honored and they've made us feel so very loved and special. Okay, it is now 5 o'clock and my lipstick has worn off by this point. But it's been a great day. In the last few hours, I've met with medical students to serve as a portfolio coach, just going over their progress, making sure there's no major concerns, and kind of giving some advice for their upcoming clinical rotations. And answered many emails. I saw an email pop up about researchers that are going to be working with honeybees and they request to have an EpiPen in the lab. So we just have to figure out how do we acquire that, what's the payment process, who's responsible, and things like that. So it's always interesting and it's always fun. Hi, so my day usually starts in chaos with getting kids to school. But let's skip that part. My day varies all the time between patient care at the Center for Occupational and Environmental Health, teaching residents, administrating the residency program, work social events, and getting to go on some fun worksite visits with our residents. I'm also involved with the Western Occupational and Environmental Medicine Association. And as you can see, it's a lot of fun. Trying to get in family time is important to me. And lucky for us, we are in driving distance of the slopes. Overall, I enjoy the variety, the balance, challenges, and the opportunities for innovation. I'm not as charming as Anna or Alia and didn't have the energy to put together a video. So I'm just going to give you five, seven minutes of how a day goes like for me from a corporate setting. So first of all, no two corporate roles are the same, not even similar in many instances. So if you're working for Corporation A and then Corporation B, the likelihood is very different. Even within a corporation, the roles are very, very different. So I'm going to talk to you about that. And therefore, the day is almost never similar. You've got new things going on all the time. Now, one thing that attracted me to the corporate work after I finished my internal medicine residency, a master's, a residency in occupational medicine, and a doctorate program, is I wanted to have my hands in some clinical work, but I also wanted to do some other things at the same time. And I like the impact. How much impact can you make and how broadly you can make an impact? And so from my perspective, a corporate job in an occupational setting provides the broadest possible impact. The other role could be the government job, depending on if you're able to develop a law or a guidance that is used broadly. So for me, for example, my roles have been, when I joined the corporate role, after many other roles that I did, I was the senior medical officer for a corporation, a Fortune 50 corporation. Then I progressed to an assistant medical director, an associate medical director, a regional medical director, a country medical director, a continent medical director, a multi-continent medical director, and then a global medical director. All of those roles evolved over a course of 20 years, and they are all different. There is an element of similarity, but they are very different, and how they are different. So my first role was 90% clinical. I was seeing patients. I was going out into the field, working with industrial hygienists and with toxicologists. So it was almost purely clinical. As my role evolved, the clinical component got a little smaller and smaller and smaller, until my last role as the chief medical officer, my clinical component was about 10%. So it started with 90-10 and ended with 10-90, clinical versus what I would call, you can call it strategic, you can call it leadership, you could call it management, or all of the above. So by that, you can see there are differences even within one career if you want to do that. Now, what are the key traits that are necessary to be in a corporate medical role, if you are interested in that? So from my perspective, number one, you need to have a generous listening skill. So if you're impatient, that's not a role for you. Number two, perseverance. You've got to be dogged in your approach, because you've got to keep on pushing and pushing. Although many jobs are like this, but if you're on your own clinic, you're your boss. Then you need to have a high level of emotional intelligence. So you're smart, all of us are smart by definition, but subject matter expertise is just one part of life in a corporate world. Next, you should have a strong backbone, and I mean both physically and metaphysically, and an ability to say no in a nice way. You don't want to tick off people, but yet you want to say no. And last but not the least, or maybe one more, you have to be a succinct communicator, which means you need to be able to give your message in five minutes or less. So if you want to tell stories, it's not a job for you unless you learn that skill separately. And last, what I would say is you have to have an eye on what I would call forecasting, seeing the future a little bit, because you want to be ahead of the game, not behind. I just came from the Council of Scientific Affairs, and there were lots of conversations, but I'll summarize that in 10 seconds, is our scientists and our government experts and our academicians said about that Ohio train derailment, we really don't have enough data to produce any evidence at this point in time or guidance. It'll take us about a year. Guess what? The train has already passed one year down the road. Businesses never do that, right? You figure it out. You forecast. You may be wrong. That's okay. But you've got to jump on it right off the bat. Otherwise, there are other perspectives. Other businesses come in. There is competition. All right. What energizes me? Well, two things. People