Climate Change and the Practice of Medicine: Essentials for Resident Education

Abstract

Despite calls for including content on climate change and its effect on health in curricula across the spectrum of medical education, no widely used resource exists to guide residency training programs in this effort. This lack of resources poses challenges for training program leaders seeking to incorporate evidence-based climate and health content into their curricula. Climate change increases risks of heat-related illness, infections, asthma, mental health disorders, poor perinatal outcomes, adverse experiences from trauma and displacement, and other harms. More numerous and increasingly dangerous natural disasters caused by climate change impair delivery of care by disrupting supply chains and compromising power supplies. Graduating trainees face a knowledge gap in understanding, managing, and mitigating these many-faceted consequences of climate change, which—expected to intensify in coming decades—will influence both the health of their patients and the health care they deliver. In this article, the authors propose a framework of climate change and health educational content for residents, including how climate change (1) harms health, (2) necessitates adaptation in clinical practice, and (3) undermines health care delivery. The authors propose not only learning objectives linked to the Accreditation Council for Graduate Medical Education core competencies for resident education but also learning formats and assessment strategies in each content area. They also present opportunities for implementation of climate and health education in residency training programs. Including this content in residency education will better prepare doctors to deliver anticipatory guidance to at-risk patients, manage those experiencing climate-related health effects, and reduce care disruptions during climate-driven extreme weather events.

Developing and implementing core competencies in children’s environmental health for students, trainees and healthcare providers: a narrative review

“…Pediatricians can play an important role as protectors of the health and safety of children, and as advocates for changes that address both the mitigation and adaptation to climate change [ 17 , 53 , 54 ] . Climate change has been highlighted as an important topic for medical school and residency curricula [ 55 – 57 ].…”

“…However, by introducing key EH topics in a more substantial way during pre-clinical and clinical years for trainees, and through continuing education for practitioners, healthcare providers could become better prepared to address parent and patient concerns, access EH resources, address exposures, and provide anticipatory guidance on EH. Given the climate crisis, and its multiple effects particularly on children, it is imperative for institutions training health professionals to increase their educational initiatives related to climate change [ 55 , 57 , 62 ] The following are some examples of existing strategies for integrating EH that can increase foundational knowledge, enhance clinical skills, and address community health concerns. Preclinical foundational coursework: Integrate EH topics into relevant existing curriculum sessions and associated assessment (e.g.…”

The medical response to climate change

“…The CDC response to antibiotic and antifungal resistance in the environment Dawn Sievert, 1, * Amy Kirby, 2…”

“…The environment (e.g., water, soil) can be a major reservoir of ARGs that impact human health and is affected by land use and waste management practices that vary around the globe. 1 The environment ultimately receives runoff and waste discharge from built environments including our homes, healthcare facilities, factories, public and private buildings and institutions, the runoff from stormwater and from animal and plant production, and the excrement from all wildlife it supports. This important role for the environment was highlighted in the November 2019 Centers for Disease Control and Prevention (CDC) second Antibiotic Resistance Threats in the United States report (AR Threats Report).…”

Severe Acute Respiratory Syndrome Coronavirus Disease 2019: More Safety at the Expense of More Medical Waste

“…Sustainability in health care, both mitigating environmental emissions and adapting to supply shortages like those seen during COVID-19, should be part of medical school and postgraduate curricula, as today’s students will be operating entirely in a climate-disrupted world. 39 The American Academy of Ophthalmology and the American Society of Cataract and Refractive Surgeons have joined the Medical Society Consortium for Climate and Health 40 and must continue to take steps to educate their members about safe and environmentally friendly practices to encourage more sustainable processes and products from manufacturers, and to work with policy-makers to develop safe and flexible policies that enable resource-efficient healthcare delivery. As the building industry has the LEED “green building” certification and household appliances can be labeled “EnergyStar” efficient through the US Department of Energy and the Environmental Protection Agency, ophthalmology societies and medical accrediting bodies might consider some form of “green” certification to encourage, validate, and reward a larger shift toward more sustainable practices.…”