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Perspective: Environment, Biodiversity, and the Education of the Physician of the Future

Gómez, Andrés PhD; Balsari, Satchit MD, MPH; Nusbaum, Julie MD; Heerboth, Aaron; Lemery, Jay MD

doi: 10.1097/ACM.0b013e31827bfbeb

Ours is an age of unprecedented levels of environmental alteration and biodiversity loss. Beyond the exposure to environmental hazards, conditions such as environmental degradation, biotic impoverishment, climate change, and the loss of ecosystem services create important health threats by changing the ecology of many pathogens and increasing the incidence and/or severity of certain noncommunicable conditions. They also threaten health in the future by weakening the Earth’s life support systems.

Although physicians remain one of the most often accessed and most trusted sources of information about the environment, there is currently little emphasis on educating medical professionals about these environmental issues. This lack of training reduces the ability of most physicians to be efficient science–public interfaces and makes them ineffective at contributing to address the fundamental causes of environmental problems or participate in substantive environmental policy discussions. This is an important challenge facing medical education today.

To turn medical students into effective physician–citizens, an already-overwhelmed medical school curriculum must make way for a thoughtful exploration of environmental stressors and their impacts on human health. The overarching question before medical educators is how to develop the competencies, standards, and curricula for this educational endeavor. To this end, the authors highlight some of the critical linkages between health and the environment and suggest a subset of key practical issues that need to be addressed in order to create environmental education standards for the physician of the future.

Dr. Gómez is deputy director, Wildlife Health Program, Wildlife Conservation Society, and visiting scientist, American Museum of Natural History, New York, New York.

Dr. Balsari is director, Weill Cornell Global Emergency Medicine Program, assistant professor, Weill Cornell Medical College, New York, New York; and visiting scientist, Harvard School of Public Health, Cambridge, Massachusetts.

Dr. Nusbaum is a resident physician, Emergency Medicine, New York–Presbyterian Hospital, New York, New York.

Mr. Heerboth is an MD candidate, Weill Cornell Medical College, New York, New York.

Dr. Lemery is assistant professor of emergency medicine, University of Colorado School of Medicine, Denver, Colorado; visiting scientist, Harvard School of Public Health, Cambridge, Massachusetts; and president, Wilderness Medical Society, Salt Lake City, Utah.

Correspondence should be addressed to Dr. Lemery, University of Colorado School of Medicine, Department of Emergency Medicine, Leprino Building, B21, 12401 E. 17th Ave., Aurora, CO 80045; telephone: (917) 861-0272; e-mail:

© 2013 Association of American Medical Colleges