Good morning, good morning, everybody. We'll go ahead and get started. I'm Cassandra Day Walker, and I'm your panel moderator for today. I want to thank everybody for joining us. We have a great lineup in store for you. No matter what point in your career, whether you're just getting started, you're pivoting, or you're thinking about it, welcome to the wonderful world of occupational and environmental medicine. One moment, y'all. This is our tech guru here. Thank you all. Okay, and so a lot of us found our way to occupational and environmental medicine almost by happenstance. Raise your hand if you knew about occupational and environmental medicine as a medical student. And what ... Oh, clap it up, y'all. Oh, another one. Clap it up for these people who saw the light early. And so if I could just ... I just want to know who I'm speaking to today. Are there any students, medical students in the room? Clap it up for the future of occupational medicine. We're glad you're here. Residents? Residents? Graduates? And then folks who are in another specialty, who have already trained in ... What specialties? Yes? Infectious disease and infectious disease. Wow, wonderful. Back there? Infectious disease. Okay, we're two for two. Anybody else? Any other specialties in the room? Uh-huh? Okay. We've got some ... Anyone else want to tell me what they what other specialty they might be here from? Family medicine. We love our family medicine folks. Any recovering surgeons in the room? I see you and I love you. So no matter where you're coming from or what point in your career, occupational and environmental medicine is a very special specialty, right? There are so many natures and a diversity of paths and careers that one can take, such as working in the hospital or clinic setting, in an academic setting, public health, working for corporations both large and small, your own independent and consulting. You'd be surprised to know how many folks have their nine-to-five employment as well as their own entrepreneurial practices, as well as theme parks and resorts, right? Right here, Disney, Netflix, American Express, law and safety enforcement, and your traditional industrial sites, oil, gas, you name it and we're probably there. And it's so interesting that it's such a well-kept secret, but maybe not for long. And so I want you to meet the panelists. Like I said, I'm Dr. Day Walker and my friend and colleague, Dr. Santiago, wants to do the honors of introducing me because I feel like it's always, you know, you see yourself best through the eyes of a friend and so I like to introduce others and I let others introduce me. Thank you. Thank you, everyone. Yes, so as Rosandra, my colleague, mentioned, so I'm Dr. Romero Santiago, the chair of ROG this year, and it's my great honor to give you all an introduction for our moderator today, who really put the effort, not just this year but in past years, to get this group together for us to really have this event to showcase what our specialty is all about and really reach out to all of you. You know, we are the future of this field and as you've heard many times that, you know, the current OEM positions in practice who are really in the trenches, they're getting closer to retirement and really, you know, we need to really transition into those roles. And so really just to introduce you, Dr. Day-Walker is not only, like she mentioned, had that background in surgery and occupational and viral medicine, but she's also our ambassador when it comes to total worker health. She's our representative to the Society of Total Worker Health out there and that's a very interdisciplinary field that is under the federal NIOSH, National Institute of Occupational Safety and Health. And so, you know, without further ado, just wanted to give you that intro for Dr. Day-Walker and please proceed from here. Thank you. So, a little bit more about me professionally. As Dr. Santiago mentioned, I am board-certified in occupational environmental medicine as well as lifestyle medicine and I hold certifications and we'll talk about these certifications such as MRO, FMCSA, NRCME, a lot of alphabet soup, CAOHC, and NIOSHPFT certified. And I've had experience both in clinical and corporate medicine, consulting, fractional medical directing, and consulting, and I actually did my occupational medicine residency in Texas at the UT Health Science Center. And I just love learning so much that one residency wasn't enough, two wasn't enough, and so I had to go back and get my PhD, so I'm actually working on my dissertation right now in total worker health. And I love what I do, I love this specialty, and so you'll see me around doing different leadership activities, whether it's in ACOM or total worker health or different sections throughout. So, these are some of the things that you can ask me about, corporate medicine, total worker health, lifestyle medicine, ACOM involvement, entrepreneurship, etc. And we have Dr. Santiago. And so Dr. Santiago is based in Illinois, where he is an attending physician at Carl Health, as well as the Carl Illinois College of Medicine as an assistant clinical professor and OEM ambassador. He is OEM fellowship and certified through Yale, and also did family medicine, family community medicine at UC Davis, as well as, and I love this, but his undergraduate was economics and music. That's really, really interesting. I love that. And so, he'll love to talk about the application process for OEM training and programs. There are different pathways, right, to get to occupational medicine. The job search, organized medicine engagement, such as ACOM, med ed, and primary care, and the synergism with OCMED. Then we have Dr. Bill Martin, MD, MBA, MPH, MMCI, and his current roles include as a consultant and partner with MetaPrize, as their global medical director for Huntsman, as well as other director roles in oil and gas, etc., as well as another company called Proxima WorkTech, where he's the CMO and partner. And his background includes not only OCMED residency, but because he completed it at Duke, he also had the opportunity to get his master's in clinical informatics. So that's another thing that we'll talk about today. And he also served in the Navy, I see. We have our military, our military represented in the room today. Thank you all for your service. And ask him anything about starting his own company, about corporate medical consulting, clinical informatics, and telehealth. Then we have the amazing Dr. Dominic Dabrowski. Okay, med school, American University of the Caribbean, PGY-1 was in anatomy and clinical pathology, represented in the room, as well as having his MPH. He is wrapping up. Are we wrapping up residency in a few weeks? All right, clap it up for our soon-to-be recent graduates, right there at Health Partners, and where he's serving as chief. And he's also going to be doing a fellowship in addiction medicine. Again, talking about that diversity of career paths in OCMED. And he would love to talk to you more about residency and fellowship. Now, Dr. Adag Bougie cannot be with us today. This panel is near and dear to her heart, but she's actually doing her MRO certification studying and testing over the next, this day. And so, a little bit about her. You will probably meet her somewhere along the line, if you haven't already. But she is also OCMED board certified, as well as a fellow. And her professional experience includes medical directing, clinical consulting, corporate, military, international. She was stationed in Germany for several