OBJECTIVES: Identify relevant gaps and suggest modifications to OEM Graduate Medical Education to increase knowledge about potential climate change impacts, teach practical skills, and promote relevant actions to protect workers. METHODS: ACOEM competencies were aligned to the Global Consortium on Climate and Health Education (GCCHE) physician competencies. ACGME OEM milestones were re-examined using a milestone curricular guide based on the peer-reviewed GCCHE competencies. RESULTS: Climate-change related OEM knowledge and skills are proposed for each OEM core competency domain. Nine residency milestones mapped to the ten ACOEM core competencies are highlighted by incorporating a climate-related activity along with a call to action. CONCLUSION: OEM training already provides more climate-relevant content than other specialties. Nonetheless, OEM residents need more climate change education to help employers, workers, and their communities to anticipate, mitigate, and adapt to climate change.