Why aren’t Medical Students Learning about Climate Change?
Originally published in the Sudbury Star on June 26, 2021 as "Climate change a health issue; medical students should be learning it" https://www.thesudburystar.com/opinion/columnists/climate-change-a-health-issue-med-students-should-be-learning-it?
Fifteen months ago, when COVID-19 brought down the curtains on Broadway, on air travel, on eating out in restaurants, on getting together with family and friends, and even on being present with loved ones who were dying, everything changed. Suddenly, we were forced to see all of life through the lens of a brutal and unrelenting virus, and to reckon with the consequences of our lack of preparation. Most of us understood that an unprecedented threat required an abundance of caution, and accepted the limits placed on our lives.
First year medical students took their classes on-line. No doubt, like generations before them, they learned about the influenza virus and its proclivity for genetic drifts and shifts. Drifts cause year-to-year variations in severity. Shifts can cause deadly global outbreaks, like the Spanish flu pandemic of 1918-19. No doubt it was all very real and relevant, given these COVID times.
On the whole though, pandemics don’t get much attention in med school, at least until one strikes. Then suddenly the topic becomes inescapable, infiltrating every nook and cranny of the curriculum.
Back in 2015, then-US President Obama convened a meeting at the White House to discuss how to squeeze coverage of what is arguably the 21st century’s most pervasive health issue into the curriculums of US medical and nursing schools. Presumably he thought it would be important for emerging health professionals to be educated about the dire health implications of climate change, the complicity of the American health care system (which produces 8-10 percent of US greenhouse gas emissions), and the tremendous health co-benefits of a rapid transition to clean, sustainable energy.
However, unlike the novel coronavirus, which quickly acquired its rightful place in medical education by dint of its obvious urgency and immediacy, climate change, and all the other planetary derangements that term has come to stand in for, have yet to be accorded more than token recognition within the curriculums of most medical schools in Canada. Somehow, our dangerous interference with the planet’s life support systems has not inspired the needed sense of urgency.
The teaching session I’ve personally started offering to 4th year medical students during their pediatric rotation is not actually part of the pediatric curriculum. It exists only because I’m willing and insistent. That isn’t how things should be. After all, our pediatric patients have by far the most at stake; they have many decades ahead of them on this planet. Their physical and mental health are already being impacted by the state of the planet, and unless things change drastically, their lives will increasingly be defined by dangerous global heating, melting ice and permafrost, sea level rise, unprecedented fires, droughts, and storms, acidified and deadened oceans, and the sixth great extinction of species.
You might think that teaching about the impact of planetary derangement on human health would have become an integral part of medical school curriculums by now. It’s not brand new knowledge, by any means. But there are obstacles. That seeming lack of “urgency”, for one thing. And lack of time. And a certain lack of expertise about the issue amongst those who teach.
Ironically, much of the impetus for change is coming from medical learners themselves. Several years ago, the Canadian Federation of Medical Students formed a subgroup called HEART, which conducted a national evaluation of medical school teaching about planetary health in 2019. Not surprisingly, they identified “clear opportunities” for improvement. They’ve also created an evidence-based set of “core competencies”, which provide a framework for developing curricula within medical schools nation-wide. We can only hope their efforts are taken seriously by those whose job it is to ensure that medical education remains accountable to the current and future needs of society. Afterall, neither societies nor people can remain healthy on a sick planet.
Sources:
Hackett F et al. Training Canadian doctors for the health challenges of climate change. The Lancet/Planetary Vol. 4, January 2020
https://blogs.bmj.com/bmj/2019/09/26/climate-change-is-impacting-population-health-and-our-future-patients-remaining-silent-is-not-an-option/
Xie E et al. Students help shape medical education to keep up with the times. CMAJ 2018; 190:E1486. doi: 10:1503/cmaj.70816
Wellbery C et al. It’s time for medical schools to introduce climate change into their curricula. Acad. Med.2018 December; 93(12):1774-1777.
And many more available on request.