Practicum Sites and Preceptors

exterior of employee health building entrance

Duke Employee Occupational Health and Wellness (EOHW) is responsible for health care delivery to over 35,000 employees at Duke University and Duke University Health System. Duke Occupational Health (DOH) provides full service occupational clinical and consulting services to over 50 companies and agencies located in the Raleigh / Durham / Chapel Hill area including state agencies, academic institutions, state public health lab and medical examiner’s office, state and local law enforcement agencies, fire departments, microelectronics manufacturers, biotech, biopharma, agricultural R&D, textile manufacturers, metals producers, chemical production.   

Faculty Preceptors

EOHW: Carol Epling, MD, MPH; Kristen Said, MD, MPH; Satish Subramanian, MD, MPH; and George Jackson, MD, MPH 
DOH: Dennis Darcey, MD, MSPH 

Both EOHW and DOH provide:  

  • Toxicological assessments 
  • Work-related injury and illness treatment 
  • Substance abuse awareness 
  • Health risk appraisals 
  • Injury prevention programs 
  • Smoking Cessation 
  • Health maintenance exams 
  • Disability assessments 
  • Federal Aviation Administration, Department of Transportation and Occupational Safety and Health Administration (OSHA) examinations 
  • Worker’s compensation evaluations 
  • 24-hour blood and body fluid exposure services 
  • Drug testing 
  • Medical Review Officers services 
  • Job-related immunizations 
  • Travel Medicine 
  • Corporate consulting 

EOHW also employs counselors for its Employee Assistance Program, and manages a contracted health promotion program, LIVE FOR LIFE, which serves Duke employees. 

During their rotations with EOHW and DOH residents: 

  • will participate in projects with the industrial hygiene and safety staff learning principles of worker protection, spill clean-up and chemical waste disposal 
  • will gain experience in the diagnosis and management of musculoskeletal disorders 
  • will guide patients through a rehabilitation program 
  • will attend weekly disability case management conferences attended by a multidisciplinary team of OEM faculty members, physical therapists, occupational nurses, a social worker, and a vocational rehabilitation specialist 
  • may chose a project regarding management of a wide variety of health promotional services provided to university employees 

Occupational and Environmental Epidemiology (OEE) is the branch of public health that deals with environmental and occupational conditions and hazards that may pose a risk to human health. OEE identifies and quantifies exposures to environmental and occupational contaminants; conducts risk assessments and risk communication; provides medical evaluation and surveillance for adverse health effects; and provides health-based guidance on levels of exposure to such contaminants. 

About the Preceptor

Rickey Langley, MD, MSPH, is a former Duke OEM faculty member who serves as the onsite preceptor for resident projects. Dr. Langley is a medical epidemiologist at the Occupational and Environmental Epidemiology Section of NC Health and Human Resources in Raleigh, NC. He has certifications in internal medicine and preventive medicine/occupational medicine. His special interests are in occupational and environmental epidemiology. 

About NC Occupational and Environmental Epidemiology

The primary educational objective of the practicum experience at OEE is to offer resident trainees an opportunity to actively participate in public health investigations of occupational and environmental health hazards that have statewide impact. 

Secondary objectives include understanding occupational and environmental health statutes and regulations, and understanding the legal and ethical constraints when mediating between legitimate citizen health concerns vs. industry/economic interests. 

During their rotation with OEE, residents: 

  • are involved in longitudinal activities or block rotations. Objectives include understanding occupational and environmental health statutes and regulations, and understanding the legal and ethical constraints when mediating between legitimate citizen health concerns vs. industry/economic interests 
  • are involved in the initial assessment of a health hazard, planning and conducting an investigation, and preparing recommendations for action by the state health department 
  • have an opportunity for hands-on training in environmental monitoring techniques and interpretation of data generated from sampling results 

Additional opportunities include designing epidemiologic studies and interpretation of occupational disease surveillance data. Resident projects include a written report that is reviewed by the onsite preceptor and Duke faculty. Some studies may lead to publication. 

  • Resident health hazard evaluations have included: 
  • Evaluation of health risks to community residents living near a hazardous waste incinerator 
  • Health risks to community residents living near a polyurethane manufacturing plant 
  • Health of watermen living on the North Carolina coast exposed to pfiesteria 
  • Investigation of a cancer cluster in a wood-working plant 
  • Developing a preventive education program for workers at risk for heat exposure in agriculture  
  • Evaluation of teachers complaining of multiple chemical sensitivities that developed after exposure to sewer gas in a day care facility 

The Office of Occupational Medicine and Nursing (OOMN) in OSHA serves as an instructional site for current resident physicians who are receiving training in occupational and environmental medicine, general preventive medicine, and aerospace medicine. At any time throughout the year, OOMN may host up to four resident physicians for an eight week training rotation. Future occupational and preventive medicine leaders have the opportunity to fully participate in OOMN activities and will also receive an organized series of lectures and presentations on the clinical and administrative aspects of occupational medicine.

About the Preceptor

John Cromer, MD, MS, MSPH, is medical director of Occupational Health Services in Wilmington, NC. He holds a certification in preventive medicine/occupational medicine, and has interests in hospital occupational health and corporate consulting. Formerly a full-time faculty member at Duke OEM, Dr. Cromer directs this busy community-based occupational health service in Wilmington, NC, and serves as the resident preceptor. 

About Occupational Health Services

The OEM team consists of Dr. Cromer and a physician assistant, as well as four nurses, an x-ray technician, an occupational health nurse, and a physical therapist. 

Residents see patients for medical surveillance and injury care in the clinic as well as at onsite industrial clinics. Most of their time, however, is spent in addressing work-related concerns through site visits in association with company safety and industrial hygiene personnel. A detailed written evaluation of safety and health concerns and recommendations for changes for each site visit is required by the end of the rotation. 

Work site opportunities include General Electric Aerospace division plant that manufactures aircraft engines and nuclear reactor components, Corning Glass (manufacturing fiberoptic cables), American Crane (manufacturing and welding steel products), Interroll (manufacturing bearings and rollers), Bulk Lift (manufacturing bag house materials), Siemens (manufacturing circuit breakers), City of Wilmington (serving police, fire fighters, waste workers, etc.) and many other local industries.