years. Compensation and pension, disability exams, DOT, and so much more. And she did her first residency in urology, another recovering surgeon, like myself. And then, her OCMED training at Meharry. And as you'll see, all of us, in some way or shape or form, have done some sort of leadership with ACOM. It's very, very easy to get involved. And the more the merrier. We love to have more and more people to join, and to really fall in love with the specialty. So, ask her anything about flexibility in practice, international leadership, ACOM consulting, and especially, she loves talking about the job search and financial planning. And then, Dr. Means, I have one more person who, because she just loves us so much, she actually did the panel last year, Dr. Tamra Means. And I'll let you introduce yourself, because I don't have the slide up there, but I just want to point out the dedication. Dr. Means is in a sling, but that didn't stop her from coming to fill in for Dr. Bougie this morning. Thank you so much for that great introduction. As she said, my name is Dr. Tamra Means. I am actually at Vanderbilt University, the assistant medical director there. Did my background at Meharry Medical, is where I did my residency, and also did a master's in public health there, and got a master's, as well, over at Johns Hopkins University, and did my undergrad at Johns Hopkins, as well. I really love this field. It's unique. It has a little bit of everything, and my interest, or things, topics you can talk to me about, is kind of how to find that first career, like pitfalls along the way, and how to avoid them, and pretty much anything you have a question about, I'm more than happy to try to help. All right, thank you. So, just to give you a primer, or what to expect during this conversation, we have a lot of slides. We have way more slides than we have time, but those slides are available in the SwapCard app. Please open it, follow along, download them, save them, email them, whatever you need to do, take notes. We will not be spending a lot of time on the slides. They'll be more so for reference, and so each of the panelists will have just a couple of minutes to just give a very quick overview and primer on their slides, but really, the point of this is to have a dialogue, to have a conversation for you to ask questions on any and everything that you can imagine about the process, about certifications, about success in this field, and in the organization, okay? So, without further ado, Dr. Sanzu, I'm going to take it over. All right, so big picture forward. So, really wanted to kind of set a framework for where occupational and viral medicine really sits itself, and so we are board certified under ABPM, American Board of Preventive Medicine, and as you can see, there's a list of, we are one of the primary specialties, one of the three primary, and within ABPM, there are subspecialties, including addiction medicine, which my fellow panelist is going into, clinical informatics that Bill Martin has, and several others, and so I've included the links here so you can see more in detail of the different pathways, as Rosandra had mentioned, that there's the traditional residency pathway, you know, for people who are in that traditional augment program, but there are also complementary pathways as well. Those people who are in the mid-career role that are looking to switch or add to their additional training, there is this option available, and it's definitely someone, you know, something that is not as utilized as it can be, and so definitely check out more information on that, and within ABPM, there is this special pathway I just wanted to quickly highlight, that of the three primary specialties listed towards the top there, one could apply if you are OEM boarded, you know, if you also are doing a lot of public health, more in the general preventive medicine sense, or aerospace, you could apply for to be boarded in an additional primary specialty, and so there is a route for that, but those who have, say, a secondary specialty like, say, clinical informatics, you wouldn't necessarily be able to do, you know, through that expedited pathway, but not to say that you can't get that as well through a more traditional route. Just had to put this out there in terms of the timeline, that's one of the things that we realized in talking to our group, is that there is a timeline of certain steps in terms of applying, and so this timeline is for this year of 2024, so this slide will be available for reference, but just keep in mind these dates, because ABPM does have that structure of you need to work with your program directors and so forth to get these materials in and do that in a timely fashion, and there are letters of support and so forth, so that you don't have to pay any late fees or anything like that, so please keep this in mind. Towards the bottom, you'll see the exam format. They recently changed this, where now they've integrated, there used to be two separate exams, one for the general preventive medicine piece and then the core, and the specialty, but now they've integrated it where 150 of the questions for the AUCMED boards are AUCMED, and the other 50 are the general preventive medicine public health questions, like biostatistics and so forth, so it's one exam only now, so it's a little shorter and a little more easier to manage, so please keep that in mind and the structure. And then another aspect I just wanted to share, and this slide is available for reference, is, you know, why we're here, right, and why it's important to be involved with organized medicine, including ACOM. So as you're aware, ACOM has a special designation of the fellow designation, and I wanted to highlight, you know, these steps that are ways to get involved, things that are looked at when you apply to be considered an ACOM fellow, and so you have to have the board certification, obviously, have a copy of your CV, those things, active membership, so that criteria does not include student and resident years, it's after you finish your training where you're considered an active member for at least those three years, and so getting to meet people at conferences like this is critical, right, because they are asking for letters of support from current ACOM fellows or other ACOM members, and so that really helps you not only with the fellowship application, but also in your professional growth. We are a very friendly niche group of people, and so you will definitely see that. In terms of opportunities for engagement, so we have a resident recent graduate section. Sections are collections of people getting together with a common interest, from transportation, to issues of residents and recent graduates, to corporate medicine, and so forth, and then there are councils and committees that interface to the board of directors of ACOM, and all these have links that you can see of different opportunities. There are vacancies still available, and it's on a cycle where I think June 30th is the deadline for considering to apply for vacancies, so please look into that because they are looking for our voices as residents and recent graduates, and so there are some general FAQs on the process, but please feel free to ask us more questions because there are ample ways to be involved, and that does count towards the bigger picture also being considered a fellow. So without further ado, I will turn it over to my fellow panelist, Dr. Dabrowski. I'll try to stay in line with that. So hi folks, my name is Dominic. I'm a soon-to-be graduating