RCPI’s Smiley Symposium hears Occupational Medicine in U.S. is being blighted by funding cuts
Funding cuts are impacting occupational medicine training in the U.S, attendees heard at the annual Smiley Symposium – a meeting by RCPI Faculty of Occupational Medicine honouring Ireland’s first industrial health doctor Dr. James Smiley (1907-88).
The lecture at No. 6 Kildare Street on 14 November 2025 was given this year by Dr Christopher Martin, the programme director of West Virginia University’s Occupational Medicine residency programme.
“Some programmes are reliant on federal funding that’s now been cut under the current regime,” said Dr Martin.
As the future of occupational medicine training looks uncertain, Dr Martin urged the need to address a long history in the U.S. of training not meeting workforce needs – an issue, Dr Martin showed, was reported as far back as 1966, when Dr John C. Hume, dean of John Hopkins School of Public Health, mentioned in an article for the Journal of American Medical Association that industry was in desperate need of medical doctors.
“This is what my colleagues don’t like to discuss,” said Dr Martin. “That we have these positions but not able to fill them.”
“We have the lowest burnout rate of any speciality. We’re top of the pack for work-life balance. We have a problem recruiting but our physicians are undoubtedly happy,” he said.
In thinking about how to give greater visibility to occupational medicine, Dr Martin distinguished it from other specialties that attract doctors curious about specific diseases; occupational medicine attracts doctors curious about people brought together by their work. That requires an appreciation for environment and community.
He quoted from Dr Smiley’s path-finding 1956 article ‘Occupational Medicine as a Vocation’: “The factory doctor knows his patients intimately as individuals but he can, if he will, know them too as members of a social group."
“Our essential quality as a specialty is a deep understanding of the workplace gained from being in the workplace,” said Dr Martin. “How is a 22-year-old undergraduate student meant to know what that’s like?”
He said that a majority of occupational medicine physicians in the U.S. transition into the specialty mid-career.
Facing an uncertain future, Dr Martin said the importance of occupational medicine training in Ireland and elsewhere will increase with training programmes in the U.S. being cut. His lecture concluded on an uplifting note, however, by quoting from Dr Smiley – who, he says, “knew what’s needed to be an occupational medicine physician.”
“Occupational medicine as a vocation beckons to its technically good doctors,” wrote Dr. Smiley in 1957, “… adventurous in their seeking, and courageous when, as sometimes happens, they are misunderstood by those whom they serve.”
Other presentations were also delivered as part of the symposium. Dr Emma Wallace (occupational medicine physician, Northern Ireland Civil Service) spoke of a trip to the Ny-Ålesund research centre in arctic Norway, where she carried out a workplace assessment for scientists.
Her assessment took into account workers’ workwear protecting them from subfreezing temperatures, sun protection against midnight sun, and safety measures against black ice, unidentified toxins, and threats by polar bears and arctic foxes. Dr Wallace was wary of workers sustaining long-term impacts to their health while at Ny-Ålesund. “What happens in the Arctic doesn’t stay in the Arctic,” she said.
Dr John McDermott (occupational medicine physician, Healthwell Clinic Dublin) made a case for the pre-placement health assessment – a questionnaire and/or medical consultation assessing a job applicant if they’re medically fit to do a job. He cited his recent work as occupational health advisor to Luas as an example.
“Luas tram drivers have a very difficult shift-work pattern that can impact their wellbeing,” he said. During recruitment in 2024, 63% of applicants passed a pre-placement health assessment. “A small risk over an extended period of time can be a significant risk,” he said. “Pre-preplacement health assessment is an essential element of good employment practice.”
Lastly, Dr Ruth McCullough (RCPI Higher Specialist Training in Occupational Medicine trainee) shared a research project at Tallaght University Hospital testing if visible flu vaccination-uptake by hospital managers would lead to increased uptake by their staff. Dr McCullough said healthcare worker flu vaccination rates have been falling since 2022.
Her research found that flu vaccination uptake by staff in Tallaght University Hospital staff rose from 20% to 48% following vaccination of hospital managers.
“We need it to be 75%,” said Dr McCullough. “What we can say is there is a strong statistical association. The vaccination rate increases with higher manager vaccination uptake.”
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