Abstract
BACKGROUND AND AIMS: Advancements in knowledge and technology, along with the increasing complexity of occupational health requirements, make it essential to update the educational curriculum and standards in occupational medicine. This aims to improve worker health, reduce work-related illnesses, and enhance the satisfaction of service recipients. This study was conducted to identify the current challenges in occupational medicine to support these goals in Iran. METHODS: As part of this qualitative study, the Delphi method was utilized, with 20 occupational medicine specialists participating in the first phase, followed by 14 in the second and third phases. Initially, experts answered general questions on occupational medicine challenges. A second-stage questionnaire with a Likert scale was created based on these responses. The comments were then reviewed, scored, and prioritized. RESULTS: A total of 79 challenges were identified by the experts. Among these, the following issues were considered top priorities: the inability of occupational health specialists to prescribe medications and paraclinical tests under insurance coverage; the absence of a specialized occupational health committee within health departments and health offices to play a role in policy-making, guideline development, and related activities; the lack of return-to-work examinations; the limited role of occupational health specialists in laws and guidelines as the primary authority for occupational health services. These services include return-to-work examinations, fitness-for-work evaluations, work exit examinations, case-specific assessments, and compensation determinations. CONCLUSION: According to expert opinions, addressing the challenges in occupational medicine requires revising outdated labor and health regulations to reflect modern workplace risks. This is particularly concerning for mental health and remote work. Moreover, strict enforcement mechanisms should accompany these changes. Furthermore, integrating structured training in functional capacity evaluation into medical education can enhance specialization, professional standing, and workforce productivity.