resident. I'm over in Minneapolis, and I'm gonna be going into fellowship, so that's my disclosure. This is my cup of tea, so maybe it's not for everyone, but I do want to just make my pitch for it, and I do raise the very logical question. You are taking a cut in cost. You're not going to be making an attending salary for one year, possibly two years, depending on which one you're looking into, so I'm just here to say that there are good reasons for it, and I'm gonna dive into those in the next few minutes. Now first, just an overview of the sort of traditional ones that occupational medicine has done in the past, so you wouldn't be the first if you attempted these. There's toxicology, addiction medicine, aerospace medicine, informatics. There will shortly be a correctional medicine fellowship. That's still kind of in the works. There is officially one in the country, but they're looking to make more. They're waiting for ACGME accreditation, and then I just made a pitch for lifestyle medicine since Dr. Day-Walker has done it. I'm in the process of doing it. Not an official fellowship, more of a during your residency or after your residency kind of training thing, but again that just speaks to the diversity of occupational medicine. You can do all sorts of things to really customize your career, if you will. So a little bit of my journey first. I'll start with addiction medicine. It's a one-year program, so I am from the East Coast. I really like the East Coast. I wanted to be back on the East Coast, so I applied primarily to programs on the East Coast, and how do you do that? Well, it's very simple. If you remember residency, you'd go through the ERAS system. You go through an NRMP type system. The nice thing is that it doesn't take you all the way until March to get there. I found out in November where I was going, so it's condensed, July to November, so it's a little shorter. Things happen a little bit more quickly. You spend a little less time waiting, and so you get through it a little faster. So these are the places that I interviewed at, and just for disclosure, this was a lot of the programs just kind of in the Northeast. I didn't really apply a lot of other places, so if you were a little bit less geographically restricted than I was, you could apply all over, and you could probably have five or six times as many interviews if you really wanted. One of the problems with OEM is that unfortunately we have less and less training programs. We're down to the low 20s at this point. Since I started applying back in July to right now, they've opened ten new addiction medicine programs, so it really is a booming field, and then this is just a look at the sort of curriculum that I would have at my particular program. I'll be over at Rutgers in New Jersey, so there's a lot of consultation and longitudinal community clinic. There, of course, is a VA, as there are in many residencies. There's a homeless clinic, an ambulatory detox, a specific opioid clinic, and there's special populations for OBGYN, and a buprenorphine clinic, and infectious disease. So just to give you an idea of what sort of rotations you might be having in that particular one. Moving along, because I want to be representative to others, I know one person who applied to toxicology. He was also a little bit picky in his choosing, so he only applied to three programs, but these are some of the places that did grant him interviews. So again, we're not known by everybody. We're not the most popular specialty, but people do recognize us out there. They do value what we do, and you can get interviews, and a lot of times the interview is just, hey, what is occupational medicine? Well, I can explain to you. I'm literally your only applicant this year for occupational medicine, so I'll just give you my elevator pitch. So again, there's a way to differentiate yourself and make yourself kind of the special person in the room if you want. And then on my particular toxicology rotation, which we had, this is what the program director had to say from their specialty. So as you can see, they're relatively open to occupational medicine. They have a little more exposure with us because we do a few educational activities together. That said, they do recognize our unique perspective, so again, do not be discouraged from applying just because there's a lot more people from, let's say, emergency medicine applying. And then I wanted to dive into some of the cool ones. So to explain this slide, in blue are the military programs, In red are the civilian programs. And then at the very bottom is King's College London. Everything's a little bit different over in London in the UK, so I'm not really going to touch on it too much. It's a little bit like OEM residency in America in that there is some clinical work and also some classroom work, but I'll just sort of leave it at that. But again, another one year fellowship. There are not very many in the country and they're relatively small on the order of one or two fellows typically, but definitely exciting, very specialized, and of course they love occupational medicine since the majority of their applicants are from there. So again, consider applying there. And then I just wanted to touch briefly again on the new kid in the room, correctional medicine. So correctional facilities are in desperate, desperate need of clinicians and they're trying to solve this problem by starting fellowships. They're still awaiting ACMGME accreditation officially, but they hope to have a variety of rotations and educational opportunities for that population. They're also multidisciplinary, meaning you can apply from just about any residency specialty. And again, there is one at Nova Southeastern University in Florida currently. That said, they are of course not ACMGME accredited. And I just kind of wanted to wrap up quickly. So don't look at it as an opportunity cost with fellowship. Look at it as an opportunity to become a expert, not just in that field, but think about it. Within occupational medicine and then with your new specialty, you become one of 10, 20 people in the world who has that particular knowledge base. So you really have a lot to offer in both directions. You can become the OEM person for your new specialty. You can become that specialty person for ACOM. So there's a lot of opportunities not just for making money and seeing your particular patient population, but also to contribute to the greater body of knowledge. So I really do want to support that. And then while there's not that many fellowship options for us in particular, the ones that we do have are very good and there's more coming. And then finally, again, we may not be universally well known like internal medicine, like psychiatry or surgery, but we do definitely have a unique perspective to offer. And the people that are program directors are aware of that. So do not be discouraged. It's a wonderful idea if you're into it. Thank you very much. And I'd like to hand it off to Dr. Daywalker. Thank you. That was wonderful for giving us that primer on all the different fellowship opportunities. Okay, so you have finished training. Maybe you've gotten board certified or not. Maybe you're getting certified or you just want to sort of pivot gently into the specialty. Well, what are some key certifications that would be desirable for doing this line of work? And so this is about mastering the market and really boosting your career opportunities with certifications and other training outside of traditional residency or board