interaction. Interaction with my own team. Interaction with people all across my organization. My organization employs 90,000 people, 90,000 employees and many others, and I interact with probably over my career 5,000, 6,000 people. That's not bad directly. The second thing is the diversity of thought. We have the benefit of multiple cross and interfunctional and interdiscipline people that you can talk to, get multiple perspectives, and then form and make an informed decision. So if you're in a clinical practice in your own boss, you have very little perspective beyond your own. You can get some consultancy, talk to some friends, maybe read something, et cetera, but that's about it. I have in my department an entire school of public health. I have epidemiologists, biostatisticians, health and human performance people, toxicologists, environmental scientists, industrial hygienists, et cetera, et cetera, right? Everything that you can find in a department, division, or a school of public health. That's how, and that's internal. Only my own team. The other team is, I have safety and environment professionals, human resource professionals, 20,000 engineers, PhD scientists, biochemists, et cetera. So when I have a problem that I need to address, I need to get some input from others, and then devise a strategy that would make sense for the population that I have in our organization. That's part of that strategic point that I was talking about. Once we form the plan, then we have a roadmap to address the plan, and then we have tacticians who operationalize the plan. The third thing that energizes the external interface. I work with community affairs people working with community, government affairs people working with legislations and government agencies across my scope of work, not just U.S. And that brings another interesting perspective because everybody has their own way of thinking, way of approach, and way of addressing a problem. None of them are wrong. Everybody's right. What you need to do, what I do is take all those perspectives and make it fit for purpose for my organization. Yeah? So true diversity of thought there. Now, what is the distribution of my work time? People ask those questions. So my last job, and so I told you from clinical it was 90% earlier, right? So my last, this last CMO job, 20% goes in strategy development, 20% I spend time with my team. I have 120 people on my team across the globe. 20% of my time roughly goes into business partnering or business influencing, which is meeting all the people outside of my team, from the engineers, from the CEOs, from other presidents, and all other people, including the employees and contractors, because I go out into the field probably 5% of my time, and try to convince them of what we need to do that will be sensible for the corporation and for the people. In fact, I turn it around and say what would be important for the health and performance of our people first, and that will help to help the performance of the corporation. And then ask them for money, because I don't have money of my own. I have to get money from them. Yeah? And resources, both fiscal and others. And the last thing is, you know, the broad interface, as I described to you from everybody. Another 20% of my role goes into the governance and assurance. Yeah? We want to make sure everything that we are doing, not only for us, but also across, you know, makes perfect sense, both from the regulatory purposes, but also other purposes. Yeah? And then 5% of my time, which remains, I use for my personal self-development and reflection. I can tell you, early on in my career, I had no time for myself. I worked 55 to 65 hours a week for 30 years straight. And I figured out after 25 years, stupid me, right, that I need time for myself to think and reflect, which will help. And I can tell you, the last seven or eight years of my life in the corporation were the most productive, because I had the time to think about the problem rather than jump into it. I think my time is about up. Yes, sir. Thank you so much. Thank you, Dr. Kahn. Thank you. All right. You want to go to the next slide? Oh, you want to go back? Do you want to explain anything? Okay. All right. So it's me again. As I've been introduced, my name is Alia Kahn. I'm currently the Residency Program Director for the UC... Am I getting feedback here? You guys can hear me, okay. I'm the Residency Program Director at UC Irvine's Occupational Environmental Medicine Residency. And I want to take a few moments just to start talking about my journey here, because I think that's important to understand what I'm currently doing and what I plan to do. So I started off in internal medicine. I wasn't really sure where I was going to end up, whether I was a hospitalist or some type of specialist. And frankly, I was getting a little bit burned out, as obviously, 80 to 90 hours in the ICU and whatnot. And I was getting encouraged to go into pulmonary critical care. I really enjoyed being in the ICU, dealing with the complex cases that came through. But even though I wasn't married or had kids, I was like, I don't know if that's the lifestyle I want either. And eventually, all those medical problems get to you. So I spoke to my program director, who was a mentor to me, and she told me about an alumni who did occupational environmental medicine. And I'm like, huh, what is that? That's a typical reaction people have when they hear about it. And she told me about it, and I spoke to him, and I was like, oh, that's interesting. I ended up doing an elective at Rutgers, which is close by here, and I had the most amazing time. It was only a two-week elective, but I learned so much in that two weeks. For example, learning about