Table 5 Educational and clinical resources in environmental medicine are lacking

Education process

IPs

Difficult education process, everyone develops in their own way.

There is no one single organization I think of as the best. And that’s why I go around to lots of different organizations and learn from all different sources.

The resources just cover fragments and they specialise in one area. I find it very hard to find one organisation who does the whole picture. You have to put the fragments together.

AFOEM training

OEPs

My college has been very slow at developing the EM side but they’re working on it, but we’re not getting there fast.

Recently-admitted fellows would not have very much training in chemical exposures, even at workplaces.

The newer fellows (OEPs) really don’t know where to submit samples to for analysis.

ACNEM training

IPs

Good introductory course.

Limited in their scope.

We need a lot more in-depth teaching.

It is probably the most comprehensive program at the moment (in Australia), but compared to what you can learn from abroad, from the States, it’s not as comprehensive.

Journals

OEP

Many of the things that come up (as an expert witness in court) require me to do quite a bit of research with Dr. Google and the online journals.

IP

I haven’t found any (journals) that are very useful. I usually do searches and just try and pick up general articles when I am researching a particular topic.

Textbooks

IPs

I’m not aware of a really good environmental health textbook. Is there one?

I’ve got toxicology textbooks but they tend to be far more involved with acute toxicity, rather than chronic, often low-level toxicity… a lot of what I think we see, is to do with the latter.

Peers

IPs

80% of what I learn, comes from a colleague emailing me, or passing on a paper from some source and then I go and read it and move on from the references there.

I went to the Australian Society of EM’s annual meeting (now disbanded). About fifty to sixty other doctors would gather and talk and get lectured to and then go out and try to apply that elsewhere. So, the education was primarily through that group.

Patients

OEPs

Now I just learn from each case that I see. I still have a long way to go. There aren’t a lot of experts in this area.

I teach general practitioners to listen much more to the patient, rather than get into your standard position of physical medicine.

IP

I have my little army of a few thousand chemically sensitive, chemically poisoned, affected people. And I’m forever getting notices and emails like: Did you see that? Here’s the biomarkers of chemical sensitivity, Here’s what organochlorines do, There’s the glyphosate paper...