certification in occupational and environmental medicine. So you'll hear, if you haven't already heard about a lot of these, and these are not restricted necessarily to occupational and environmental medicine professionals or physicians. Any specialty can get these certifications, but you will find that the vast majority of us have these certifications or are required to do this as part of our role. So the first one I wanted to highlight is the Medical Review Officer or MRO. And so this is a certification that allows physicians to interpret and review drug and alcohol test results for employers. So as you know, there are many, many, many employers, safety sensitive positions, federal, private, you name it, where drug testing, pre-employment or intra-employment testing is required. Somebody has to review those results and make rulings and determinations because it's not always black and white. You can have a positive drug test come back for a valid prescribed medication, and that is where the MRO comes in to do a mini investigation and just clear or not clear an employee. And so there are certifying bodies, the MROCC as well as the AAMRO, and those trainings are actually available every year at this conference or you can get it outside of the conference at another point in time, which is what I did probably in Dallas. Similarly, there is the National Registry of Certified Medical Examiners or NRCME for short. You'll also hear people sort of refer to it as DOT, Department of Transportation. What is that? That is a certification to perform DOT physical exams for commercial motor vehicle drivers. There are probably millions of commercial vehicles on the road at any given time, whether they're 18 wheelers or big waste trucks or trucks carrying hazardous materials. And the people that drive them are required to get a very special federally regulated medical exam to ensure that they are safe to operate these vehicles. This, you know, otherwise it might present issues of safety for not only themselves, for the public at large. And there have been a big, big, big cases in the past where, you know, buses with people had major accidents or large commercial vehicles had major accidents that resulted in huge, huge, huge settlements. And so this is extremely important for employers that have this and for folks who want to stay on the road. It's not a very, it's not a simple medical exam like you would get, you know, at your annual exam, your annual exam. It requires a very astute and very specific guidelines and interpretations to make sure that someone is safe to be on the road. And so you can get that through, sorry, that's duplicated, but through FMCSA, I should say. NIOSH, spirometry training program. NIOSH is short for the National Institute of Occupational Safety and Health. And so a lot of employers also require their employees to wear respirators or respiratory protection. Someone has to participate in performing, managing, leading, directing, or interpreting those pulmonary function tests as part of that. And so it's essential for evaluating their health, monitoring, medical surveillance, etc. It's another great certification to have that would boost your career opportunities and help you to perform your duties. And that is through NIOSH. And similarly, there is the Council for Accreditation in Occupational Hearing Conservation. Again, a lot of us in our roles are required to manage, direct, lead, or otherwise interpret hearing tests and manage their hearing conservation because noise exposure is another huge exposure that a lot of employees face in a lot of different job roles. And so again, these are things that are, that come down from federal bodies like OSHA. These are requirements, national federally regulated requirements, and thus a lot of the time employers rely on their occupational environmental medicine professionals to lead these programs. This one, a little bit less common but still in demand. I got asked about this the other day actually, but a NIOSH certified B Reader. Again, this is a special class, a special certification for classifying and interpreting chest x-rays as part of different medical surveillance and other requirements. Again, through NIOSH. And then I will plug for Total Worker Health. This is a newer, a newer program that comes from the CDC, NIOSH as well. And it basically looks at how we can take our traditional understanding of health and safety in the workplace and protection from hazards and integrating it more with health promotion and a lot more illness and injury prevention and what that means for truly advancing worker well-being. And worker well-being in this country, of course, we are the backbone of the economy, we're the backbone of our communities, but also post-COVID, that really, really came into the spotlight, what was going on in our workplaces. And so now more than ever we're really understanding just what role the workplace has on our health and our well-being and vice versa. And so there are plenty of Total Worker Health affiliated university-based programs that are all offering their own version of some sort of training or certification and you can find that through the CDC NIOSH website. And then I just wanted to include a couple of other certifications and trainings that could be interesting or maybe you came from this world and that's what brought you to occupational and environmental medicine. This is not an exhaustive list, I'm sure there's others out there, but there's certified safety professional, certified industrial hygiene certifications, and then sort of a small lead-in to my colleague later, but telemedicine and informatics is on the rise. Okay, so there's a lot going on in the world of technology as it pertains to our specialty and so these are also things that we're seeing on the rise, whether it's through an actual master's program or otherwise getting certified or trained. And so that's all I wanted to highlight in my five minutes and since Dr. Bougie could not be here, I'll take another five and again these slides are available in the SwapCard app. If you need us to email it to you, we can get that to you through those means as well, but every year Dr. Bougie gives a really great talk on the job shirts and her personal anecdotes of lessons learned, you know, sometimes the hard way and we've all been through it, but essentially some of the things that she wanted you to know was to start early. It's never too early to start, right? A lot of times we apply for a job, especially now in today's market, and you might not hear back for three, six months, a year, so start early. And there again so many different opportunities and paths, whether you want to go the academic route and more professorial and mentorship or you want to go clinical, such as your bread-and-butter clinics out in practice or on-site with different corporations, different companies, as well as the entrepreneur route. Dr. Dabrowski talked about fellowships. I will let her speak more on how many jobs you should apply to. I don't think I have a number, but it's probably as many as you need to or want to. And different factors to really consider is what do you want? What do you want out of your life? What do you want your lifestyle to look like? And that's one thing that a lot of us understand in this profession. When we were in medical school or residency, a lot of us thought that lifestyle was a bad word. It was a four-letter word, but it's not, right? Because if we're not well and we don't have balance, then how can we show up and be our