air pollution and PM2.5 particulate matter and how that's related to cardiovascular disease, spending time with patients, first responders from the World Trade Center disaster, being able to develop rapport, doing an in-depth history, and dealing with very complex cases. And I could see that each interaction, each faculty member that I was working with had a different type of work experience. And as I shared with you earlier, how we have a variety of different career settings in occupational environmental medicine, that's what really attracted me and pushed me to finally apply to OEM after internal medicine. And I trained at UC Irvine, and then after graduating, I decided I'm going to go in and do bread and butter occupational medicine, and I started working at Kaiser. At that point, I had a six-month-old at home, and it was getting pretty tough, to be frank. And I decided to take some time off, and I had another kid. And literally one week after having my second kid, I get a call from my program director at UC Irvine, and she's like, I have a job for you here. And I'm like, I just had a baby. This is not the right time. And she's like, no, we'll work with you, and we'll be flexible and everything. So I ended up joining as faculty at UC Irvine, working with residents, and then eventually I transitioned into the program director position that I am in right now. And so it's been quite a journey. I didn't know where I was going to end up, and I still don't know where I'm eventually going to end up, but I've been excited to see where my journey has thus been far. What I currently do, essentially, is that in terms of clinical work, I work at the Center for Occupational and Environmental Health, right? So I work with residents in the clinic, and for those of you not from California, the Centers for Occupational and Environmental Health were actually created by the state governor back in the 70s because there was a group of workers working with pesticides, and they noticed that they were infertile. Their wives were talking to each other and realized that none of them were getting pregnant. They made the association eventually between that pesticide that they were using at work and the infertility. And so the state governor decided to create these centers for occupational and environmental health that would do research in OEM, that would do education, and would do service. So it's service to the community and industry. So the COEH clinic that I'm a part of provides that service to our communities. So we see firefighters, we see police, we see consuls from hazmat teams, we see patients that are directly being referred by their own primary care doctor because they have a concern of toxicology. Hey, I think I'm being poisoned, or I have mold issues at my home. Those kinds of things that take very, it takes a long time to investigate. One of the things I really like about the clinical practice of OEM, especially where I am in COEH, is the ability to develop your niche, right? So even though it's clinical, you can have that ability to be like, hey, I want to be the expert in X, Y, and Z. I'm going to be the expert in silicosis, I'm going to see these patients, or DOT exams or whatnot. Our field can naturally develop that for you. So I think that's really exciting from the clinical aspect. The other aspects of my job include a lot of emails, but a lot of teaching. And honestly, that is the love of my job, the passion of my job, is to be able to work with the residents, to be able to teach with them. And honestly, I learn so much from them myself. I get to work with a future generation of occupational environmental medicine, but they teach me so much more. So we do journal clubs, clinical case conferences, we work with patients. We also want to take care of our mental health. So the last picture over there, our chief resident applied for a grant for our wellness committee at UC Irvine, and we did coloring activities after journal club, and we had coffee and drinks and we chatted and we invited faculty and staff, so that was great. And then sometimes I do have to bring my kids to work because that's just the reality of life. But having that flexibility in my job, for example, I don't have to be in clinic 9 to 5 every single day, and being able to go to their activities, deal with their homework and those kinds of things in addition to my job is something that I really value. And taking our residents out to work site visits, you saw from the video, I really like that aspect of being able to go to the work site directly, see what the hazards are, and then share that with our residents. And then the other thing that I wanted to mention, another big part of not just my day job, but being involved in professional organizations, such as ACOM, right? You guys are here at AHC, I don't know how many of you are first-timers here at AHC? Anyone here for the first time? Oh, wow. Well, welcome. I hope they rope you in. That's how I got roped in as a resident. I started attending AHC. I'm part of the Western Occupational Environmental Medicine Association, so I got involved in WOC, and they have various committees, councils, and ways for us to be actually involved in the field of occupational medicine. So from the WOMA side, the Western OEMA, I was a board director, and now I'm on the executive committee of second VP, and I was chair of the conference last year. And so being able to work with my colleagues that I don't directly work with at UCI has been such an immense blessing and an honor. I learned so much from them, we have great time, and they become very close friends. So I hope you guys will take advantage of getting involved in our professional organizations, especially our component organizations, because