Photo by: Flickr user eu_echo

The first residency curriculum to better prepare doctors for climate change

09/09/2020 | Harvard Chan C-CHANGE

Curriculum, linked to ACGME core competencies, teaches residents how climate change affects health, clinical care, and health care delivery

BOSTON, Mass. – A new paper proposes the first curriculum framework for teaching medical residents how climate change harms health, requires physicians to adapt their clinical practice, and undermines health care delivery. The paper by physicians from Harvard Medical School, Emory University School of Medicine, Icahn School of Medicine, Washington University School of Medicine, University of Illinois, and University of Colorado School of Medicine was published today in Academic Medicine.

While the American Medical Association publicly supports including climate change and health in medical education, no peer-reviewed, published resource has been available to guide residency training programs in teaching this content until now. This paper is the first to link learning objectives, learning formats, and assessment strategies to the core competencies set by the Accreditation Council for Graduate Medical Education (ACGME), the organization responsible for accrediting all graduate medical training programs in the United States.

“When Hurricane Maria wiped out an IV bag factory in Puerto Rico, I was forced to ration IV fluids that are a foundation of medical care. The next generation of doctors needs to be ready for a world where climate change makes practicing medicine more difficult,” said senior author Dr. Aaron Bernstein, Interim Director of the Center for Climate, Health, and the Global Environment at Harvard T.H. Chan School of Public Health (Harvard Chan C-CHANGE). “Receiving training on climate change during residency is essential for future physicians to safeguard the health of their patients, explain the health implications of climate change and advocate for policies that protect people and avoid worsening health inequities.”

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. Additionally, increasingly dangerous natural disasters worsened by climate change impair delivery of care by disrupting medical supply chains and compromising power supplies.

“In Atlanta, we are already experiencing more extremely hot days where the air quality is so bad that it is unsafe for our children to play outside and where our doctors are seeing more kids needing emergency care because of asthma attacks,” said lead author Dr. Rebecca Philipsborn, Assistant Professor of Pediatrics at Emory University School of Medicine. “This curriculum will teach residents how climate change is worsening common illnesses and creating new and emerging threats so they can better care for their communities.”

Residents in all specialties require basic knowledge of the health impacts of climate change to
care for patients amid the ongoing climate crisis. For example, residents in:

  • Emergency medicine benefit from more training in disaster response.
  • Internal medicine, family medicine, and pediatrics can tailor guidance to protect patients from climate-related health threats, such as how medications and activities (like sports and outdoor occupations) may increase the risk of heat illness.
  • Direct patient care will face climate-related mental health concerns from disorders stemming from disruption of life and livelihoods, displacement, disasters, and heat exposure.

The American Medical Association (AMA) passed a resolution in June 2019 supporting the inclusion of climate change and health in medical education at undergraduate, graduate, and continuing medical education levels. More than 70 healthcare organizations, including the AMA, American College of Physicians, American College of Emergency Physicians, American Academy of Pediatrics, and Physicians for Social Responsibility, have declared climate change a health emergency and called for greater engagement of the health sector in climate action.

About Harvard Chan C-CHANGE

The Center for Climate, Health, and the Global Environment at the Harvard T. H. Chan School of Public Health (Harvard Chan C-CHANGE) increases public awareness of the health impacts of climate change and uses science to make it personal, actionable, and urgent. Led by Dr. Aaron Bernstein, the Center leverages Harvard’s cutting-edge research to inform policies, technologies, and products that reduce air pollution and other causes of climate change. By making climate change personal, highlighting solutions, and emphasizing the important role we all play in driving change, Harvard Chan C-CHANGE puts health outcomes at the center of climate actions. To learn more visit https://www.hsph.harvard.edu/c-change/

Contact: Anna Miller, amiller@hsph.harvard.edu

A Pediatrician’s Guide to Climate Change-Informed Primary Care

A practical approach for connecting climate change with health during pediatric well visits.

Read Now

The medical response to climate change

Our Director Dr. Aaron Bernstein lays out five pillars for the medical response to climate change.

Read Now

Adding A Climate Lens To Health Policy In The United States

Our Yerby Fellow Dr. Renee Salas and Interim Director Dr. Aaron Bernstein outline specific recommendations for achieving climate action through health policy and decision making.

Read Now

'We Don't Have To Live This Way': Doctors Call For Climate Action

A sprawling analysis published by The Lancet focuses on public health data from 2019, and finds that heat waves, air pollution and extreme weather increasingly damage human health.

Read Now

Challenges and opportunities to sustainably scale up surgical, obstetric, and anaesthesia care globally

Strategies for the surgical, obstetric, and anaesthesia community to sustainably scale up SOA care to reduce greenhouse gas emissions and address health equity and social justice issues.

Read Now

A pathway to net zero emissions for healthcare

Dr. Renee Salas charts a path to net zero emissions for healthcare.

Read Now

The first residency curriculum to better prepare doctors for climate change

New framework can teach medical residents how climate changes affects health, clinical care, and health care delivery.

Read Now

The climate crisis and COVID-19—A major threat to the pandemic response

Strategies for local communities and states to reduce the risk of COVID-19 transmission during climate-related extreme events like heat waves, hurricanes, and wildfires.

Read Now

Climate Change and Cancer

Climate actions can make cancer treatment facilities more resilient and improve cancer outcomes.

Read Now

The climate crisis and clinical practice

Read Now

Pandemic lessons can help in fight against climate change

Climate change causes new health problems, worsens existing health problems, and affects healthcare delivery. But it is not an equal opportunity harmer.

Read Now

New climate report sparks demand for change in healthcare

Healthcare organizations, medical societies, and individual healthcare practitioners call for decarbonization and disaster preparedness to protect our health from climate change.

Read Now

In these hazy skies, a public health warning from a warming planet

Smoke from wildfires in western states decreased the air quality in Boston to levels where the public could become sick and those in sensitive groups could suffer serious health effects.

Read Now

What can doctors do about climate change?

Clinicians can screen for climate change–related health risks during appointments to ensure their patients understand the role climate change plays in their health.

Read Now

The climate crisis is making us sick. Doctors need better training to treat it.

Climate-informed clinicians can keep their patients healthier in a changing climate.

Read Now

Health as the Central Driver for Action on Climate Change

"There has never been a better time to put health at the center of action on climate change," says Dr. Renee Salas

Read Now

Climate change impacting health care to the tune of $820B a year

A new report finds the financial impact tops $820 billion in health costs each year, and it could cost all of us more in the future.

Read Now

As Climate Change Threatens Many Safety Net Clinics, Harvard Researchers Look To Houston

As climate-related illnesses only intensify due to hotter temperatures and more frequent hurricanes, researchers look for ways safety net clinics can better protect the most vulnerable.

Read Now

Doctors put a price tag on the annual health impacts of climate change. It’s $820 billion.

“Receiving care for climate-sensitive diseases can quickly add up,” says our ClimateMD leader Dr. Renee Salas.

Read Now

NO TIME TO WASTE

How Harvard Chan School researchers are taking action on climate change and fighting for a healthier, more equitable planet.

Read Now

Dr. Aaron Bernstein

Aaron Bernstein MD, MPH

Aaron examines the human health effects of global environmental changes with the aim of promoting a deeper understanding of these subjects among students, educators, policy makers, and the public.

View Profile