Okay, so we have several panelists that volunteered. Some may be still coming down, Dr. Campbell, Dr. Clark, Dr. Eskew, Dr. Estip, Dr. Fowler, Dr. Klatka, Dr. Silverman, Dr. Sullivan, Dr. Warrants, and Dr. Wriston. So you're free to come down or stay where you're at. So what we'll do, I'm going to, first I'd like to welcome the residents. Thankfully you didn't have to, I love Dr. O'Neill, but it's kind of torturous for our own members here because we just had a lifestyle medicine lecture and the benefits of vegetarianism and then we serve you meat pizzas with cheese and whatnot. Just so you know, we were discussing that upstairs. So make sure you make the room smell really good. Yes, ma'am. Yeah, they're all here and we also have a conference app. It's called a YAP app, Y-A-P-P, and they're all on there. So I'll have Ms. Jessica email all of you a link to our YAP app. The other thing I want to invite you to do, we're actually having lectures all through the weekend at the Kansas City Courtyard Marriott in the Plaza District. It's on the one on Main Street, yeah, the Marriott, right, Country Club Plaza. Anyway, so y'all can come and watch the lectures in person or you could watch it via Zoom. So we gave gratis access to all your faculty and student body. So if you enjoy preventive medicine, occupational medicine, aerospace medicine type lectures, all about keeping populations of patients healthy, we would enjoy you to partake in those at your leisure. Okay, so I'm going to go through a very, our profession is unique in a lot of respects. So preventive medicine, we'll talk about that. We'll talk about real briefly how our residency programs are set up and trained and then different ways to enter into a career in these disciplines. We'll tell you a little bit about the college. And if you decide to do something else early in your career and you get burned out and you want to transition mid-career, this discipline every year Medscape does an analysis and they publish a table that shows the specialties with the highest and lowest burnout and the highest and lowest job satisfaction. These disciplines, particularly OcMed, PrevMed, Aerospace Med, are always the ones that have the most job satisfaction and the least burnout, but very few people know about it and we'll talk about that a little bit too. So our preventive medicine specialties, I've already regurgitated those three all the time. The interesting thing about our training is the didactic portion of the residency leads to an MPH degree or its equivalent, such as a Master's of Occupational Health. So there's preventive medicine subspecialties, addiction medicine, clinical informatics, psychology, undersea hyperbarics, correctional medicine, and disability impairment evaluation. You know, all dealing with the defined population of patients. So of course, how to find information about the residency program, it's under the ACGME website. You could also search that website to find out where the 73 different residency and fellowship programs are located throughout the country. Sorry, my phone is ringing in my hearing aid. So you have to start these residencies in your second year, which means you'll have to do a primary year or a TY residency your first year. A lot of these residencies also have either a primary care residency that sponsors the PrevMed residency, so there's a fixed pathway from the same institution from one to another. They don't participate in the match. So what you do is you match into a TY or a family med with the understanding you'll be there a year and transfer out, and then you informally interview with the program director and they can, you know, offer you a PGY 2 and 3 spot. These residencies are not funded through Medicare, CMS, Cost Reports, like all the others are. They're funded through NIOSH grants. Dr. Carl Wurz is in our audience. He's a former program director and can kind of tell you a little bit about the process of that interview that I mentioned. So this is the website I talked about. You'll notice, is there a pointer on here? Yeah. Somewhere. So what you see here is how you find the programs, and then if you go to specialties, they're all listed under preventive medicine. So that's where you would go to find out about these programs. Oh, see there I had fancy little graphics that I forgot about. So that's what I just told you. There's five programs in aerospace medicine. So guess where those are? Generally in the military. There's one at Mayo Clinic that's civilian. Yeah. So OCMED has 24, and then General Public Health Preventive Medicine, 43. And there's a handful of fellowships in toxicology and hyperbarics, et cetera. And that's where you find the different residency programs, and you could search for the programs right there. And then it'll pull up that menu once you click on program search, and you want to pull down preventive medicine from this place. So note on the preliminary year. So usually the kids that go into transitional year, I say kids, I'm sorry, I need to stop that. The very mature men and