The Medical Education Planetary Health Journey: Advancing the Agenda in the Health Professions Requires Eco-Ethical Leadership and Inclusive Collaboration

Abstract

Climate change and the declining state of the planet’s ecosystems, due mainly to a global resource-driven economy and the consumptive lifestyles of the wealthy, are impacting the health and well-being of all Earth’s inhabitants. Although ‘planetary health’ was coined in 1980, it was only in the early 2000s that a call came for a paradigm shift in medical education to include the impact of ecosystem destabilization and the increasing prevalence of vector-borne diseases. The medical education response was, however, slow, with the sustainable healthcare and climate change educational agenda driven by passionate academics and clinicians. In response, from about 2016, medical students have taken action, developing much-needed learning outcomes, resources, policies, frameworks, and an institutional audit tool. While the initial medical education focus was climate change and sustainable healthcare, more recently, with wider collaboration and engagement (Indigenous voices, students, other health professions, community), there is now planetary health momentum. This chronological account of the evolution of planetary health in medical education draws on the extant literature and our (an academic, students, and recent graduates) personal experiences and interactions. Advancing this urgent educational agenda, however, requires universities to support inclusive transdisciplinary collaboration among academics, students and communities, many of whom are already champions and eco-ethical leaders, to ensure a just and sustainable future for all of Earth’s inhabitants.

Planetary health: a new standard for medical education

“…We can no longer ignore the broader planetary context that influences the pathogenesis of disease and its prevention and management. 14,15 We must also acknowledge that health care is contributing to the problem. Health care contributes about 7% of Australia's carbon footprint and generates enormous waste.…”

“…Beyond their intrinsic importance and value in culturally safe practice, the Aboriginal and Torres Strait Islander and Māori knowledges of wellbeing and health care recognised in the standards can also contribute to the realisation of more sustainable and holistic practices. 12,15,18 The revised National Framework, scheduled for implementation in 2024, will inform how Prevocational Training Accreditation Authorities (PTAAs) accredit hospitals and other health services training doctors in their first two years of practice. 1 The AMC in turn accredits the PTAAs using the National Framework.…”

“…Barriers include the demand for content inclusion in already full curricula, and lack of familiarity among educators. 14,15,22 However, educators are experienced in adapting to the continuously evolving medical landscape. Integrated approaches can reduce pressure on curriculum content, 14 and resources are increasingly available to aid this transition.…”

“…Integrated approaches can reduce pressure on curriculum content, 14 and resources are increasingly available to aid this transition. 15,24 The International Association for Health Professions Education consensus statement on planetary health and education for sustainable health care provides model learning outcomes, objectives, domains, Perspectives activities and assessment approaches. 28 Welton and colleagues share their experience longitudinally implementing planetary health in Brown University's competency-based medical curriculum.…”

“…It is time to reorientate the training and practice of medicine to engage with these challenges. We can no longer ignore the broader planetary context that influences the pathogenesis of disease and its prevention and management 14,15 . We must also acknowledge that health care is contributing to the problem.…”