best selves in the workplace? And I think that's something that a lot of our colleagues across the board in AHMED understand, and that's probably why a lot of folks who pivot to this specialty also found attractive. So understanding that as well as availability, your finances, what's going on with your family situation, and your willingness to expand geographically where you want to go, and planning being essential. Some other factors she wants you to think about are making sure that you're up-to-date on your pre-employment screenings. They will ask, some of them will ask for that, as well as your ACLS, BLS, or ATLS certifications, and your personal finances, as well as whatever else you might need to take care of yourself during this time. Interviews. Dr. Igbuchi says that hiring decisions are made in the first 30 seconds of the interview. So I'll let her expand on that when she can, but some other things. People may not remember everything you say, but they will remember how they felt when you spoke it. It's okay to stumble. It's okay not to say every single thing that you thought you planned or rehearsed, but remember to be your most authentic self and hope that that allows that to shine. Assess. It's a two-way street. The interview is not just them interviewing you, it's you interviewing them. So you want to assess your compatibility with the program and what their strengths and weaknesses are, as well as confirming or expanding upon any information or questions you might have about the job role. Practicing can make you calmer, more organized. Practice with your friends, your classmates, as if it were a real interview. Have a list of questions. Now you can Google. A lot of these interviews may be going to those sort of behavioral type questions, and you can Google them, find them in advance. Some of them will actually post, like a lot of the federal jobs at the VA, they'll actually post a list of potential questions. And now we have a lot of help in the form of AI. You can practice with AI. AI helped me craft a potential response to a question based on my personal experience. Research. Research. Research. The place that you're going to thoroughly. And ask your colleagues, ask your friends, ask your network. A lot of the time, especially if it's occupational environmental medicine, a lot of us may know someone who works there or know someone that knows someone that works there or has worked there. It's a pretty interwoven community and network, so to speak, in our specialty. So don't be afraid to ask. And so on. Be yourself. Know yourself. Smile. Be humble, yet confident. Speak clearly. Articulate yourself. Have at least two good questions to ask. Dr. Agbiji talks about the appearance and about just professionalism and being ready to shine. Let's see, we've got one more minute. So, I like what she said about creating a checklist of things you want or need in a workplace. Something that I've learned along the way is, just because the job posting says it's one way, doesn't mean that you don't have the opportunity to potentially craft it the way you want it to be. Okay? And a friend told me a long time ago, and I've never forgotten this, but the worst they can tell you is no. And you've lost nothing. So, for example, they're saying they want you to work nine to five, five days a week, but maybe you want to work ten hours, four days a week. Ask. What's the worst they can say? The best they can say is yes. So go for it. More about appearance, and then her pearls. Early start in planning is essential. Have a vision. Plan financially. Learn to negotiate. Stay informed. Take care of yourself during this time in self-care. Talk to your network, whether it's family, friends, colleagues. Be prepared for finishing with residency, and be proud of yourself. Always be prepared. Stay focused, and Dr. Ibuji wants you to know that you can and will do this. So thank you very much, and this one's very exciting. No pressure. Okay, so I am the entrepreneur of the panel, which doesn't feel much better than saying I'm the influencer. But yeah, so here's your five-minute MBA. So I have helped start two companies in the past year, so it's been a great experience, and so there's a little bunch of pearls and hopefully some bullet points that are thought generators, but I'm just gonna skip a ton of them. They're there for your reference, and then if you want to email me ever, have any questions, follow on. We can get more into it, but the best thing about occupational medicine is it's a license to dabble, and so when you're trying to come up with your business idea, it's not I'm gonna be a corporate medical director. It's not I'm gonna be a nurse case manager. It's what problem are you gonna solve? Are you gonna fill compliance gaps? Are you gonna have speed up return to work? And that leads next into what is your value proposition? The who, what, and how. So how do you create value? And it's not just like a meaningless MBA exercise that we do. I've been asked verbatim for that to be written down, but that helps you build your elevator pitch, because you cannot explain what a corporate medical director does in an elevator pitch. You need to explain to your clients, your prospective clients, how you're gonna create them value. There's a lot of ways to structure your business. Obviously can't even get into that. I operate under, for MetaPrize, a trusted advisor consulting model. So recurring fee, monthly fee, take care of all your corporate medical director needs, nurse case management, things of that like. Lean, lean, selling machine. This is for mostly recent graduates who have debt like me, so you can do this pretty cheap. And so you start off with building your business plan. Not for most businesses, you're not going to need a 40-page business plan, okay? But you do need to put pen to paper and challenge yourself to actually articulate what you're doing. And so a business model canvas, it's a one-page document, it's a nice little template. They'll ask you, what is your competitive advantage? What distinguishes you from the juggernauts like ISOS? You know, what is your future? Do you have industry knowledge, customer relations? You need to know these things so that when you go up against these folks, you can beat them. Branding, name-wise, MetaPrize is medicine and enterprise. The only thing I ask is you don't do some play on Occu. You do not need to pay $10,000 for a branding Bible. I got my logo done for 150 bucks done by a wonderful designer in Bangladesh. Font Ninja, go steal it from McKinsey. And color palette, just random generate until you figure it out. Otherwise, just there's some other little points about making sure you're tracking it, tracking your name against the various databases, and also having the website available. Website, so contractors, the gig economy, great for small business owners, probably been pretty horrible for workers. But if you need freelancers, anything technical, I go to Upwork. So my software developers, my website developers, they all come from Upwork. Fantastic platform, have had great success. Anything else, five or fifteen to two hundred bucks and I can have anything built. Makes me happy. Otherwise, the usual suspects, bookkeepers, accountants, lawyers, your support staff. You're gonna use like references. So working with either Chamber of Commerce, professional societies like SCORE that help small business owners, and also just physician practices in the area. Who to use for your lawyers, etc. Money often costs too much, yeah. So all of my initial