they have so much to offer. And that's essentially it. Thank you. Well, thank you, Dr. Khan. And my turn now. Okay. Well, I mean, if some of you probably were walking in a few minutes late, or like we had a pre-talk dance party, which you missed, so we had music going on, and then some of the audience was up here. So that was a lot of fun. We want to show you all the fun sides of OCMED, and not the darker side. No, there's no darker side. So thank you for showing us how you spend your day. My first couple minutes about my journey to where I am now in OCMED. But even before I do that, we did a little poll in the beginning, like asking for who were the residents. And now, since then, I see some of the brightest residents sitting in the audience, and some soon-to-be residents. So just a show of hands, residents, current and soon-to-be residents. I'm sure we'll have a lot more than the... Okay, quite a few. Great. So welcome, everybody. So my journey actually started more like after my internship. I did an aerospace medicine residency, had some research component, like my master's. So I did that for a couple of years, and I did a lot of fun things. I mean, I worked with the FAA. I worked with some of the airlines as a resident. And then my third year, I worked at Cape Canaveral with NASA, which was a lot of fun, a lot of learning. Worked with some of the space missions at that time at Cape Canaveral as the biomedical team resident physician then. But then during that time, I did some occupational medicine rotations, and even at Cape Canaveral, I would regularly go to their augment clinic, and I just loved some of the cases, the complexity, and how the investigative mindset to look at the cause of the injury, the mechanism, then treating, then preventing that injury from happening again. Again, worker safety, workplace safety. So I really wanted to do occupational medicine. I thought I found my passion there. But at the same time, I wanted to be more clinical, like in the general medicine, so I got into a family medicine residency. Soon after doing my family practice residency, I got into private family practice, but I kept occupational medicine as one-third of my practice. So talking about the journey, we had corporate medicine, we had academic medicine. So I started as a family medicine physician doing OCMED. And then I was the family medicine physician doing OCMED in that city. There was only one OCMED doc, and soon I was like the flight – sorry, not the flight surgeon. That was before. Fire surgeon for the fire department for the city, then I was the police surgeon because I was seeing that workforce. So then after that, I got into full-time OCMED, and then I wanted to be board certified. A requirement at that time was you have to have a residency. And I really didn't want to go back to a full-time residency or a residency, so then I heard about this wonderful occupational and environmental medicine residency program. I can't take the name because I had a disclosure. Just kidding. So I got into that program. This was back in 2006, 2007. I graduated, and then I got board certified in OCMED. But I had been doing occupational medicine at that time pretty much full-time for a hospital-based practice. And then I did that for many years as a medical director for a community-based hospital occupational medicine practice where I was seeing, like, your hospital employees, then your outside clients. So it was a nice mix, and that's where I really got to do the bread and butter of OCMED for many years. And then about eight years ago, I switched gears a bit, and I got into academia, so academic occupational medicine along with doing clinical work. So my day now is – this is mostly from the residency other than that one in the gown is the clinic. So I do a nice mix of the clinic where, like, two days a week I see patients from early morning to late afternoon. I have a nice mix. In this setting, 90% of the workers that I see are affiliated with healthcare or education. But then in addition, there's others like police, fire, and researchers working in an institution. We have a lot of research. We have, like, 18-plus research labs doing all sort of research, including, like, animal research and so forth. So there's a lot of, like, biohazard. Well, I mean, it's safe, but there is that potential where you have to keep your workers safe. Going over these pictures, these are mostly, like, from the residency, but again, like, I was saying that I learn a lot from being in a residency program. So here, like, in the picture at the bottom left, you see we are doing, like, a workplace walkthrough. This is the hospital boiler room, and we have a few residents with us. On the top picture, that's, like, our corporate medicine, and that's, like, a highly interactive. And then some of the other activities, like we go to OSHA, like a field trip, or at least we used to, and then participate in conferences. So it's, again, a nice mix. I do the clinical. I do the academia, which, again, is a great learning process for me. Meeting, as part of my job, I get to go to, like, different areas, different clinics, do, like, site visits, then do workplace walkthroughs, and it's always a learning experience. So, and I'm learning from Dr. Bojani that the 5% of the time that, you know, I should start thinking about that 5% too. But it's a great specialty, especially, like, if you are, I know we have quite a few residents here, and I know some of the residents, this is a mid-career change, and when we say a mid-career change, you have been in that specialty, or you've been doing ARCMED for a while, and now you decide to take that as your specialty. So if I have to do it all over again, I would do the same. I probably will start