women that are proud graduates of our medical schools that go into transitional year residencies typically want to go into ophthalmology, radiology, anesthesiology, dermatology. There used to be seven disciplines that required them. I think we're down to four or five, and a lot of those are taking that first year and adding it to their categorical. Back in the day before the single accreditation system, there was a bimodal distribution in what we used to call our traditional rotating internships. So you had the folks that were super good on comlex, that wanted to go into DERM, and you had a few people that maybe misplayed the match and did that, or they weren't sure what they wanted to specialize in, so it was kind of a bimodal distribution. Well now it's all the folks that want to go into those uber competitive second year positions. So if you're wanting to go into preventive medicine, any of these disciplines, and you're scared about your competitiveness into a TY position, don't forget that you could also come in in your second year after one year of primary care, whether it be internal medicine or family medicine. So and then that's the second bullet, you know, make sure that you're looking at places that have both an OCMED or a PREVMED program and a core primary care year for you. So a lot of times the military will take their general medical officers, and those are folks that have done their first year of training, and then they'll make you be a physician for a period of time, and after a period of a few years, then they'll send you to a residency. And a lot of times that's how we get our OCMED physicians cooked by the military. There's another pathway mid-career, if you did decide to go into family medicine or internal medicine, ER, any of the other disciplines, we got anesthesiologists in our ranks, we got surgeons that burned out or have dexterity issues that occurred mid-career. As long as you hold a primary board certification by any of our AOA boards, you can go through a basic course in occupational medicine and gain a certificate of added qualification on top of your primary board certification. So we have a number of people, Dr. Wriston here, Dr. Walker, that came through a mid-career or at least like in Dr. Walker's case, after a third of his career into our profession and they are great physicians and that primary care base serves them very well. So our college exists to support these physicians and we provide CME for them and networking and collegial support. We help them get connected and certified. We help them expand their scope of practice by other courses, such medical review officer courses and the National Registry of Certified Medical Exams so that they can conduct Department of Transportation physicals. We also have a sister organization that we started called Occupational Preventive and Aerospace Medicine, mainly so that our CME conferences can appeal to a much broader audience, including our allopathic colleagues and also the PAs and nurse practitioners that we work with. So these are the OPAM workshops we talked about. This is how you join in that bottom email address. That's where you send complaints to. That's an inside joke. That's our office manager, Ms. Rhonda, and she could help network you to the resources you're looking for. So I'm going to briefly introduce the panel and Dr. Everson, who's the one that's dressed like a bush. You can't see me, I'm camouflaged. A few more slides specifically about careers in the Department of Defense. So Dr. John Campbell, and I'm going to do a very brief bio, is in the audience. Dr. Campbell is retired from the Army and he's down at around Dothan, Alabama. But he's from New York, so he could speak slow or fast. Yeah. Dr. Clark is triple boarded in all of our disciplines, had a long career in the Air Force, just left Texas to relocate further west. Dr. Eskew is a correctional medicine expert, practices in Wyoming. Dr. Eskips in Joplin, Missouri, right here. And Achmed, currently in medical administration. Dr. Fowler, you talk to him, make sure you give him a dollar so that your conversation is protected under the attorney, client privilege. He practices both legal medicine and occupational medicine, and for a while was the oldest active duty soldier in the Army. Is that right? Yes. All right. Dr. Clacka does community-based public health in Ohio. She's a former Army reservist as well, did a lot of MEPS physicals for military entrance processing. But she's the one that the local TV stations would go to get comments from during the COVID crisis. Dr. Silberman is a world-renowned expert. He's out of Oklahoma City in aerospace medicine, worked for many years with the FAA. He's an internist originally, and then did his aerospace medicine training as well. So Dr. Silberman. Dr. Sutherland is a retired Air Force officer, and he does both aerospace and occupational medicine. And he's the handsome guy in the white beard and blue shirt. Dr. Carl Warrants, introduced earlier, does a ton of OCMED in Morgantown, West Virginia. He's