startup fees really went into legal, fun. But these are really important documents. Some of these agreements will guide your company during the bad times or the good times. What do you do in an event of a sale? How do you protect against a silent partner? How do you distribute revenue? And so with my point with lawyers always is, have all the business conversations solved before you talk to the lawyer. The lawyer is not there to tell you what is fair or not fair. They're there to talk to you about the law. They'll charge you four hundred dollars an hour to try to answer what is fair, but try to make sure you have that all cared, taken care of before you talk to them. So eventually you're gonna be somebody's first client and you should do everything in your power to not make it seem like you're, they're your first client, okay. So building up credibility statements and this is how you attract new prospective clients too. And so you need to have good presentation, header on your invoices, a website, signatures in your emails, look legitimate. But it's also how you attract people in your credibility statements. How I got into the cannabis field was I wrote a case for, you know, just like kind of basically a business report on occupational asthma and ground cannabis dust and that's led to some great leads. I found, I don't know if he's in this crowd, I'll give him hell for skipping my talk, but how I met one of my newest business partners was from a paper I'd written about color vision testing in the healthcare place. So you can find a lot of business that way and you need to start building up your niche, what is your subject matter expertise, building that sense of credibility. Finally a pitch deck, that's a shot of mine on the right. If you want it, you can have it. It's very prescriptive, it's just a formula that you follow, build it out, have it ready so that you can describe what you guys do. These are just some options, some examples. Example of Fiverr, they put together a beautiful report and then just some things I have on my website, reports I've written for clients, looks way more legit than my company was at the time. So this should be part of the talk where like you shouldn't be an entrepreneur because some people will starve and so how you not starve is you start like getting clients and getting work and so network network network. AOHC last year gave me my two biggest gigs to start off my company. So and as George Carlin said, a few winners, a whole lot of losers. So you'll have a lot of people that you meet and network. I'd love to connect, I'd love to help you and then nothing. And then you'll have people, especially you'll meet here at AOHC, that would give you the shirt off their back. Some of the best mentors in the field are in this building today, so make sure to connect with them. It's just gonna take a couple people to find them. And then finally it takes a long time to get paid. Everyone needs to put a signature on it, purchasing HR, legal, EHS, your ultimate decision makers, and then finally, once you actually start working, they're gonna be brutal to you. They'll put you on a 60 day payments term schedule and you're not gonna get paid for another two months after service is rendered. So be prepared to be hungry. And then good old sales wisdom, pouring concrete. Every contact with a client is about solidifying the deal. And so it's not, hey, let's reconnect sometime soon. It's, hey, what's your availability in two weeks? Let's get this back on the books. Parting wisdom, if you can call it that. So everything was made up by people that were no smarter than you. So when you're at AOHC, surrounded by the titans of the industry and some of the most greatest minds in occupational medicine, it can be intimidating. But if you're in this room, you're more than capable of starting your own company and going into these fields. Doesn't mean you should, but you guys have the opportunity. And chance favors the prepared mind, which is the doctor's smart way of saying you create your own luck. When the frustrating things happens, when you're trying to find advice about getting into corporate medicine, they'll tell you the serendipitous story. And you're like, well, that's just luck. No, those people that are big time corporate medical directors created their own luck. They were prepared. And that's how they arrived at those opportunities. So thank you. Thank you. So, I'll save this slide for closing, but now, questions, please. That was a lot of information. I'm sure someone out there has at least one question, so either come up to the mic right here. That was you? Yeah. Come on and see what we can offer or what we can crowdsource from the audience. Hi. Good morning. My name is Ahmed. I'm an almost-graduating resident from Maheri. Now, a quick question. I saw a slide there where you said a bunch of fellowship opportunities, which the first one was pain medicine. So I wanted to do pain medicine, but the issue is there is no ACGME-accredited pain fellowships which we can go to. We have one of our graduates from last year who went to a non-ACGME-accredited pain fellowship, but the future is questionable with that, like if you're going to be able to get onto insurance panels, if you're going to get into legal troubles, how are you going to defend yourself not being board-certified and stuff? I know last year, Dr. Saeed, I believe, from ACOM, was trying to get us on pain medicine accreditation or something to be accredited by ACGME. So I wanted to know, is that in the pipeline or process? Or if not, how can we go about it? So your question is a valid one. It is a very murky field. I actually just met somebody yesterday here at this conference who they did go through a pain medicine fellowship, and they appear to be working as an ACGME-accredited pain fellow graduate would. I don't personally know the details about that because the majority of the stories I've heard are similar to yours. Will you get into legal trouble? Will insurances honor you? So I stayed away from that in my presentation because I plead relative ignorance. But there is supposedly a path forward. I wish I could tell you more about that. Anybody have anything to add? Anybody in the crowd have any experience with this? Hey! Can you come up? Can I just shout at you? You can just shout at the seat. Dr. Martin, can you tell us about, just give us a little bit more grit and more detail about one of your cases. So choose a client and tell us how you got them, how they came to you, what exactly you did for them, and how that relationship has progressed. Just give us a better idea of exactly what you did. Yeah, so I guess I've got two good ones. So I was at AOHC last year. I was at the professional supervisor training for CAYOC. And I met, there was a nurse that was there. She was a corporate nurse for Huntsman. She introduced herself, said she was from the Woodlands. I was like, that's where I'm moving. And then I told her about what I was doing. And then she said, we need that desperately. And so that took another six months, though, to materialize. And so in the interim, she was like, well, I really want you on board. I want you on board. There's a bunch of decision makers who now I have one over. But we're not, we're a little bit skeptical. And so just in the meantime, they had a bunch of really complex stuff that had happened, and then just pro bono took care of it for them, helped them out, got them in touch with the right referral sources, and took care of cases. And then when I went to pitch, they took it. And I, so for MetaPrize, for fractional medical directorship, it's like finger in the wind kind of pricing sometimes. So definitely under bid on that one. It's been corrected. But yeah, that was, it was just basically, here's my pitch. You're going to pay me this much dollars per month. We have a professional agreement about kind of what that looks like as a fractional thing. I don't bill by the minute. I don't bill by the hour. I want people to pick up the phone and call me. So that's kind of how that went about the work service agreement. If you are going up against a corporate juggernaut, just sign it. You have no negotiating powers. And then, of course, they're going to put you on a 60-day payment term, like I told you. So just being mindful that after services are rendered, you're still waiting two months to get paid. And that's pretty industry norm, unless you're pretty big. So that's that. Other ones that have just been, I found a problem I was solving. So an oil and gas group, they needed help with pre-placement. I built an online tool to basically get the kind of sped along. And that's been now, okay, you took care of that for me. That was my foot in the door. Now can you do a review on this? Hey, what do you think about this accommodation? And that's grown into now kind of a more traditional medical directorship that really started off as a clinical informatics kind of remote health role. So what you'll find, as well, is that a lot of companies are going towards outsourcing their medical departments. And so that's another great way to find contracts. And you'll also find that within our group, there are a lot of folks who, again, have the 9 to 5, but also have the, quote, unquote, side hustle. Whether it's, you like that, whether it's as an independent contractor or as a formal business operation like an LLC with multiple employees. And so there's so many opportunities. And also, don't sleep on federal contracts. Those are also great opportunities. Federal contracts, whether at the local or federal or local contracts. And there are different websites we can share. We can have that conversation. But I want to say it's sam.gov or something. sam.gov or something to that effect. But there are so many ways to find these contracts and these requests for proposals, whether it's at the private, corporate, or the federal level. And if you're a doctor or medically trained, like he said, you're smart enough to start your own business. Believe it. You are. I will say Concentra is my greatest source of referrals, as in I solved the problems that they didn't solve. So that's what I'm, when I try to talk to you guys about that business model is just really what is your competitive advantage. I mean I've beat out a big companies for big contracts, well not to them big contracts, to me they were big contracts, they felt good. But you can beat out these big companies, but that is what is your competitive advantage. You know I pick up my phone, I know the industry that I'm actually consulting in. You know they think they're just going to plug and play and drop the director in there and they're just going to, they're going to struggle. And also it's not always the, you have to have the whole package when you come to them. So when they were talking about those certifications at MRO, that's a great side hustle to do on your own. And it's, you can do it pretty much anywhere, you know. And that's kind of when you start looking at these certifications and start looking at these things, start looking into how can I fit this hustle into my life or turn it into where I want to lead my life. Because you don't always have to have the whole package, but if you know a specific small group, like particularly the MRO, you can, a lot of people just need that one thing. Sometimes the big, the big ones like the Concentras and Novas don't actually offer what the companies are looking for. So they might not have a fractional medical director to loan, or they just don't provide the services. And sometimes there are situations where employees may go to clinics and get examinations done, but then they need, the company needs somebody internal or, you know, outsourced to actually review and make sure that the T's are crossed, the I's are dotted, and that everything is actually covered and they're cleared to work for them. So there are a lot of ways to go about this. Great points from my colleagues. Just something to add too is, you know, sometimes with us, with you being a smaller entity, say the Concentras and so forth, they have a lot of protocols in place which they think is evidence-based, like this is the way to do it. But sometimes, you know, certain entities, they need a more personalized, nimble way of doing it. And we're able to kind of flex and be more flexible, as Bill had said, where sometimes, you know, there are guidelines or there are evidence, but not everything fits the guidelines. And so we have to be nimble. And I think that could be something that's a huge competitive advantage for, you know, someone that's smaller, not these large Concentras and so forth that have all, everything's based on protocols. So something to keep in mind. And maybe you have a better price, so they'll come to you. Okay, mine's not, mine's not related to starting a business. Mine's my own personal issues I've had along the time. So I've been an Oc Med for many years and I have a job that we support multiple clients and some of those clients have varying requirements. And some of those are requirements for B-read reports. Is there anybody out there has a shortcut on how to interpret a B-reader's report? Because you get this report with a thousand numbers and this and that and they all look good and they all look bad and, you know, I just need the bottom line, do they got a problem or not? And those reports don't answer that. And, you know, there may be something out there, but I don't know where it is and I'm probably not the only one that gets this piece of paper and go, what the heck? Do you want to build this? I'd need to know what the answer was first. Does anybody have experience with that? I mean, I've had to read them and interpret them, but I had to go and train myself to figure it out. Yes. So I will say, Dr. Glenn Chang, I don't know if he's attending this year, but one of the JD and graduates from the Harvard program, but he's doing some work with the B-reading more I think in the AI field and stuff, but he's probably obviously looking at result generation and kind of stuff like that. So he may be a good person to connect with. He's also just a fantastic doctor now. Just quickly, with my colleague mentioning Glenn Chang, there will be another panel that will happen I think on Tuesday, the Federal Careers, and so Glenn Chang will be one of the presenters. So if you have time, you can track him there too. So, I will say, like, finding a good local IME has been, like, is nice, is a great resource and stuff. So, one of the problems I had to solve for clients early on was, like, who's the IME? And so, you can turn to CHR, who's now a work care product, I guess. But that's who we have. Clarify what an IME is. Huh? Clarify for the audience what an IME is. I am not a good authority on them. I did not do a great job in residency in my IME training. Independent medical evaluation. So, if you want to get on that, you want to find, basically, a third-party administrator who is looking for IMEs to help them out. So, it was incredible how, in the Houston area, it was hard to find, like, a qualified