earlier than what I did, I guess, in this lifetime. So I'll... Thank you. I think I'm going to... Actually, okay, I'll come down here. Could you trade your time? We'll have some time at the end for questions. Thank you, sir. Thank you. Okay. So I'm going to just take about five minutes or so to share with you my story, and then we can take some questions. We can even do small groups if we want. So my name is Anna Nobis, and I wanted to ask if anybody here knows of St. Martin of Lima from Peru. Anyone? Yes, okay. Tell us what you know about him. Okay, okay. Well, that's good. So St. Martin, in Spanish, was a mulatto, so his father was a Spanish man and his mother was a black enslaved woman from Peru. So when he decided he wanted to become a priest, they said, no, because you are mixed and we won't accept you into the church to be a priest, but you can clean the church. So they gave him a broom and gave him a little room, and that's what he did, and he eventually went on to sainthood. So the reason I bring this up is because it is part of my story. My dad is from Peru. My mother is from Costa Rica. And when I was little, I would travel to their countries, and I saw a lot of poverty. I would see a lot of children on the street begging for money. The situation is better now, thankfully. So I decided I was going to be a nun and a surgeon. So as you could see from my video, that obviously is not what happened. But that was my idea through medical school. I had a statue of St. Martin on my desk, and I thought the only purpose of life was just to help others and do good. And so it was an unexamined maybe fantasy. So when the time came to do your rotations and all that, I realized I don't have the personality of a surgeon because I'd probably be like, well, okay, that blade might be good, or maybe we should try the other one. I'm not sure. Let's think about it for a little bit. And also I met my husband and decided I didn't want to be a nun after all. So once I realized I wasn't going to be a surgeon, I did pediatrics, actually. So I did pediatrics in the Southeast. But I'm going to save you 15 years of deep introspection and spiritual examination and just tell you that the lack of sleep was causing me to burn out, and the child abuse cases were just a little bit more than I could handle. So same as Alia, I was put in touch with a colleague because I was like, okay, plan A did not work to be a surgeon, plan B to be a pediatrician, so what am I going to do? And so I love the field of OEM because it's given me my place in the world. And so, you know, thankfully I met a colleague. She told me about it, and I did preventive medicine first. So I took a very circuitous path. And then I did OCMED at the great UIC in Chicago. And one of my former teachers is here, so it's a little stressful. I have to live up to his expectations. So what I could say is, so, okay, then I finished. I had my first child after residency. I did part-time work, and then I was actually going to move to Vanderbilt, but my husband's opportunity and mine didn't line up. So the day that I found out I wasn't going to be able to accept a job at Vanderbilt, the first time around I found out I was pregnant with twins, the very same day. So, you know, sometimes there's a reason for things. But eventually we were both able to move down to Nashville. So my mom works at Vanderbilt, I work at Vanderbilt, and my husband works at Vanderbilt. And I started out, just like Dr. Bojani said, mostly clinical, probably 90%, which I think is a great way to start because that is the foundation of what we're all about, right? Everything else is built off of that. So I did clinical, and then the pandemic really changed things for me because I had to step into an administrative role and help with our COVID return-to-work program, so tracking our 40,000 employees, you know, who has COVID and when can they come back, and talking to people about exposures on the units. So that actually led to other opportunities for me, and I'm now in the position of medical director at Vanderbilt. So I think what I can say just to sum up is, you know, I've learned, like, I'm not doing what I planned to do, but I've learned to recognize good opportunities along the way and I think have the courage to go through those doors. I would say, especially for those starting out, really for all of us, you do have to advocate for yourself because sometimes the world may not perceive you the way that you perceive yourself, and they may not, you know, know the kinds of things you're capable of. So always advocate for yourself. Ask for the whole pie, you know, because we don't always get the whole pie, right? But you should ask. And believe in yourself. So I think I read a fascinating article in the New Yorker recently about imposter syndrome and how really it's not abnormal to have imposter syndrome. Really, the person who doesn't have imposter syndrome is maybe the anomaly, you know, and maybe it's not us, it's kind of the society around us that's wrong, that makes us question our own belief in ourselves. So, you know, you're not the only one dealing with that if you're having those kinds of thoughts. And then the last thing I would say is, just like Dr. Kahn said, you know, I love being a part of ACOM because you want to be part of something larger than yourself. Some people get to do that through their day job. They find enough fulfillment in that. I do enjoy my job a great deal, but I enjoy also being part of things like this, where you're able to talk to other people and, you know, help educate the future residents and future practitioners. So I would just say, you know, your time and your energy are like seeds, okay? It's limited. You don't want to just be tossing it into the