Urgent need for universities to incorporate climate education in curricula

According to the World Health Organisation, 23% of all global deaths are due to environmental factors, with an additional 250,000 climate-related deaths expected annually to 2030.

Doctors are at the coalface of dealing with the immediate and long-term consequences of climate change, from heatstroke to persistent anxiety.

Despite these risks, few medical schools, either in Australia or internationally, incorporate climate education in their curricula.

In a 2019 survey, the International Federation of Medical Students’ Associations found that only 16% of medical schools across 112 countries teach climate science.

While the climate is changing rapidly, medical faculties globally have been slow to recognise the training needs of the next generation of doctors regarding the health consequences of a heating planet.

We know that climate change increases the frequency, duration, and severity of heat waves, floods, bushfires and droughts.

Additionally, climate change exacerbates the effects of chronic health conditions, including asthma, diabetes, and heart disease, as well as increasing risks to vulnerable populations such as pregnant women, the elderly and disadvantaged communities.

Climate change also leads to food and water insecurity, reduces biodiversity, worsens air quality, and increases exposure to vector-borne and infectious diseases, including dengue fever, hendra virus, lyssavirus, Ross River virus, and buruli ulcer.

In 2022, members of the WHO-Civil Society Working Group to Advance Action on Climate Change and Health released an open letter calling on all education stakeholders (that is, universities) to ensure health professionals are prepared to identify, prevent, and respond to the health impacts of climate change and environmental degradation.

Preparing health professionals for a future impacted by climate change is the responsibility of all education stakeholders, including the deans, academics, managers and other teaching staff of health professional educational institutes, as well as the associated accrediting, examination, and licensing bodies.

At Monash Rural Health in Gippsland, we developed a board game to better-inform medical students about sustainability and climate change, introducing first-year medical students to what they may face regarding healthcare issues in the face of a climate emergency.

This simulation is based in part on the lived experience of Monash faculty and students, as well as healthcare workers practising in the Gippsland region during the prolonged 2019-20 bushfire season, and the severe floods that impacted this area in 2022 and 2023.

These events forced evacuation of our Gippsland campus, and stranded several of our clinical teachers, preventing them from reaching the hospitals and clinics where they normally practice.

Climate Disaster Response: The Game has different scenarios in which a group of medical students imagine themselves as practitioners in a rural or remote community during a high-impact climate event.

The scenarios ask students to consider how a heatwave (for example) would affect patients with existing health conditions that could be aggravated by the disaster, such as those with respiratory or heart ailments, pregnant or breastfeeding women, and elderly and very young people in the community.

The board game involves students placing themselves as junior doctors in one of seven locations, including an aged care facility, a GP clinic, a farm, a hospital, at home (self-care), a pharmacy or an emergency shelter, and thinking about the various implications of a serious flood or heat event on themselves and their patients or practice with various “chance” obstacles thrown in.

The students are highly engaged with the game, and the only negative feedback we received was that delivery near the end of the academic term meant students were unable to act on what they learned (by joining advocacy groups and spreading information in the community, for example).

“The Game”, as it is known now, has been shifted closer to the beginning of term and, anecdotally, we’ve noticed students raising climate concerns in their medical studies throughout the year, in topics ranging from physiology and pharmacology, to the social determinants of health.

This April, Melbourne will be hosting the World Health Summit Regional Meeting, where the impact of climate change on global health will be a key focus.

It’s about a decade since the first public calls for training of medical students and junior doctors in how to deal with the physical and mental health consequences of climate change – it’s time to go beyond ad-hoc solutions, and for every medical, nursing and allied health facility globally to incorporate into the curriculum dedicated consideration of this urgent and pervasive health threat.