Building Climate Change into Medical Education: A Society of General Internal Medicine Position Statement

Arnab K. Ghosh, Division of General Internal Medicine, Department of Medicine, Weill Cornell Medicine, 420 E 70th St, New York, NY, 10065, USA. ad.elysium@gmail.com.
Alexander Azan, Division of General Internal Medicine, Department of Medicine, NYU Grossman School of Medicine, 550 1ST Ave, New York, NY, 10016, USA.
Gaurab Basu, Department of Medicine, Cambridge Health Alliance, Harvard Medical School, 1493 Cambridge Street25 Shattuck Street, CambridgeBoston, MAMA, 0213902115, USA.
Joanna Bernstein, Department of Medicine, Medical College of Wisconsin, 8701 W Watertown Plank Rd, Milwaukee, WI, 53226, USA.
Elizabeth Gillespie, School of Medicine, University of Colorado Anschutz Medical Campus, Leprino Building, 4th Floor, 12401 East 17th Avenue, Aurora, CO, 80045, USA.
Lesley B. Gordon, Department of Medicine, Maine Medical Center, 22 Bramhall St, Portland, ME, 04102, USA.
Sudarshan Krishnamurthy, Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, 27101, USA.
Darlene LeFrancois, Division of General Internal Medicine, Department of Medicine, Montefiore Medical Center, 111 East 210th St, Bronx, NY, 10467, USA.

Abstract

Building expertise in climate and planetary health among healthcare professionals cannot come with greater urgency as the threats from climate change become increasingly apparent. Current and future healthcare professionals-particularly internists-will increasingly need to understand the interconnectedness of natural systems and human health to better serve their patients longitudinally. Despite this, few national medical societies and accreditation bodies espouse frameworks for climate change and planetary health-related education at the undergraduate (UME), graduate (GME), and continuing (CME) medical education level. As a community of medical educators with an enduring interest in climate change and planetary health, the Society of General Internal Medicine (SGIM) recognizes the need to explicitly define structured educational opportunities and core competencies in both UME and GME as well as pathways for faculty development. In this position statement, we build from the related SGIM Climate and Health position statement, and review and synthesize existing position statements made by US-based medical societies and accreditation bodies that focus on climate change and planetary health-related medical education, identify gaps using Bloom's Hierarchy, and provide recommendations on behalf of SGIM regarding the development of climate and planetary health curricula development. Identified gaps include (1) limited systematic approach to climate and planetary health medical education at all levels; (2) minimal emphasis on learner-driven approaches; (3) limited focus on physician and learner well-being; and (4) limited role for health equity and climate justice. Recommendations include a call to relevant accreditation bodies to explicitly include climate change and planetary health as a competency, extend the structural competency framework to climate change and planetary health to build climate justice, proactively include learners in curricular development and teaching, and ensure resources and support to design and implement climate and planetary health-focused education that includes well-being and resiliency.