an expert on mine safety, people that handle animals in research labs, and a host of other things. He's a longtime program director of an OCMED residency and served on the ACGME's Preventive Medicine Review Committee. So he knows all the ins and outs of the requirements. And Dr. Wriston practiced many years in family med in Ohio and came through our CAQ course. And she does a lot of executive physicals and also takes care of a lot of Japanese patients that have come over as expatriates. So she does a lot of that stuff too. So with that, I'll let Dr. Everson go through the slides, and then we'll kind of open it up for Q&A. And obviously, our panel has mics that they could pass back and forth. But we want to give you guys time to ask any questions. All right. While I go through my obligatory active duty slides, I want to remind everyone, thank you for coming out. Like we started, sorry, I started pimping them upstairs. I'm glad you came out to find out a little bit more about occupational environmental medicine. Ground rules. Ask questions. This is for you. Okay. I'm going to go through my slides pretty quick because it's going to be redundant. You have many other military members here who had equally as great a career and as much fun as I had in the Air Force. But what I want to do is you've heard about preventive medicine. Let's narrow that down a little bit to occupational environmental medicine under the same umbrella. Who do we take care of? We have the same population. If I leave you with one thing to remember, I want you to ask every patient you talk to, what do you do for a living? And never take, oh, I just stay at home as a mom. I'm retired. These people do things. They have hobbies. They volunteer. Find out what your patient does for a living or what they do for fun. This will play into their healthcare and what they're doing and what's going on. What type of training do we have in occupational environmental medicine? For me, what makes it so much fun? Take a look up here. We have a broad array of things that we are trained to do, all the way from emergency management down to public health, toxicology, work fitness and disability management. How many of you think in family practice you're going to be doing some of that? How do you get your people back to work? This is important things. We need to communicate back and forth well together. As in recognition, going into a workplace and finding out what these workers really do and how to keep them safe. This is all preventive medicine for the worker, the workplace, and the owners or hiring agency. How do we work for all of them together at the same time? Same thing in a wonderful word description from JOE. I'm sorry. That word source did not come through. As I describe it, it's a specialty within a specialty. What do I do? I work for the Department of Defense. Obviously, I know I'm hard to see. I just now got my official Space Force patch. That's right. That's right. I'm an airman and a guardian at the same time. I am a primarily trained occupational environmental medicine physician. I went in after an ER residency. I worked my way up through a standard clinical oc med. I'd see workers. I'd see flyers. I'd see active duty. I'd see civilians, take care of them in the workplace and industrial complexes. The Air Force has three incredibly large industrial complexes. You've seen some of our planes on TV and these commercials and stuff. Some of them have been flying since the 1940s. Guess what? Those parts aren't in production anymore. Guess what they have to do? They roll this plane in a giant hangar. One of them sitting at Tinker Air Force Base, Building 3001, is 1.1 miles long. That plane rolls in one door, comes apart down to the airframe, the wiring, everything off. By the time it hits the other end, that plane is airworthy, ready to go up, meaning they have to create parts. It is amazing what they do. Who else do we see in the DOD, not just in the Air Force? As you can see here, we have occupational health clinics distributed across the world. This goes out to the Department of Defense. We support three-letter agencies with Leo Medicine. Name the three-letter agency you want, FBI, CIA, all the other three-letter alphabets. What do the numbers look like that I get to take care of, or at least write guidance for at my position at Office of the Surgeon General? We are seeing approximately 1.36 million. These are 2020 and 2021 data. These fluctuate slightly, but you see we have active duty, guard, reserve. Biggest thing is civilians, Department of Defense civilians, and this workforce that keeps our planes, our tanks, our ships, all these things going. These people are just as important to keep safe, healthy, and on the job as the soldier, as the seaman, as the airman fighting the battle. If they don't have the tools, they can't go out and play. So that's some of the things I do on the active duty side for the Department of Defense. And we're back to Jeffrey. So this job's been great to me. After clinical medicine, I went on to be a