• Worsening air quality and warmer, stormier weather in the Great Lakes region caused by climate change are threatening human health
• Michigan medical students are pushing for curriculum changes to address these health threats
• As a result, more medical schools are teaching future doctors about climate change

Climate change is no longer a “backburner” issue for medical students like Sierra Silverwood. It’s essential to understanding human health when new and greater health threats are emerging because of climate change.

But integrating climate topics into an already “packed medical education” isn’t easy, said Michigan State University fourth-year medical student Silverwood.

Despite the challenge, future doctors across Michigan and the nation are taking their education into their own hands — creating climate health curricula and calling on faculty to integrate the material into their programs.

“We’re starting to see how (climate change) impacts our patient care,” said Silverwood. “I think that’s really gotten individuals inspired to take action.”

‘The face of the climate crisis’

This story is part of a series by the Great Lakes News Collaborative that connects the region’s changing climate and abundant water to human health.

The collaborative’s five newsrooms — Bridge Michigan, Michigan Public, Circle of Blue, Great Lakes Now and the Narwhal — are funded by the Charles Stewart Mott Foundation.

The urgency of climate health education for medical students is more apparent than ever with a dangerous heat wave hitting the Midwest this week.

Climate change is making these extreme heat waves hotter and more frequent.

In the Great Lakes region, average annual temperatures increased 2.3 degrees Fahrenheit since 1951 and are expected to rise several more degrees this century.

Along with extreme heat, flooding, wildfire smoke, air pollution and vector-borne diseases like Lyme disease are sending people to hospitals, sometimes killing people.

A 2019 study by U-M researchers estimated that the number of emergency room visits in Michigan caused by extreme precipitation may increase to 220 per year by 2070 from 170 historically. Deaths from extreme heat may increase to 240 from 33 per year in the same period.

“Health is the face of the climate crisis,” said Dr. Lisa DelBuono, founder and president of Michigan Clinicians for Climate Action, which is why doctors need to be trained to recognize climate threats to better treat their patients.

But practicing doctors may be hesitant to acknowledge the environmental factors causing their patients to get sick because climate change was highly politicized — or maybe not talked about at all — while they were in medical school, said DelBuono.

A recently retired diagnostic pathologist herself, DelBuono understands these doctors’ concerns but thinks the health threats are too big to ignore.

“If they’re not prepared for what’s coming down the pike, then they’re not going to be able to do their job,” she said.

Current medical students are facing this reality, which is why they’re pushing for the integration of climate health topics in their curriculum.

Preparing for a changing future

Efforts on the campus of the University of Michigan and Michigan State University are examples of how that can work.

Medical students at University of Michigan took action in 2019, forming White Coats for Planetary Health (WCPH), a group of 12 to 15 medical students pushing for increased education about climate health in their curriculum.

In 2022, the group successfully created a health and climate-change elective for third and fourth-year medical students.

The elective prepares students to recognize environmental impacts on health, such as how air pollution affects lung health and the relationship between extreme rainfall and water-related illnesses such as E. coli infections.

Medical student Andrea McGowan, co-chair of education and curriculum for White Coats for Planetary Health, said the course is “pretty popular among students,” even though it’s not required.

“Med students like to be prepared,” said McGowan, “and a lot of students are starting to recognize that (climate change) might impact what they see in the clinic.”

U-M professor and WCPH mentor Alexander Rabin told students about the dozens of patients he saw last summer with breathing problems because of wildfire smoke.

Seeing and hearing about those impacts is motivating students to advocate for change, said Rabin.

Rabin got involved in climate advocacy when he was a medical student in 2018, and said students are “the lifeblood” of climate health advocacy.

“They’re politically engaged, and they’re worried about their future,” he said.

What’s next for student advocacy

Students are continuing to advocate for climate health education at their schools.

U-M students earned a big win with the inclusion of the climate health elective, but they aren’t stopping there.

Medical student McGowan said the next step for WCPH is to fully integrate climate health into the existing four-year curriculum.

For example, during a class about cardiovascular health and heart disease, students might watch a video lesson about how extreme heat can affect patients with existing heart conditions.

WCPH students are teaming up with faculty across the country to create such educational videos in partnership with Climate Resources for Health Education (CRHE), a global professional-led climate health initiative.

With summer break in full swing, McGowan said she’s not sure when the videos will be done, but the completed videos will be free and available on CRHE’s website.

Other medical schools in the region are also working towards integrating climate health into their curriculum.

MSU College of Human Medicine is close to adding a climate change course to its program, said Silverwood, who is working with the MSU curriculum committee to cement the change.

Silverwood said the course would be a required introduction to climate change. From there, students can pursue research about climate health topics that interest them, like climate impacts on cancer or environmental justice.

Without specialized climate health courses at MSU, students will likely have to search for educational material about topics of interest from outside organizations.

CRHE is one such resource. Along with new climate health video material, the initiative provides 44 courses complete with learning objectives, slide decks and facilitator guides.

CRHE says all its resources are “evidence-based, expert-reviewed,” free and open-access.

In addition to CRHE, Medical Students for a Sustainable Future (MS4SF), a global, student-run climate health advocacy group, provides free educational resources like webinars and lectures on its website.

The group also organizes research opportunities and training programs centered on the link between climate and health, which medical students can apply for.

Silverwood is the curriculum co-chair for MS4SF. She said the students who founded the organization in 2019 were “pioneers” in climate health advocacy, and since then, MS4SF has been crucial to driving change in medical schools across the country.

Efforts to integrate climate health into medical school curricula are fairly new — much of CRHE material is only two years old. Many medical schools, like U-M and MSU, have begun reforming their curricula, but others haven’t made any progress.

In fact, the American Medical Association found that 45 percent of U.S. medical schools don’t require climate health as a topic in their courses in 2022.

Medical students wanting to propose curriculum reform at their schools can use MS4SF’s curriculum guide, which takes students through writing a letter to their curriculum committee to create syllabi for climate health courses.

Many schools still have a long way to go, but Silverwood said student efforts are only growing.

MS4SF’s regional chapters are starting to work together to push nationwide climate health education reform, said Silverwood.

“I feel like the organization is gaining a lot of momentum,” she said. “We’re excited to find new and better ways to facilitate curriculum integration for students.”