First Year of Fellowship Training

Master’s at U.C. Berkeley School of Public Health

All first year OEM residents and fellows attend the School of Public Health at the University of California at Berkeley to obtain a Masters degree (MPH or MS) in Environmental Health Sciences or Epidemiology. The school year at Berkeley covers two semesters beginning in August and ending in May.  Required coursework includes biostatistics, epidemiology, health services organization and administration, environmental and occupational health, and social and behavioral influences on health.  For the MPH, a minimum of 42 units and a passing score on the comprehensive exam is required for graduation.  The Curriculum for the MS degree is similar, but trainees may take fewer course units and are expected to complete a research project rather than take an examination. The research project can be completed over the first 18 months of training.

Sample Curriculum:

Fall:   
PH 142A Probability & Statistics (Required) 4 units
PH 200C Overview of Public Health (Required) 2 units
PH 250A Epidemiologic Methods (Required) 4 units
PH 269E  Topics in Environmental Medicine + Seminar (Required) 3 units
PH 297 Field Study (Clinic) 3 units

Spring:
PH 200D  Integrative Breadth Course (Required) 2 units
PH 270B  Toxicology (Required) 3 units 
PH 269C Ergonomics (Required)  4 units
PH 297 Field Study (Clinic) 3 units

Advanced Courses/Electives:
PH 254B Advanced Occupational & Environ Epidemiology 3 units
PH 271 Environmental Science and Policy 3 units
PH 270A Exposure Assessment and Control 3 units
PH 220 Health Risk Assessment 4 units
PH 272A GIS and Remote Sensing 3 Units

Weekly Clinic, Rounds, and Seminars

Fellows participate in clinic for a half-day per week throughout both years of training. Clinic may be at the Occupational and Environmental Medicine Clinic at UCSF, at the Kaiser Occupational Medicine Clinic, or at the Tang Center Ergonomics Clinic at Berkeley. 

Occupational and Environmental Medicine Clinic at UCSF/ Mount Zion
Cases include referrals for occupational and environmental exposures, toxicology, and complex musculoskeletal disorders. Some families and pediatric cases are seen in collaboration with our Pediatric Environmental Health Specialty Unit. Industrial hygiene and nursing students also participate in patient evaluations, as does our faculty Industrial Hygienist. Faculty attendings in this clinic include Drs. Solomon, Jewell, Fischman, Goldberg, Born, Das, and Rinker.

Ergonomics Clinic at UC Berkeley Tang Center
Evaluation and management of upper body musculoskeletal cases with Dr. David Rempel.

Kaiser Opera Plaza Occupational Medicine Clinic
Primary occupational medicine clinic services under the direction of Dr. Paul Johnson.

Fellows also attend Grand Rounds, Journal Club, and Research Seminar on every 2nd & 4th Thursday morning. Case conference occurs on Thursdays immediately preceding clinic at UCSF.

Fellows also are on call to cover the UCSF needle-stick hotline for 4-6 weeks during both years of training. Calls are taken from home at night and on weekends.

 

Second Year of Fellowship Training

Clinical Rotations A minimum of two months must be devoted to clinical rotations. Additional elective months may also be spent at these sites. Additional clinical months will be required for residents or fellows who have had limited prior clinical training. In most cases, at least one month must include full-time occupational medicine at Kaiser or CPMC.

Kaiser Permanente Medical Group - Occupational Medicine Clinic. General primary occupational medicine services with an emphasis on musculoskeletal evaluations and ergonomic issues. Location: San Francisco, CA.

California Pacific Medical Center (CPMC). A busy comprehensive occupational health service that provides consultation and medical surveillance for occupational and environmental hazards, evaluation and treatment of work related injuries and illnesses, and case management. Location: San Francisco, CA. UCSF Ergonomics. This rotation includes onsite ergonomic assessments, evaluation of musculoskeletal disorders, orthopedics, and medical management. Location: Tang Center, U.C. Berkeley.

Lawrence Berkeley Lab, Health Services Department  (Clinical focus). National laboratory with extensive health services and research activities. The rotation includes occupational health services for employees, ergonomic and industrial hazard evaluations; learning about safety and industrial hygiene programs; health promotion, disease prevention, employee assistance programs; and workers compensation management. Location: Berkeley, CA.

Lawrence Livermore National Laboratory, Health Services Department (LLNL) (Clinical focus). LLNL is a Research and Development Laboratory with a focus on national security issues.  The Health Services Department serves over 7000 employees and provides comprehensive clinical and consultative services, including medical surveillance, evaluation and treatment of work-related injuries and illnesses, ergonomic, safety, and industrial hygiene evaluations, health promotion, employee assistance programs, and workers compensation management.  LLNL has many interesting and unusual occupational health issues ranging from beryllium to biological agents and radiation. Location: Livermore, CA.