chief of medical staff at two MTFs, fancy word for medical treatment facilities, two hospitals. So from there, I took an opportunity to go to DC, worked for the Surgeon General, be a consultant, write policy, take care of things on the larger population level. These numbers that you see, that's just a fraction of some of the stuff we do. All these COVID policies coming out. Red Hill. Who's heard, in here, heard of Red Hill? Well, not you, I'm sorry. Who of the student population have you heard of Red Hill? So there was an issue with fuel down in the Hawaiian Islands that we accident released it into an aquifer that fed an active duty base. How many, I think, 50 or 70,000 gallons of jet fuel. Not a good thing. Currently, I am also on an advisory committee for, we have an issue with miscellaneurs and cancer study. We have pilots that are having elevated cancer risk, and we're trying to research. Lots of things. Who in here has heard of the PACT Act? All right. So before we came up with occupational laws, OSHA and the OSH Act, there were environmental laws. So that's part of our coverage as well. The environment. How the environment interacts with our workers, our staff. I'm sorry. I'm getting the move along song. All right. We're going to leave contact information for questions, expanding, things like that further. But I want you to hear from the panelists who take occupational medicine under those training categories that we said before, and what do they do with them? Where are they at? How does their practice work? Who would like to go first? Dr. Wriston? I'm president of the AOCOPM, and I was in family practice for 20 years, and by fate ended up doing, actually, I had been chair of a department, president of the Columbus Academy of Osteopathic Medicine, and I was asked to come help with the associate health of the hospital system, which is part of ACHMED, you're taking care of employees, and slowly got reeled into it. I started, I did the COQ, I went through, I wanted a basic course in ACHMED because I'm certified in family practice, became the guru for bus driver physicals, which take care of handling your six-year-olds. I told them, you want to get your name in the paper, pass somebody to drive a bus that shouldn't have been passed, and let them kill four of the six-year-olds in the community. I said, we will make the headlines. So I teach and onboard physicians and nurse practitioners, and of course, also commercial drivers. I point out if commercial driving, that you basically have given them a several-ton instrument of death. The average number of people killed in a commercial driving accident is five, and it costs the company $3 million. So again, pass a truck driver that shouldn't be passed. And now, I am at, toward, certainly not at the beginning of my career like all of you. I do executive physicals. It turns out that if you keep the leaders of a company healthy, production goes better, even more so than the one actually on the line. So through Japanese-owned companies, I do the executive physicals for not only the associates, but the spouses. And so that is preventive medicine, and they are very willing and want more to hear about what can keep me healthy, what can keep me from getting osteoporosis. They like white American women are at the highest risk. What can keep me from getting stomach cancer? Their stomach cancer risk is very high as compared to the United States, and there are reasons for that. So that has been a wonderful niche for me because just like in the osteopathic profession, AT still, the body will heal itself if you will get it back into its healthiest state. That to me is what I do now, is trying to keep people healthy. But we wanted to do this panel for you to show you that within all of these slides, the OCMED, preventive medicine, aerospace, there are these almost subspecialties of niches. You have sitting in here with you, a flight surgeon for the entire United States. We have a very small membership, but like your profession, it is understated. This gentleman right here that will be very humble and low key, he investigates the airline accidents. You never know it just by looking and what he'll say to you. He also is ultimately, if somebody is going to let a pilot drive a plane, fly a plane, ultimately he's the ultimate word in it. So just to be aware that there are very many interesting niches, and they were sorry they gave me the mic first because they knew I'd talk more. Okay, I'm going to pass it on. But each one up here represents a little different aspect, and I had never heard of occupational medicine until I had been in family practice, until I was reeled into it by hospital leaders. So we want all of the medical students of our colleges to be aware that you do have some other choices. Let's have you go. Let's just go. This is crazy. He did three, for instance. He had three boards. Four. Okay. Okay, I'm board certified in family medicine, OCMED, PREVMED, and aerospace. And yes, it was because of the military. You just keep collecting things. I will