1450 Outcomes of an innovative train-in-place occupational medicine residency program

Introduction Physicians making a mid-career change in specialty may find options for formal training limited. We describe a train-in-place program, with measureable outcomes, created to meet the challenge of training mid-career physicians desiring formal training in the field of Occupational Medicine. Our objective is to evaluate educational outcomes from a novel residency program for mid-career physicians seeking formal training and board certification in Occupational Medicine. Methods Physicians train-in-place at select Clinical Training Sites where they practice, participating in eighteen visits to Philadelphia over a two year period. Program components include competency-based training structured around Subject Area Rotations, mentored trainee projects and periodic auditing visits to the Clinical Training Sites by program faculty. The main outcome measures are achievement of Accreditation Council on Graduate Medical Education milestones and American College of Occupational and Environmental Medicine competencies, performance on the American College of Preventive Medicine examinations, diversity in selection and placement of residents after training, and the number of graduates who remain in the field. Results Graduates, 113 to date, comprised 7.5% of new American Board of Preventive Medicine diplomates over the past decade, score competitively on the certifying examination, achieve all milestones, express satisfaction with training, and are geographically dispersed representing every region of the United States. Most practice outside of the 25 largest Standard Metropolitan Statistical Areas. Over 95% remain in the field. Conclusions Training-in-place is an effective approach to provide mid-career physicians seeking comprehensive skills and Board certification in occupational medicine formal training, and may be adaptable to other fields.