Building an environmentally accountable medical curriculum through international collaboration

Abstract

Background: Global environmental change is associated with significant health threats. The medical profession can address this challenge through advocacy, health system adaptation and workforce preparedness. Stewardship of health systems with attention to their environmental impacts can contribute to mitigation of and adaptation to negative health impacts of environmental change. Medical schools have an integral role in training doctors who understand the interdependence of ecosystems and human health. Yet integrating environmental perspectives into busy medical curricula is not a simple task.

Content: At the 2016 Association for Medical Education in Europe conference, medical educators, students and clinicians from six continents discussed these challenges in a participatory workshop. Here we reflect on emerging themes from the workshop and how to plan for curricular change. Firstly, we outline recent developments in environmental health and associated medical education. Secondly, we reflect on our process and outcomes during this innovative approach to international collaboration. Thirdly, we present learning objectives which cover core content for environmentally accountable medical curricula, developed through a reflective process of international collaboration integrating current literature and the workshop outcomes.

Conclusions: International collaboration can bring together diverse perspectives and provide critical insights for the inclusion of environmental health into basic education for medical practitioners.

Acknowledgements

The authors would like to thank the following for their valuable contributions to this paper’s findings: David Pearson, Eleanor Dow, Heather Baid, Andrew Punton and non-author participants in the AMEE 2016 workshop.

Disclosure statement

AV and SW are members of the Sustainable Healthcare Education network core working group, but have no financial or other non-financial conflict of interest. All other authors declare no conflict of interest and ICJME forms are available on request from the corresponding author.

Glossary

Eco-health: The field of study which examines the impact of changes in biological, physical, social and economic environments on human health. Through a transdisciplinary approach, eco-health aims to study and understand how ecosystem changes impact human health and propose solutions to reduce or reverse the negative health effects of such changes (Wilcox 2004).

Eco-health literacy: A patient’s ability to gain access to, understand and use environmental health information to improve their health (adapted from Bell 2010).

Eco-medical literacy: A doctor’s ability to gain access to, understand, and use information to improve environmental health and sustainable healthcare (adapted from Bell 2010).

Sustainable healthcare education: “Teaching and learning which prepares future health professionals to promote sustainable health and deliver sustainable healthcare” (Walpole and Mortimer 2017).

Walpole SC, Mortimer F. Forthcoming 2017. Evaluation of a collaborative project to develop sustainable healthcare education in eight UK medical schools. Public Health. doi: 10.1016/j.puhe.2017.05.014

Notes on contributors

Sarah Catherine Walpole, BSc, MBChB, MRCP, MSc (Res), is an Honorary Lecturer, Hull York Medical School, UK and currently working as edical doctor for Medecins sans Frontiers, in the Democratic Republic of Congo.

Aditya Vyas, MBBS, MPH, is a Lecturer in Public Health, Norwich Medical School, University of East Anglia, UK

Janie Maxwell, MBBS, BMedSci, DRANZCOG, FRACGP, is a General Practitioner, Associate Lecturer, The Nossal Institute for Global Health, The University of Melbourne, Australia

Ben J. Canny, BMedSc, MBBS, PhD, is Head of School, School of Medicine, University of Tasmania, Australia

Robert Woollard, MD, CCFP, FCFP, LM, is a Professor, Department of Family Practice, Faculty of Medicine, University of British Columbia, Canada

Caroline Wellbery, MD, PhD, is a Professor, Department of Family Medicine, Georgetown University Medical Center, USA

Kathleen E Leedham-Green, MBBS, BSc, PG Cert APHE, C DipMed Ed, AF HEA, is a Teaching Fellow, Department of Primary Care & Public Health Sciences, King’s College London, UK

Peter Musaeus, MSc, PhD, is an Associate Professor, Center for Health Sciences Education, Aarhus University, Denmark

Uzma Tufail-Hanif, MRes, PhD, is Master of Surgery degree Programme Co-ordinator, University of Edinburgh, UK

Karina Pavão Patrício, MD, PhD, is a Professor, Public Health Department, Medical School of Botucatu, Universidade Estadual Paulista (UNESP), Brazil

Hanna-Andrea Rother, BA, MA, PhD, is an Associate Professor and Head of Environmental Health Division, School of Public Health and Family Medicine, University of Cape Town, South Africa