Medical schools must prepare students to work in a world altered by climate change

Posted On: March 21st, 2019


The following excerpt was taken from an article by Anna Goshua, a first year medical student at Stanford University School of Medicine, published March 19, 2019 in STAT. Read the full article here.

“Medical schools already have what some see as overloaded curricula. It is difficult to argue that they should add more material. Yet the medical curriculum lends itself to promoting eco-medical literacy and sustainability over all four years of education.During the preclinical years, this could take the form of connecting pathophysiology to climate, such as how climate change contributes to cardiovascular disease. A health policy course could be an opportunity to discuss relevant climate change policy action and opportunities for student engagement. During clerkships, the focus could be on how to identify and communicate with patients who are especially vulnerable to the effects of climate change, as well as diagnose and manage climate-related physical and mental health issues.

There are at least three major ways that climate change will affect the practice of medicine and for which medical education must prepare future physicians.

First, climate change will directly and indirectly affect individual and population health. Extreme weather events like drought affect physical and mental health, but also affect social determinants of health such as water and food security, air quality, and housing. Given that marginalized communities are most susceptible to the effects of climate change, it will widen existing health disparities. Physicians will need to work with patients to manage climate-induced health burdens, educate them about their risk factors, and help them develop contingency plans in case of environmental emergencies.

Second, climate change will require an unprecedented degree of adaptation to unexpected and changing threats. Diseases previously thought to be unrelated to climate, like chickenpox, are turning out to be climate sensitive. The geographic distribution and seasonality of various infectious diseases will change. Extreme weather events of increasing severity will strain our capacity to deliver care. Future physicians must be prepared to handle these challenges in both the clinical setting and, more broadly, work collaboratively within their communities to plan and implement pre-emptive strategies.

Third, physicians and the rest of the health care sector must be aware of and accountable for their collective contributions to climate change. The U.S. health system is the seventh-largest producer of carbon dioxide globally. It released 614 million metric tons14 of carbon dioxide equivalents in 2013, which would generate between 123,000 and 381,000 disability-adjusted life years of adverse health effects in the future.

My generation of physicians must envision a new sustainable health system to reduce its substantial carbon footprint. Possibilities include expanding telemedicine, integrating environmental impacts into cost-benefit analyses of health services, and committing to carbon neutrality. Future physicians must also advocate for changes to health infrastructure that make health care facilities more resilient to climate damage. Without physicians lobbying for the greening of the health system, the good we accomplish could be outpaced by the damage we inflict.”