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 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

'Like a sunburn on your lungs': how does the climate crisis impact health?

Our Co-Director Dr. Aaron Bernstein and Research Fellow Dr. Renee Salas share insight into how the climate crisis threatens public health and complicates healthcare.

Read Now

Medications can raise heat stroke risk. Are doctors prepared to respond as the planet warms?

Our Co-Director Dr. Aaron Bernstein discusses the effects of extreme heat on vulnerable populations, particularly those on medication.

Read Now

Gina McCarthy Is Fired Up About Climate Change and Public Health

Explores the links between climate change and health, including who is most vulnerable and how healthcare will be impacted by climate change.

Read Now

Climate change threatens public health and doctors’ ability to provide care

Dr. Ari Bernstein writes about how climate change compromises healthcare providers' abilities to care for their patients in this op-ed.

Read Now

How Climate Change Is Challenging American Health Care

Our Director Gina McCarthy and Research Fellow Renee Salas on the 2018 Lancet’s report on climate and health.

Read Now

Alcohol: Balancing Risks and Benefits

Moderate drinking can be healthy—but not for everyone. You must weigh the risks and benefits. –Introduction –What's Moderate Alcohol Intake? What's a Drink? –The Downside of Alcohol –Possible Health Benefits of Alcohol –Genes Play a Role –Shifting Benefits and Risks –The Bottom Line: Balancing Risks and Benefits Introduction Throughout the 10,000 or so years that…

Read Now