wind. You want to pick things that you're passionate about and plant those and tend to them. The rewards are not going to be overnight, but if you give it enough time, some of those projects and the things that you dedicate yourself to will come to fruition. So I'm sure you've all heard that parable, and I'll end there, but there's a parable about the three bricklayers. Anybody know that one? Yeah, you know it? Okay, so there's three bricklayers. This is a true story. There was an architect in London, and he stopped to these three workers who were working on the church he had designed, and he asked the first, what are you doing? And he said, I'm a bricklayer. I'm doing my job so I can feed my family. And he went and asked another one, what are you doing? He said, I'm building a wall as part of a church. And the third one said, I'm building a cathedral that's going to last through the ends of time. So it depends on how you perceive what you're doing. That first one, it was just a job. For the second one, it was an occupation. And for the third, it was a calling. So if you really think about your purpose and your motivation, those are the things that really bring joy and life into what you do every day. So I'll end there, and we'll take some questions. I'll take an editorial comment. Although Dr. Anna Novacek has not gone into an interview, she's still not, but she preaches to all of us. Right? Okay. If you have any questions later, we can start. Any questions? Comments? Thoughts? It was so clear or so murky that Dr. Anna Novacek's It was so clear or so murky that Dr. Anna Novacek's We'll have another dance party if you guys don't say something. I'm very uncomfortable with silence. Thank you all for sharing your story. My question is to all of you. Where would you advise new residents or when you were first looking for your first job? Besides something like this sort of forum, what else would you advise? Thank you. So I believe you were asking what advice you give to residents for the job outlook out there. Or people just trying to search for the next step. I guess I can start off. I think it depends on, first of all, what your ultimate why is and what you're looking to get out of OEM. So my personal approach to residents is to start asking about it during the interview. Not necessarily what kind of job they want, but why they picked the field and what are they trying to get out of it. And as you can see from all of our talks, having a five-year plan, ten-year plan is great, but it doesn't always pan out. And so knowing that you should have some room for flexibility is important. And as I work with residents in the short time that I do have, we have those type of discussions and where their passions really lie. Because as you may be aware or you may not be aware, there are so many different niches within occupational environmental medicine. So being able to work closely with them to see where their interests lie is important for me to help guide them into what field. So if they already are passionate about clinical medicine, they really want to get in there and do workers' compensation, we can guide them about different health care systems or hospitals that they can join. But sometimes they have interests in other things. For example, I have a resident who's interested in mental health. And with discussion with her, she decided to do a fellowship in addiction medicine after OEM. We have had residents that are interested more on the public health side, so they decided they wanted to then join a public health department, those kinds of things. So I think it's important to look into the why. And from my personal experience, not jumping into the next job that's available is a good idea all the time, unless there's other circumstances that might be there. Saj, do you want to add anything? Well, all of the above. And also, when you're looking for a job in occupational medicine, you should first see how much you would like to do clinical, admin. In occupational medicine, admin comes with it. Some do more administrative work than clinical, and vice versa. So when you're looking into a practice or a job, see how much clinical. And also, you make sure you get some administrative time, because there is, like I said, a lot of admin in workers' comm, case management, speaking with the clients, giving talks to safety and stuff. So keep that in mind. Also, see if there's any potential of doing other not purely clinical services, like being medical director at some of the client companies or locations. Also, like doing medical review officer work, doing IMEs, being an expert witness, or some of those other things, which may become a bigger part of your clinical practice down the line. So, yeah. I just want to quickly add quickly, when you're looking at jobs, it's also important to know who you're reporting to, what the structure of that system looks like, and how supportive they would be for OEM. And I'm sure Dr. Bhajani can speak more about that from the corporate side, too. So, yeah. Let me say a couple of other things. So life is full of serendipity and strategy. If you have serendipity and no strategy, you are like electrons moving in random motion. If you have strategy and no serendipity, you don't have a clear intention or purpose in life. So my advice to particularly those folks who are starting off is to have a clear purpose and intention in life. Work is one part of life. Work is not life. This is from somebody who's worked 60 hours a week for 30 years. And document it and write it down. And then go back to it every few months, at least once a year, to see, are you going and moving towards your purpose? And write down your priorities for the next two or three years. So as long as you're working