Doctors Call For More Training to Respond to Climate Change

A team of doctors is urging officials in charge of medical residency programs to add curriculum addressing climate change and its effects on both health and health care. The doctors made their case in a new scientific paper and created a framework for residency programs to use.

“In the west, they are figuring out how to deal with surges of ailments from air pollution from the climate fires, including asthma attacks, heart attacks, and more respiratory infections,” study co-author Aaron Bernstein, MD, MPH, the interim director of the Center for Climate, Health, and the Global Environment at the Harvard T.H. Chan School of Public Health in Massachusetts, tells Verywell. “In Fort Charles, Louisiana, they have had their hospital closed because there is no safe water to use, possibly for weeks. These are examples of how most people in health care come into contact with climate change today. We want to change that.”

In the paper published on September 8 in the journal Academic Medicine, six doctors from six states wrote that there are currently no guidelines for residency programs—postgraduate training for medical students—to address climate change, posing a challenge in training doctors.

The paper states that climate change increases health risks for a multitude of conditions, ranging from heat-related illness to mental health disorders. Meanwhile, natural disasters caused by climate change are multiplying, increasingly dangerous, and can disrupt supply chains, the authors say.

A 2019 resolution from the American Medical Association calling for schools to teach future doctors about the health impacts of climate change inspired the paper, lead study author Rebecca Philipsborn, MD, MPA, an assistant professor of pediatrics at Emory University in Georgia, tells Verywell. “We lacked resources to guide educators in this effort,” she says. “My co-authors and I hope that this framework fills that gap and supports residency programs heeding the calls to action.”

A New Framework

People who graduate from medical programs currently face a knowledge gap in understanding and treating the health consequences of climate change, the authors say. These conditions are expected to intensify in the coming decades, directly impacting the kind of health care doctors will need to deliver.

The authors created a curriculum framework in order to provide residency program leaders with guidance. They suggest that the curriculum be tailored to geography and local populations. These teachings can be incorporated in various different ways, from small group discussions to direct patient care. For example, education on wildfires and lung disease may be incorporated into primary care or pulmonary rotations.

Medical students following this framework during their residencies should leave the program with a demonstrated understanding in:

• Knowledge of climate change and its effects on health
• Climate-change related adaptations for clinical practice
• Implications of climate change for healthcare delivery

The paper also features a review on how climate change can impact health, including potential mental health issues and food insecurity in patients who are displaced due to a natural disaster. It also includes information on high-risk populations, like low-income families and the elderly.

Bernstein says that the goal is for healthcare professionals “to learn about the risks of climate change-driven extreme weather before disaster strikes so they are better prepared.”

How Climate Change Impacts Health

There are many ways climate change can impact health. The Centers for Disease Control and Prevention (CDC) states that the following can be impacted by climate change:

• Air pollution
• Allergens and pollen
• Diseases carried by vectors
• Extreme temperatures
• Floods
• Food security
• Mental health and stress-related disorders
• Waterborne and foodborne diarrheal diseases
• Wildfires

“Climate change worsens common illnesses and creates new and emerging threats—with implications for nearly every subspecialty within medicine,” Philipsborn says. “Threats are many, and range from storms and wildfires, to extreme heat itself, to worsening air quality, to changing patterns of infection.”

As a result, she says, patients can experience things like heat exhaustion, asthma attacks, infectious illnesses, and mental health concerns. 

“Studies have shown that newborns, our youngest patients who’ve contributed nothing to this problem, face a greater risk of premature birth and birth defects because of heat and air pollution, with lifelong implications for their health and well-being,” Philipsborn says.

How Climate Change Impacts Health Care

The authors say that climate change will reshape many different areas of health care.

"Physicians will have to recognize different patterns of illness and adapt our diagnoses and treatment plans,” Philipsborn says.

But climate change can also cause potential issues that most people—including healthcare providers—may not think of. “We have evidence that many commonly prescribed medications, such as those used to treat heart disease or mental health disorders, may be less safe during a heat wave,” Bernstein says. “We know that heat waves are more frequent and severe because of climate change. We don’t educate clinicians about these risks and may be putting some patients at increased risk of harm as a result.”

Climate change can also impact patients who have a severe illness. Bernstein points to one JAMA study published in 2019 that found that lung cancer patients who lived in places severely impacted by hurricanes were more likely to die of their disease because their radiation treatments were interrupted by the natural disasters.

Philipsborn also expects climate change to disrupt supply chains and create barriers for patients and staff trying to access clinics and hospitals. In more severe cases, extreme weather events may require that patients be evacuated.

Educating Doctors About Climate Change

There are a few medical schools and residencies currently incorporating climate change into their curriculum.

“Two emergency medicine programs—University of Colorado and Harvard—have climate change fellowships,” Bernstein says, noting that many medical schools, including the University of California San Francisco, Emory University, Mt. Sinai, the Cleveland Clinic Lerner College, and Stanford University, have started addressing climate change through their curriculum. “But we still have a long way to go,” Bernstein says.

Ultimately, Philipsborn says she and her co-authors hope they can help increase awareness of climate change in curriculums. “Across the country, more programs are seeking to incorporate this content,” she says. “We hope this curriculum will support their efforts.”