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

'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

The climate crisis and clinical practice

Read Now

Harvard and NEJM to tackle the clinical impacts of climate change in Boston, Australia and across the U.S.

Six health systems across the U.S. and one in Australia commit to convening local providers to explore how the climate crisis impacts care delivery.

Read Now

Despite climate change threats, few medical schools teach it

Climate change poses threats to public health and concerned health care professionals call for medical schools to incorporate it into their curriculum.

Read Now

Rx for the planet's fever

A physician makes a call to action to his colleagues to treat climate change as a critical health issue.

Read Now

Viewpoint: Encouraging health professionals’ civic engagement to address health impact of climate crisis

Health professionals who want to address the effects of the climate crisis on the health of people and the planet should become more civically engaged.

Read Now

Green resolutions

How you can do right by your health, your wallet, and the planet in 2020.

Read Now

A focus on news about the environment

The Australian bush fires, the politics of climate change, and sea level rise in Boston’s disadvantaged neighborhood were among the topics discussed in a new environmental news roundtable on the WGBH radio show “Under the Radar with Callie Crossley.” One of the panelists featured in the roundtable, which premiered on January 12, 2020, was pediatrician…

Read Now

A doctor's guide to health in a changing climate

Connecting health, health care, and climate change and offering actions families can take to protect their health.

Read Now

The rising health threats of a hot planet

Patients are already feeling the health effects of climate change, and physicians play an important role in providing information and advocating for policies that put less stress on the planet.

Read Now

Why physicians see climate change as a health emergency

Research Fellow Renee Salas on how climate change disrupts patient care.

Read Now