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Letters to the Editor

In Reply

Wellbery, Caroline MD

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doi: 10.1097/ACM.0000000000002876
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In Reply to Saltzman:

I thank Saltzman for her letter, which coincides with the recent joint declaration representing 77 health organizations stating that climate change is a health emergency.1 While this collaborative launch is focused on climate policy, medical students and medical educators can contribute to the campaign by ramping up climate change and environmental health education.

Medical student demand is a strong driver of curricular content.2 Among the most powerful actions students can take are meeting with the course directors of their preclinical and clinical courses and asking them to incorporate specific environmental content. Students can also speak with their dean and address their institutions’ committees on medical education to show how to link environmental content to core competencies.3 Students can refer to journal articles that outline a spiral integration of content on sustainable health linked to learning domains and objectives.4

Students can explain to their academic leaders how content focused on the environmental impact on health is increasingly taking root in medical school curricula. The Icahn School of Medicine at Mt. Sinai is developing a Climate Change Curriculum Infusion Project, which proposes to integrate climate-relevant exegesis into traditional course content. The University of Minnesota has a multidisciplinary course addressing the health impacts of climate change—a slide deck is available for educational purposes.5 The University of Colorado Department of Emergency Medicine offers a Climate and Health elective. The University of California, San Francisco has introduced a 2-week course focused on the question, “What should physicians know and do about climate change, sustainability, and health?” Other collaborative and top-down efforts at institutions involve the development of sustainable health-focused exam questions that will drive student commitment to learning about these topics.

As environmental changes become more pressing, patients will turn to the doctors they trust and ask for guidance. Institutions should heed the climate change health emergency and equip medical students to provide answers.


1. Climate Health Action. U.S. call to action on climate, health, and equity: A policy action agenda. Accessed June 28, 2019.
2. Tun S. Fulfilling a new obligation: Teaching and learning of sustainable healthcare in the medical education curriculum [published online ahead of print June 25, 2019]. Med Teach. doi:10.1080/0142159X.2019.1623870
3. Canadian Federation of Medical Students. Health and environment adaptive response task force. Accessed June 28, 2019.
4. Walpole SC, Vyas A, Maxwell J, et al. Building an environmentally accountable medical curriculum through international collaboration. Med Teach. 2017;39(10):1040–1050.
5. University of Minnesota. Climate change and health. Accessed June 28, 2019.
Copyright © 2019 by the Association of American Medical Colleges