Jonathan Rutchik, MD. Neurotoxicology private practice, consulting and medico-legal work. Location: Mill Valley, CA.

SF Regional Poison Control Center (PCC). Physician and pharmacologist teams advise physicians and the public regarding toxic ingestions (including medication adverse effects), skin and inhalation exposures.  Consult on in-patient toxicology cases at San Francisco General Hospital, and provide telephone consultations on toxicology cases at other hospitals. Location: San Francisco, CA.

Pediatric Environmental Health Specialty Unit (PEHSU). This program is part of the OEM Division at SFGH, in partnership with the Northern California Poison Control Center and the UCSF Department of Pediatrics. The PEHSU responds to calls from clinicians and the public about pediatric environmental exposures, performs outreach and education to primary care pediatrics providers, and participates in the multidisciplinary clinic at UCSF/Mt. Zion when children or families with environmental exposures are evaluated. Location: San Francisco, CA.

Public Health Rotations                    
A minimum of two months must be devoted to public health rotations. Fellows may elect to spend two sequential months at one site, or may rotate through two different sites. Fellows interested in public health may spend additional elective months at any of these sites.

California Department of Public Health - Occupational Health Branch (OHB). The OHB is a public health program to identify and evaluate workplace hazards, track patterns of work-related injury and illness, develop training and informational materials, provide technical assistance to prevent work-related injury and illness, and recommend protective occupational health standards. Programs include the: (1) Hazard Evaluation System and Information Service (HESIS) which evaluates hazards to provide information and technical assistance on new or unappreciated hazards; (2) Occupational Health Surveillance and Evaluation Program (OHSEP) which conducts research on work-related illness, injury and death in California; (3) Occupational Lead Poisoning Prevention Program (OLPPP) which provides information and assistance to identify lead hazards and prevent work-related lead poisoning; and (4) California Safe Cosmetics Program (CSCP) which collects and provides information on hazardous ingredients in cosmetic products sold in California. Location: Richmond, CA.

California Department of Public Health/Environmental Health Investigations Branch (EHIB). EHIB works to protect the health of Californians by studying how the environment affects health and by educating and informing the public. EHIB units include: (1) Community Participation and Education Section; (2) Exposure Assessment Section; (3) Environmental Epidemiology Section; (4) Site Assessment Section. The California Environmental Contaminant Biomonitoring Program is run by staff at EHIB.
Location: Richmond, CA.

California EPA – Office of Environmental Health Hazard Assessment (OEHHA). OEHHA is responsible for developing and providing risk managers in state and local government agencies with toxicological and medical information relevant to decisions involving public health. OEHHA’s responsibilities include: (1) Developing health-protective exposure standards for different media (air, water, land) to recommend to regulatory agencies, including ambient air quality standards for the Air Resources Board and drinking water chemical contaminant standards for the Department of Health Services; (2) Carrying out special investigations of potential environmental causes of illness, diseases and deaths; (3) Making recommendations with respect to sport and commercial fishing in areas where fish may be contaminated; (4) Assessing health risks to the public from air pollution, pesticide and other chemical contamination of food, seafood, drinking water, and consumer products; (5) Providing guidance to local agencies with specific public health problems, including appropriate actions to take in emergencies that may involve chemicals; (6) Implementing the provisions of the Safe Drinking Water and Toxic Enforcement Act of 1986 (Proposition 65).  Location: Oakland, CA. 

Natural Resources Defense Council (NRDC). The goal of this NGO is to preserve the environment and protect public health through education and advocacy. Areas of focus include diesel exhaust exposure reduction; reduction of greenhouse gases and conventional pollutants from refineries, cement kilns, and mobile sources; reducing lead and mercury pollution; pesticide policy reform; drinking water regulation; and identification and elimination of endocrine disrupting chemicals in consumer products. 
Location: San Francisco, CA.

Safety and Health Assessment and Research for Prevention Program (SHARP). Research in occupational safety and health, surveillance of occupational health and hazards, assessment of emerging conditions, and cluster investigation. SHARP also provides research support for occupational health standard-setting in Washington State. SHARP has special emphasis is placed on ergonomics issues. Location: Olympia, WA. National Institute for Occupational Safety and Health (NIOSH). The Federal agency devoted to industry investigations and research and education in Occupational Medicine. The rotation is with the Hazard Evaluations and Technical Assistance Branch (HETAB) medical section. Activities include participating in worksite health hazard evaluations, responding to inquiries from the public, and participating in NIOSH research projects and seminars. Location: Cincinnati, OH.

California OSHA. State consultation and enforcement services for California OSHA regulations with offices throughout CA.  Center of Operation: San Francisco. CA. 

Federal OSHA. Development and application of occupational health policy at the national level. Work developing OSHA regulations, assisting in compliance investigations, answering inquiries from the public, and developing Safety and Health Information Bulletins. Location: Washington DC.

