Training pathways for occupational medicine

OBJECTIVE: Consider the funding, organization, and applicant pool for occupational medicine residency training positions concerns in the United States. METHODS: Postgraduate training models are compared for responsiveness to competence and workforce needs, including traditional residency, nontraditional residency, postdoctoral fellowship, extended courses, multiple certificate preparation, continuing medical education, "executive MPH," and implicit education (learning from consultants in the course of practice). RESULTS: Educational models differ in comprehensiveness, crossdisciplinary experience, socialization to core professional values, financial requirements, accessibility to physicians currently in practice, potential number of trainees, and short- and long-term impact on training outcomes. CONCLUSION: There are tradeoffs between the benefits of comprehensive program standards and the benefit of facilitated training access by reducing barriers or requirements. Recognizing and understanding assumptions about training in our discipline may inform future choices.