tell you that the best job in the world is the one that I left when I retired. Okay? I was a flight surgeon. I was a command flight surgeon. I taught flight medicine. I got to deploy. I've traveled the world. And I never really thought I'd use my preventive medicine. You know, you use it for boards and stuff, and you know how to do relative risk. And, you know, you might use it in an outbreak of a foodborne illness. And then there was the pandemic. Okay? I was out in private practice. And there wasn't a day that went by that I didn't get five or ten questions about something to do with preventive medicine. And I was like, wow, I'm really, A, I'm glad I took the residency, and B, I'm glad I have the answers, because they look to the physician to answer those questions. And there's a lot of people out there that are giving erroneous ideas of this is what's going to keep you safe. And I'm like, okay, is that part of a peer-reviewed journal, or is that just something that someone tried and it worked? If you're willing to gamble your life on the we think it works, I can't stop you. This is America. You can do whatever you want. But if you expect me to write your prescription for ivermectin, it's not going to happen. And I had to have that discussion with a dear friend who was absolutely positive that ivermectin was going to keep him from getting COVID. He's since had COVID and was in the hospital. He was lucky to survive. And he never got vaccinated because he was taking ivermectin. He was overweight, smoker, hypertensive. I mean, all the things you don't want to be and catch COVID. So the big thing I would tell you is this college is great. I can't tell you, because I don't know everything. Yeah, I got a bunch of boards. But I can't tell you the number of times I picked up the phone and called someone in the college because call warrants. You know? I wanted to know something about a mining thing. It's not my area of expertise. But we were going to take on this new group. So I called Carl. And I said, okay, what am I looking for? Or I had a client that did preclinical testing on animals. And he needed to know what vaccines the humans needed to have. I'm like, okay. I could like comb through a bunch of stuff from the CDC or I could just call Carl. So I called Carl. But so the college in and of itself is a really great resource. And there's a lot of really smart people. And they answer their phones. And it's made me a better physician. And I will answer the phone. As will just about anyone on this college. And give you our best advice about whatever question you ask for. And trust me, I got tons of questions. Carl and I also teach the FMCSA. Along with Naomi, we teach the course on commercial drivers. And it's changed quite a bit. It's been quite a ten years that we've been teaching it. It went from very restrictive to use your best clinical judgment. And if you're willing, just like you said, you're willing to sign your name on there. And potentially be invited to be infamous in the press. Because you've cleared this person to drive with X. Even though the regulations say you can. You don't want to be infamous like that. Trust me. Talking about risks. One, of course, I don't know how many of you guys remember this. But I feel very comfortable about it. I was the one that cleared Lou Bitz. That flew German wings into the... And that was way before he did this. So he actually had depression as a... All Lufthansa pilots go to Goodyear, Arizona. For their basic flight training. To get their class 3, which is a private pilot. And he got depressed there. But then once... The doctors at Lufthansa are outstanding. And he was taken care of by a psychiatrist. And was eventually put back in the air. But then years later flew the plane. So I was interviewed a few times then. Because I was already out of the FAA. So Naomi, I'm not the head of certification anymore. I was. It was a partly thankless job. But I got to do a lot of neat things. Right now I'm sort of semi-retired. But I'm not. So I want you to notice something. I wanted Scott to say. Notice that a lot of the... You'll see that a lot of the folks on this panel. Have a general specialty. Before they did whatever preventive medicine. So I didn't know squat. That this specialty existed. And I said to myself. When I went to the flight surgeon course. One of the instructors. This is a long time ago. And the guy got up and says. You got to go and do an aerospace medicine residency. And I said to myself. Oh my God. I just took a six-hour board exam. And was grilled. Because in those days. You have no idea what that was like. And I said. I'm going to submit myself to something like that. And eventually I actually did. But the boards for aerospace were a lot. Let's just say a lot less. Than the boards for internal medicine. So a lot of the guys have general specialties. So right now what I do. And Dr. Everson. I call it administrative medicine. And that's what I was doing at the FAA. I was not taking care of pilots. I was reviewing records. Besides