World Health Organization, Occupational Health Branch. WHO is implementing a global strategy to provide scientific policy, legislation and support to decision-makers, estimate the magnitude of the burden of occupational diseases and injuries, provide infrastructure support and development through capacity building, information dissemination and networking, and support protection and promotion of workers' health.  Location: Geneva, Switzerland.

Corporate/Consulting/Administrative Rotations
A minimum of two months is normally devoted to rotations in this category. Fellows interested in this type of practice may spend additional elective months at any of these sites.

Johnson & Johnson Corporation. A pharmaceutical company with facilities in Mountain View, Vacaville, and worldwide. Activities involve development and management of occupational health services, preventive activities, including site visits to various Johnson & Johnson facilities for ergonomic and industrial hazard evaluations; safety and industrial hygiene programs directed by trained professionals; health promotion, disease prevention, employee assistance programs; and workers compensation management.  Location: Mountain View, CA.

The Permanente Medical Group - Kaiser Permanente Northern California Administrative Offices. A non-clinical rotation that focuses on learning how Worker’s Compensation Utilization Review is performed, how MPN networks are developed, managed and sold from inside a large HMO. Location: Oakland, CA

Lawrence Berkeley Lab, Health Services Department  (Corporate focus). National laboratory with extensive health services and research activities in Berkeley.  The rotation will include ergonomic and industrial hazard evaluations; learning about safety and industrial hygiene programs; health promotion, disease prevention, employee assistance programs; and workers compensation management. Location: Berkeley, CA.

Lawrence Livermore National Laboratory, Health Services Department (LLNL) (Corporate focus). LLNL is a Research and Development Laboratory with a focus on national security issues.  The Health Services Department serves over 7000 employees and provides comprehensive clinical and consultative services, including medical surveillance, ergonomic, safety, and industrial hygiene evaluations, health promotion, employee assistance programs, and workers compensation management.  LLNL has many interesting and unusual occupational health issues ranging from beryllium to biological agents and radiation. Location: Livermore, CA.

Richard Cohen MD, MPH, Inc. Consultant to companies in biotechnology and pharmaceutical research and manufacturing, semiconductor equipment and microprocessor production, healthcare supplies and equipment manufacturing, and electronic equipment research and development. Location: South San Francisco, Peninsula, and North Bay areas (requires a car and willingness to travel).  State Compensation Insurance Fund (SCIF). The rotation will provide the participating Fellow with an understanding of the roles/responsibilities of medical professionals working within a large workers compensation insurance carrier and an appreciation for managed care from the payer’s perspective.  There is also an opportunity to learn about the research potential of a large administrative database. Location: San Francisco, CA.

Elective Rotations                                 
Electives may be taken from the rotations listed above, or from those below.  If the resident/fellow is interested in developing a new elective rotation that is not on this list, the rotation must be arranged and approved by the Program Director at least three months in advance so that a signed letter of agreement can be put in place.

James Craner, MD, MPH. A consultant to gaming, mining, various other industries with clinical practices throughout the state of Nevada.  Location: Reno, NV.

Jordan Rinker,MD, MPH. Consulting Medical Director to pharmaceutical research and manufacturing, biotechnology, medical center occupational health companies. Location: Various Sites in Bay Area.

Michael Kosnett, MD. Medical toxicology private practice, and medico-legal work, specializing in the toxicity of metals. Location: Denver, CO.

Chevron. Management and evaluation of occupational and environmental health programs within one of the world’s largest energy companies. Fitness for work issues, multinational and multicultural industrial medicine including travel medicine and international OEM issues, worker’s comp and disability, surveillance, and an understanding of industry-specific hazards. Location: Houston, TX.

Central Labor Institute, Mumbai, India. Opportunity to spend time at a variety of factories and observe working conditions first-hand in India. Workshops, trainings, and conferences for physicians. Opportunity to learn about occupational health surveillance and injury prevention in Asian and Pacific countries, and to develop protocols and educational materials. Location: Sion, Mumbai, India.

National Taiwan University. Academic occupational medicine residency training program in Taiwan, with clinical sites, consulting practices with local industry, and ongoing research opportunities. Fellows attend grand rounds, research conferences, case conferences, and industry site visits with faculty and trainees from NTU, and have the opportunity to see injured workers in clinic. Location: Taipei, Taiwan.

Research project                   
A research project is a required component of the training. Projects typically span most of the year with a full-time block of 1-2 months for in-depth work.  The research results must be submitted to peer review either as an abstract for a poster presentation at a conference, or as a manuscript for a scientific journal. Typically, Fellows submit an abstract to the American Occupational Health Conference in July of their second year for presentation at the conference the following Spring. In addition, the results must be presented at a UCSF OEM Grand Rounds. Competitive funding for research project expenses is available through the Targeted Research Training (TRT) grants at COEH. Applications are due in September for these grants, and trainees are strongly encouraged to apply. Examples of recent research projects include: