The role of physicians

At last year’s annual Assembly of the World Medical Association (WMA), delegates joined together in support of a climate emergency resolution. Their goal was to encourage physicians to speak up to their local governments in order to spur climate change action.

WMA president Dr. Miguel Jorge said, “Physicians have an important role in advocating for the health of citizens around the world, and we have a responsibility to demand greater action on climate change.” Jorge added that without intervention, climate change will lead to thousands of unnecessary deaths from conditions like malnutrition, malaria, heat stress, and diarrhea. 

Medical schools and climate change

Despite the fact climate change is widely recognized as a public health crisis, few medical schools have updated their coursework to address the issue. According to a survey of medical schools in 118 countries conducted by the International Federation of Medical Students’ Associations (IFMSA), just 15.0 percent of medical schools have integrated climate change into their curricula. This is a missed opportunity, says emergency room doctor and climate change researcher Dr. Renee Salas. “Climate change is truly that threat multiplier. It impacts, in my opinion, every facet of how we practice medicine,” she told Scientific American. 

Adding climate change to medical school curricula may sound like a no-brainer, but it’s not as simple as it sounds. Professor of medicine Sheri Weiser, one of the biggest advocates for incorporating climate change into medical school coursework, says, “One of the biggest barriers is competing priorities. And how to add content without taking away content.”

Unfortunately, the lack of coverage of climate change in medical school is leaving physicians without the training they need to best help their patients. In advocating for “sustainable healthcare education”, professor of medicine, and educational researcher Arianne Teherani told HuffPost, “We have to move fast to accept and apply the basic evidence that this topic impacts every single organ system, it impacts every single clinical rotation that students do.”

That more medical schools are moving in the direction of expanding climate change training is heartening. However, experts say it is still not enough. In an article published in the Journal of the American Medical Association, professor of global health and health policy Dr. Ashish Jha asserts, “Climate change is our reality. It is going to change the way we provide clinical care. For that reason, it needs to be taught in every medical school across the nation.” MarketWatch cites the variety of conditions susceptible to increased risks for climate change. These include asthma, cardiovascular disease, allergies, pregnancy complications, low birth weight, kidney strain, infectious disease and contamination, as well as depression and anxiety. 

Medical students taking matters into their own hands

Medical students are also leading a push for climate change teaching. Medical Students for a Sustainable Future leader Harleen Marwah insists, “We are the ‘Class of Climate Change’ that is going to be graduating in a health environment that already looks drastically different from what it did in the past. Thinking ahead, planning for the future, how critical climate change is to that future -- these are things that are top of mind for a lot of medical students.”  

First-year medical school student Anna Goshua joined Marwah in the push for medical schools to better prepare their students for a world altered by climate change in a recent STAT editorial. In addition to citing the three major ways climate change will affect the practice of medicine moving forward, Goshua also proposed specific ways medical schools could add climate change training over the four-year course of study without adding to the burden of their already overloaded curricula. Suggestions include connecting pathophysiology to climate during the preclinical years and incorporating climate change policy action in health policy courses. 

In an AAMC piece on the growing prominence of climate-related content in medical school curricula, Goshua says, “We’re the only ones who are going to find ourselves on the frontlines of climate change. It’s important to be able to deal with these evolving threats and meet the needs of the people that we’re going to be serving.”

While COVID-19 has taken center stage over the past six months, medical students also insist that not only are there many similarities between the pandemic and climate change, but we can and should learn from the former in order to address the latter and “flatten the curve on climate change.”

Climate change and medicine around the world

Climate change is a global problem, and medical schools around the world are doing their part. In Australia, for example, a team of experts lobbied for the inclusion of health and climate change in the education of medical students. “Health educators must prepare future doctors for the challenges ahead. Patients will present with new patterns of disease, medical practice will change as health systems move to become more environmentally sustainable and doctors will use their influence to help society to make the transition to a sustainable future. Health professionals have an important role to play in addressing climate change and medical schools must help prepare doctors for these roles,” writes professor Lynne Madden. 

Third-year medical student Georgia Behrens also helped with the preparation of a policy brief aimed at making recommendations for Australian policymakers. “There are some incredible opportunities for Australia to be a world leader in this space, and for our governments to shape a healthier future for us all,” she asserts. 

Canadian medical students have also added their voices to the call. Members of the Canadian Federation of Medical Students insisted the curriculum must change in an article in Lancet’s Planetary Health journal earlier this year. “A rapid increase in curricular content related to planetary health, including climate change, is required to equip future physicians to manage the effects of ecological change on health and health systems,” they write. 

A similar movement is underway in the UK with the Sustainable Healthcare Education network, which is made up of academics, doctors, and medical students. Lead researcher Stegi Barna says, “We need to overhaul the health care system for the 21st century to respond to many pressures, and this is one of them. As well as responding to new health risks, such as increased flooding, heatstroke and new diseases, we need to look at how the healthcare system itself contributes to climate change – and reduce its emissions.”

Medical Society Consortium on Climate and Health director Mona Sarfaty recently told the Wall Street Journal, “This is really the greatest health danger of our century. We must respond and make sure our health professionals are sufficiently educated.” The good news is that medical schools aren’t alone in answering the call; the medical students of today have shown they understand the critical nature of this issue and are ready, willing, and able to be the ones to drive the change.