IME. And I know there's IME networks and stuff. And I imagine Dr. Douglas Martin would probably be the king guru to talk to. I think he had an amazing talk last year that covered a lot of this as well. There should be a network somewhere. Yep. Our company's always looking for IMEs and locations, because we'll have a patient who needs something, but they don't want to travel far to get it. And so, we're trying to find an IME in, say, Denver area or Georgia. CHR. So, you just need to get plugged in. And people know that you're available to visit. So, you'll get the call. Are you in San Diego? No, I'm in Ohio. Where are you? Virginia. And are you an IME? Well, I'm certified an IME. Okay. So, that's something we need to research and cover together. And one thing is also the section, like, using the sections that are here and at ACOM and everything like that, pulling your information out there, like, hey, I'm an IME, anything in this section or something like that. It's really surprising what people will throw up there, though, actually, it's a great resource just to at least give you connections to where you want to be. And, you know, the worst thing they can say is no, you know? You had a question? Yes, my question is for Dr. Mark. I know that you have a background also in clinical probiotics. I Googled 10 clinical probiotics websites, and I get 10 different answers to what that means in practice. So from your perspective, what does it mean to where your future is going, and where do you think you should put your client or your team considering developing that skill set? All right. Hopefully, no one that graduated from my program can hear this, because I'm not going to do the best job answering that. But basically, what you're trying to do is you're trying to maximize the potential of man and machine here. And so for how I've applied it in my work is for pre-placement exams and stuff. So I've built tools that have automated workflows that I can click a button, this person's cleared or referred. It generates the correct email, correct PDF. It's sent to the HR onboarding people, stripped a PHI, and they know this person's been cleared or referred. So you can use that. And that's just, again, maximizing the potential and basically the scalability of me. My other company, Proximal WorkTech, and we do automated respirator evaluations. So a lot of front end work, building the algorithm to replicate medical decision making. But the amount of work that goes into that algorithm, deciding if someone's cleared or not, is 10 times probably the work that anyone puts into a respirator evaluation in person. So it's actually even better than medicine. It pulls, the employer puts in the information about the hazards, and all this information that employees typically don't know. And it's smart. The algorithm knows that. And so you're not even putting that burden on the employees. So to me, that's kind of what you're looking at is just maximizing that potential between the human and the computer interface. So clinical informatics can get, you can get EHR heavy, which is not my world. I'm like, should I hide that I'm training clinical informatics when like EHR stuff comes up, because I want nothing to do with it. But there are just like so many different applications within that. And with us, digital health technology is booming. It's nice to get involved. I believe there are a few sessions actually during the conference covering related topics. So be sure to check out the agenda and see. I think there's at least two. At least. So I'm a program director. I'm considering incorporating lifestyle medicine into an automated program. So on the lifestyle medicine certified personnel, where do you see automated people utilizing that? I know it's a little bit like preventing medicine. Well, how do you see like the stuff needs to be automated in practice? Sure. So it goes back to understanding that more and more, we're understanding that relationship between personal health and what goes on on the job and vice versa. So a lot of employers are starting to look at the overall health and well-being of their employees, because it pertains to the bottom line in terms of benefits, health benefits, but also employee productivity and safety. These things can pose actual safety and risk. And so it's going now beyond your sort of traditional, maybe not so evidence-based wellness, to truly evidence-based, gold standard, scientific-backed programming. And you're seeing that sort of that's what the Total Worker Health Initiative is sort of looking at, amongst other things. And that's one piece of it. You know, we spend so much time at work. And for some of us, some people are overworking, right? It's not just your traditional eight-hour days. A lot of folks are doing 10, 16-plus-hour days now. And then there's the gig economy and people who have multiple jobs and are floating. And so hazards and all that, it's getting very interesting. But I think that as employers are looking more and more to, one, build better reputations, you know, everyone wants to be known as the best employer, right? So that they can maintain, retain employees, and retain the best employees. It's not enough now. Salary is not enough anymore for a lot of folks. A lot of folks want work-life balance, and they don't want to leave their jobs mentally or physically disabled, right? So I think that there is a lot of overlap, and we're seeing a lot of dialogue now. As you can see, there's plenty of us. I know of another gentleman, Nathan Jones, who's a military background, but also Lifestyle Medicine, Achmed. He's getting his Lifestyle Medicine. I got mine a few years ago. So Lifestyle Medicine in the workplace is also a big growing faction. And just to give context to that, one of the pathways for Lifestyle Medicine, if you're still in a residency, is what's known as the Lifestyle Medicine Residency Curriculum. Essentially, your program subscribes to this online set of modules, which takes many, many hours, and then you have to do some certain homework assignments. You have to counsel a certain number of patients throughout the course of your residency, and that includes group counseling sessions as well, after which time you are eligible to sit for the Lifestyle Medicine board exam under the American Board of Lifestyle Medicine. One other thing to add, too, just in terms of my previous slide about ways to get involved in ACOM, and that aspect. So within ACOM, there's a section, the Health and Human Performance section, that you should definitely consider joining in terms of ACOM as an organization is trying to foster and is more extensively collaborating with ACLM, the American College of Lifestyle Medicine, trying to write position papers on this. So in addition to the curriculum aspects, at an organizational level, there's opportunities. So please do join the Health and Human Performance section. So that is our time, actually, but we will be available at the section showcases. There's two. Pacifica Ballroom 8-9. And so if you wanna continue the conversation, continue the dialogue, you have more questions, or you just wanna meet us because we're that cool, please come and find us, and we would love to meet you. Thank you so much for your participation and engagement. Thank you.

occupational medicine

environmental medicine

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Medical Review Officer

Total Worker Health

lifestyle medicine

clinical informatics

digital health technology

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