Climate change a health problem; Medical students should learn

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A doctor working on a laptop.

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Fifteen months ago, when COVID-19 changed the curtains on Broadway, on air travel, when dining in restaurants, when meeting family and friends, and even being around with dying loved ones, everything changed.

Suddenly we were forced to see all of life through the lens of a brutal and relentless virus and face the consequences of our lack of preparation. Most of us understood that an unprecedented threat required a great deal of caution and accepted the limits that were placed on our lives.

First year medical students took their courses online. No doubt, like generations before them, they learned about the influenza virus and its propensity for genetic drifts and shifts. Drifts cause fluctuations in severity from year to year. Shifts can cause deadly global outbreaks, like the 1918-19 Spanish pandemic flu. Without a doubt, everything was very real and relevant in these COVID times.

By and large, however, pandemics don’t get much attention in medical school, at least until you strike. Then suddenly the subject becomes inevitable and permeates every corner of the curriculum.

In 2015, then-President Obama convened a meeting at the White House to discuss how to incorporate arguably the most widespread health problem of the 21st century into the curriculum of US medical and nursing schools. He believed it was important to educate emerging health professionals about the devastating health effects of climate change, the complicity of the American health system (which causes 8-10 percent of U.S. greenhouse gas emissions), and the tremendous health benefits of a rapid transition to clean, sustainable energy .

However, unlike the novel coronavirus, which has quickly gained its rightful place in medical education due to its apparent urgency and immediacy, climate change and all the other planetary disruptions that this term has advocated have yet to be given more than symbolic recognition in the curricula of most medical schools in Canada. Somehow our dangerous interference in the planet’s life support systems has not created a sense of urgency.

The class that I personally began offering to fourth year medical students during their pediatric rotation is actually not part of the pediatric curriculum. It only exists because I am ready and persistent. This is not how things should be. After all, our pediatric patients are by far the most at stake; they have many decades ahead of them on this planet. Their physical and mental health is already being affected by the state of the planet, and unless things change drastically, their lives will be increasingly defined by dangerous global warming, melting ice and permafrost, rising sea levels, unprecedented fires, droughts and storms, acidic and dead oceans and the sixth great extinction of species.

One would think that teaching about the effects of planetary disturbances on human health has become an integral part of the curriculum in medical schools. It is by no means brand new knowledge. But there are obstacles. This apparent lack of “urgency” on the one hand. And lack of time. And a certain lack of expertise on the subject among teachers.

Ironically, much of the impetus for change comes from the medical community themselves. Several years ago, the Canadian Medical Students Association formed a subgroup called HEART, which conducted a 2019 national evaluation of planetary health teaching in medical schools. Unsurprisingly, they identified “clear areas for improvement”. They have also created an evidence-based set of core competencies that provide a framework for curriculum development in medical schools across the country. We can only hope that their efforts will be taken seriously by those whose job it is to ensure that medical education meets the current and future needs of society. Because on a sick planet, neither societies nor people can stay healthy.

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  • Hackett F. et al. Training Canadian doctors on the health challenges of climate change. The Lancet / Planetary Vol. January 4, 2020
  • bit.ly/3h5Qid4
  • Xie E. et al. Students help shape medical training in keeping with the times. CMAJ 2018; 190: E1486. doi: 10: 1503 / cmaj.70816
  • Wellbery C et al. It is time for medical schools to incorporate climate change into their curricula. Akad. Med. 2018 December; 93 (12): 1774-1777.

Dr. Elaine Blacklock (aka @KidsClimateDoc) is a Sudbury pediatrician and science writer. Dr. Blacklock is currently busy writing a book on climate change and our health.

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