Discussions about climate change, “the single biggest health threat facing humanity” according to the World Health Organization,1 are moving beyond the weather we see outside our windows. In 2022, the American Medical Association adopted a policy declaring “climate change a public health crisis” based on the substantial scientific evidence demonstrating its adverse effects on patients' health.2 Climate health effects include poor air quality (eg, fire particulates, ground-level ozone, allergens), extreme weather (eg, hurricanes with subsequent power interruptions, human displacements), rising temperatures (causing heat stress, poor water quality), and new vector-borne diseases.3 Worldwide, there are an estimated 5 million deaths annually attributed to climate effects, which are expected to balloon to 83 million by 2100.4 These numbers make the COVID-19 pandemic statistics—3.3 million estimated worldwide deaths up to January 2023—pale in comparison.5 The climate statistics do not include deaths in which climate change contributed to mortality, nor illnesses caused by climate change. Patients who are youngest, oldest, with chronic diseases, and historically marginalized are disproportionately experiencing climate change-related illnesses.6
Future physicians and other health professionals must be prepared for these effects, yet a search for climate change-related educational tools for graduate medical education (GME) yields few samples. The percentage of US MD-granting medical schools with required curriculum on the health effects of climate change doubled from 27% in the 2019-2020 academic year to 55% in 2021-2022.7 Undergraduate climate change curricula tends to be generic in nature and limited in quantity. For GME training programs, each specialty and subspecialty is facing different patient health care challenges, thus tailored approaches are required. For example, emergency medicine trainees may need training to handle climate-enhanced disasters while obstetrics and gynecology trainees may focus on the effects of heat, pollution, and other factors on the developing fetus and pregnant women.8 Pulmonary fellows will consider how respiratory disease patterns are changing, as well as implementing anticipatory guidance for patients using oxygen, CPAP, and nebulizers during power losses. Pediatric residents need to respond to climate-related changes in infectious disease patterns, air quality, and heat-related illnesses, which are now affecting nearly every child worldwide.9,10 Anesthesiology programs are already discussing the effects of different inhalants on the ozone layer (Table).11
New educational tools to prepare physicians for future climate-related health problems are urgently needed. How can these new materials—including curricula, resources, experiences, and assessments—be integrated into currently overfull GME programs? How can faculty quickly develop, teach, and evaluate this content? Many would argue that, as the most powerful factor influencing patients' health for the next half-century, actions in response to climate change may be one of the most powerful health promotion interventions in the physician's toolbox. Thus, we must ensure future physicians are prepared to anticipate, react to, and treat climate-related health problems in their patients.
As a result of this gap in trainee education, the JGME Editorial Board is issuing a call for articles, in ALL categories, for a JGME supplement issue on climate change and GME, to be published in 2024. This initiative will be led by JGME and guest editors, with a peer-review process. The goal of this supplement is to provide tools for GME programs located throughout the world in the areas of curriculum, resources, assessments, and faculty development. Where there are gaps, articles providing specific research directions, for enhancing our understanding of the intersections of patients, trainees, training programs, and those marginalized or underserved by health care, are strongly encouraged.
When submitting articles for the JGME climate supplement, please indicate the educational topic areas (eg, curriculum, resources, assessments, faculty development, other) in your cover letter. We look forward greatly to seeing your work on this urgent, vital topic. Please contact email@example.com with any questions.