towards your priorities and your purpose, you can do clinical occupational medicine, you can become an engineer, you can do whatever, or be a nun. As long as that's clear, because that is going to help you at the end of your career in life and throughout to be happy and fulfilling to you. Everything else, you can only have one house at a time, eat one meal at a time, drive one car at a time, or fly one airplane at a time. You may have money for 50 or 100 of those, but that's not going to work for you. So think about that. Thank you. So no more preaching, I promise. I'll try for the next few minutes at least. But Dr. Bojani is exactly right about serendipitous moments and connections. And I would just say, just do a good job during your training, because both of my opportunities came from people that were my attending physicians. So you just want to be on time, be proactive about grabbing those patients, and you just want to do a good job. And then they'll keep you in mind if they know that you're looking for something, or may even just reach out to you if they don't even know that you're around. So, yeah. All right. Are we at about time? Somebody had asked me just earlier, just this morning, about the future of OEM jobs, or like they're finishing their residency this June, and what was the future of their prospects. I think they were finishing next June, sorry. And I said, I mean, it's very bright. It's the demand time and again that when they do surveys, like every time they say like 3,000 to 4,000 OEM physicians are needed out there. You have to keep in mind that the workforce at this time in the U.S. is 140 million. Like it's 160 million, but like 132 million they're saying is like full-time and the rest part-time. And for them, like physicians, OEM, certified, any idea how many we have? 10,000, 20,000, 30,000? This is less than 5,000, actually less than 3,500. So, ACOM's Career Center is an excellent resource. I mean, if you just click on that, you'll see like they add jobs every day. And there hasn't been a day where I have seen like less than 150 jobs out there. Let me also add one thing, and I think any of you who are working out and if you want to have a conversation either on the phone or via email, feel free to send a note to any of us, and we'll be happy to engage with you. Can I ask a question to my colleagues and panelists? How do you guys seek out mentors and opportunities? Remember, Anna said that and I said that too. Mentors can come to you in two ways, right? One, you're working with people and they become your mentor, or you search for people and find the right fit. Personally for me, I searched for the people, I found the right fit, and they were like my second father and mother. Sometimes even more than my primary father and mother because they actually take you under their wings, they see your potential, and then they teach you everything. My first job that I landed, I got four job offers after four applicants purely because one, maybe a little bit of my own abilities, but because my mentor helped me out to pick the right job. I would say getting involved. Even here at ACOM and AOHC, I'm on the planning committee. I remember a few years back, I didn't know how everything worked, and I saw that it said AOHC Planning Committee, and I just walked in, and they were like, you have to be on this council, you can't just walk in. But once you sign up through the appropriate channels, they love, they need volunteers, they need people to get involved, and the more seasoned members will take you under their wing and teach you things because, as I mentioned yesterday in another talk, most of all of this is a marathon, it's not a sprint. So the people who plan to this conference, they can't plan all the future conferences, they have to pass that knowledge down. So for me, even just at my home institution, it's getting involved and getting to know people. One last question. There was one, and then I think we're on time. Hello. My name is Samantha Morales. As I said before, I'm working for the VA. I've done a, I wouldn't say a hodgepodge, but I've had a wide range of experience, and I'm trying to coordinate it to do what I want to do. And so I want to thank you for being so transparent about your journey because then I kind of don't feel like an oddball because I have worked for the health department in terms of being a resident and being the program director, being on active duty, now not on active duty, working in immigration health, working for Homeland Security, blah, blah, blah, blah, blah. And so what I'm trying to do now is figure out how best to take those experiences, stay federal but be occupational medicine. And I think I've gotten the answer that I've been looking for for the last six to nine months. So I think what I'm going to do is plug into each of you, get involved in OEM, and then I believe Ginny just gave me another answer, which is, well, confirmed. The Florida Medical Society, I reached out to them. But the issue was I found out fortunately and unfortunately that the reason why I hadn't heard back from them was because somebody passed away. So I'm trying to, because I was just hitting a lot of dead blocks, roadblocks, roadblocks. So I just want to thank you for sharing, and I would like to stay in touch with you as I try to fine-tune where I'm going to be. Yes, of course. And Dr. Bojani reminded me there is an ACOM mentoring program as well that you can plug into. So thank you all so very much, and we're here for questions. Thank you. Thank you. Thank you.

panel discussion

Occupational and Environmental Medicine

OEM

board certification

career opportunities

clinical settings

government agencies

consulting work

career goals

professional organizations