Medical Students as Agents of Change in the Climate Crisis

To the Editor: On the way to our pulmonology lecture during our first year of medical school at the University of California, San Francisco (UCSF), we walked through clouds of heavy smoke from the destructive California Camp Fire. Similar situations arose during our second and third years of medical school. Despite needing to don N95 masks to walk to class, there was no mention of the health effects of wildfire smoke in our curriculum. The intensifying climate crisis has a multitude of negative health effects on the human body, and through its carbon emissions and waste generation, the health care sector adds fuel to the fire. 1 Given these connections, why are medical students around the world not receiving climate and health education during medical school? Education on the impact of the climate crisis on individuals and systems can prepare future physicians to diagnose, treat, and prevent the growing health effects of climate change, such as wildfire smoke-related asthma exacerbations and heat strokes. Furthermore, integrating climate and health education into the curriculum can shape the developing professional identity of medical students, instilling in them an ethical commitment to improving planetary health through research, advocacy, and community outreach. Climate and health education prepares medical students to become agents of change who can develop environmental solutions that provide public health co-benefits. But how can medical schools integrate climate and health education into the curriculum and support student-driven climate action? To address this daunting question, several students, including one of the authors (K.H.), founded the Planetary Health Report Card (https://phreportcard.org/), a student-led initiative to inspire planetary health engagement. The report card consists of metrics in 5 categories: curriculum, research, community engagement, support for student initiatives, and sustainability. Since 2019, the report card has transformed into an international project spanning 62 medical schools in 4 countries. Medical students around the world have used the report card to evaluate gaps in education and outreach, advocate for institutional changes, and network across institutions, indirectly and directly kindling change. At UCSF, we used the report card and student surveys to demonstrate a need and desire for climate and health education content in the preclinical curriculum. To address the gaps identified, one of the authors (A.M.N.) worked with lecturers to develop evidence-based learning objectives and lecture materials. Moving forward, we aim to continue implementing this kind of material throughout UCSF’s curriculum with content spanning lectures, assessments, quality improvement projects, and clerkships. Every future physician will treat patients affected by climate change, and we, alongside medical students around the world, are leading the charge to make sure they are prepared to do so. Acknowledgments: The authors wish to thank the powerful international community of medical students advocating for climate action.