managing. That's a whole other story. And you also learn about management. Healthcare management in these residencies. And I'm the general where he's doing administrative medicine. So making decisions about policy. So right now. And I've retired several times. But right now I see pilots. And I help guys. Who are going to think they're going to lose their medical certificate. Or have already lost it. They call me up and I try to help them get it back. And then I have. And here's where my internal medicine came in handy. I also have now a contract. Which is crazy that I'm even doing this. One thing I'm going to tell you students. That I've learned out of this when I retired. Have some sort of a hobby when you retire. Don't let. Because my hobby was. I got some minor hobbies. But my life was medicine. So what do I do in my spare time? So I have a contract with the FAA. And I'm reading the EKGs. So I have the computer system at home. And they send me boluses of EKGs. And I read the EKGs. And I put notes in the chart. To say what kind of a work up if the EKG is abnormal. So that's what I do now. So let me. All right. Good afternoon everyone. My name is Dean. And like you. When I was in medical school. I never heard of occupational medicine. I didn't even understand what that was. I didn't know what occupational therapy was. But I didn't know what occupational medicine was. I went to school at Michigan State. College of osteopathic medicine. And in Pontiac, Michigan. They had the one and only DO. Occupational medicine residency program. And I was fortunate enough to go there. And I was a board certified. DO trained resident in occupational medicine. One of the things I can tell you most. I love about the specialty. And I just passed my longitudinal assessment exam. So I'm board certified again. In occupational medicine. You can do a lot of things. Once you're completed this residency. I had my own health care company. I owned four practices. Did pretty well with that. Sold them. And was very happy about that. You can go and work for the public sector. I've worked at Fort Carson, Colorado. As the occupational medicine health chief. I'm in the army reserve. And I've had the opportunity to go overseas many, many times. You can work for Ford Motor Company. You can work for General Motors. You can work in the private sector. You have lots and lots of options. This is one thing I loved about this practice. I never ran out of options. Most of my friends who went into family practice. Internal medicine. I was on track for ortho at one time. I didn't want the lifestyle. This is a great lifestyle. The chance of getting sued is practically zero. That's another thing to think about. Just as you get older and have a family. The lifestyle is also very nice. If you're working in a med clinic. You're taking care of people. It's basically 8-5. No weekends. No holidays. No call. Let that sink in. I'm much older than you. I didn't think about those things when I was your age. I'm happy about that now. You have a lot of options. I have a career in the VA right now. I was the chief of staff of the hospital. You have lots of opportunities. The education you will receive. It puts you at a great advantage. I like to tell people. It's a mix of primary care and emergency medicine training. You learn a lot of stuff. You can do a lot of things. I'm going on another deployment in June. I will be in charge of the program. Or I will be in charge of the emergency medicine program. I can do both. You have a lot of opportunities. That's what's cool about being a doc. Is this on? Good. I'm Ralph Sutherland. I want to give my pearls in a nutshell. First, I want to congratulate you for being in one of the best career fields. That's medicine. Many people talk about retirement. I cannot imagine giving up my license. I love waking up every day and performing medicine. This is what I want to do. I talk to my colleagues. I was on the board of medicine for five years. In 2008, after the recession crash, there were many doctors who had retired. They had to jump through hoops to get their license. That's one thing. It's a lifelong calling. It's wonderful. I went to school in Des Moines. I wanted to do pediatrics. Then I did my rotations. I love this OB stuff. I love to deliver babies. I love sports medicine and surgery. Where can I do all of that? Family medicine. That's what I'm going to do. I did a family medicine residency. Everything was wonderful. I love to deliver babies. The worst thing during that time was occupational medicine. I thought you get these malingerers. You have all of this paperwork. I don't want to deal with those folks. That's what I thought. I added some payback to do with the Air Force. That's what I did. I saw these guys in flight suits. What do they do? Flight docs. That's what I want to do. There was this residency in aerospace medicine. I thought that's cool. That's what I want to do. It was always these opportunities. Open the door, look, investigate. With the residency, we get the first semester of public health. I thought, where should I go? I want to go to one of the best ones. I went to Harvard. Taxpayers paid for that. I spent a year in Boston. It was great. Learned about occupational medicine. Learned the big thing is not the malingerers. It's prevention. I can try to prevent things from happening in the first place. This afternoon, we're going to go to the GM plant. It's different than what anybody else sees. We go look and see what kind of controls, what kind of changes can we make to eliminate back injuries, to eliminate carpal tunnel, to eliminate illnesses and injuries. That was cool. I got board certified in aerospace medicine. I loved to fly. Occupational medicine. I spent time with the Air Force. I was back at Mountain Home Air Force Base. I got out after 11 years active. I joined the National Guard. I was with the National Guard for 18 years. When I got out of Mountain Home, I did civilian occupational medicine, which was awesome. Every time I saw a patient that was injured or had an illness, I thought, what can I do to prevent this from happening again? What could you have done different? Lifting, whatever the case may be. A lot of it was education. Thank you for all being here. I'll pass this on. Thank you to the four people on the periphery. I feel like this is like the presidential debates where you didn't poll strong enough in the polls to be in the center seats. Any questions from the students? We have a 1 o'clock bus ride. Yeah, so I'm going to let Dr. Klatka answer that. Sure, I'll take that real quick. I'm Lisa Klatka and I completed a general preventive medicine residency. It was my second residency. So I went back after about 10 years of practice to do that. And I went, I've served both in the military and in the, in the community. So in the community, I work at a county health department. You'll probably find in preventive medicine, that's where most, at least at the local level, most of those jobs are going to be at a county or city level or regional health department, or possibly a state health department in an epidemiology preventive medicine kind of setting. So what I did there, and actually in the military, because I was affiliated with a installation, it was very similar parallel to exactly what I did. You'll still will find some variability. There is always some administrative work to do, like policymaking, vaccine policy, rabies policy, et cetera. Interfacing with the public was a little bit of what I did as a spokesperson, if there was an outbreak. Fortunately, I left before COVID, so I didn't get wrapped up in that, but we did have some other local outbreaks that we worked with the public. We worked with hospitals. We worked with the hospitals in some surveillance efforts for things like C-diff. So between administrative interfacing with the public, there may or may not, again, depending on the services offered by the health department, we had an STD clinic. We had some basic preventive services like breast and cervical cancer prevention. So I did participate in that. So there was some clinical work. For me, it was a nice balance. So I liked the clinical side, doing the STD, HIV prevention, like pre-exposure prophylaxis, treatment of latent TB, not active TB. It was obviously handled. It had a different facility, but testing and treatment for latent TB, things like that. So a lot of preventive immunizations, of course. Immunization policy and of course, mostly it was nursing staff providing immunizations, but working alongside, I liked working alongside nurses. Of course, in a county health department, you're going to also going to have generally vital statistics. So there are a lot of other non-medical departments, environmental health, birth certificates, death certificates are usually under the same umbrella. And then lastly, there is room to move up. Also, again, depending on your state or city regulations of who has to be a health commissioner, medical director, generally it's a physician. In some areas, a health commissioner has to be a physician. So there are opportunities to move up into leadership and management if that's desired. Yeah, Dr. Clacker really tried to mention, but everything she was saying is about populations of health, health policy and what you could do to make the entire population healthier. That's a little different than preventative care where when I come in as an old fat guy, you tell me to not eat pizza and to exercise more. They're really more looking at trying to preserve an entire population of patients' health. So I guess if I paid a guy to be a concierge physician and I went and he told me all the truth that I needed to hear, I might not pay him next visit. Unfortunately, we have a hard stop. We got to go and catch a bus to go to GM Plant. We do have free membership for students in our college and the website's AOCOPM.org. I will send that to Ms. Jessica to distribute to you. Thank you so much.

occupational medicine

preventive medicine

aerospace medicine

career paths

work-life balance

public health

AOCOPM

medical students