The GMC has been working with medical student representatives of the Planetary Heath Report Card (PHRC) initiative – an international student advocacy group evaluating planetary health content in medical schools – to identify how planetary health, climate change and sustainability should be reflected in medical education.

Here Griffin Shiel, of the GMC’s Education Policy team, summarises the need for change, the work that GMC and PHRC have done together so far, and the next steps as we look ahead to updating our standards and outcomes.

What is Planetary Health?     

Planetary health looks at how human disruption to natural systems impacts our health and all life on Earth. It is an intentionally broad description to reflect the multitude of ways environment impacts health, with topics including climate change, natural disasters, biodiversity shifts, water scarcity, changing food systems, arable land and freshwater shortages, and pollution.

The need for change

There is a clear need to equip doctors with knowledge and skills to treat climate related health conditions as well as a demand among medical students for increased teaching in this area.

The World Health Organisation has described the climate crisis as the greatest threats to health we face. It is impacting health and wellbeing in the UK in multiple ways – the Chief Medical Officer for England’s 2022 Annual Report: Air Pollution found that between 26,000 and 38,000 deaths could be attributed to outdoor air pollution.

There are links to other adverse health effects, including respiratory diseases such as lung cancer and asthma, and cardiovascular disease. Additionally, the UK’s healthcare systems are significant drivers of climate change, contributing around 4% of the UK’s carbon footprint.

The Education for Sustainable Healthcare (ESH) curriculum – endorsed by the Medical Schools Council (MSC) and included as suggested reading by the GMC – outlines learning outcomes related to the climate crisis. However, it is unclear the level of impact it has had on what medical schools teach.

Also, a 2022 survey of medical students found that 89% of students believe more ESH is needed suggesting more needs to be done to ensure planetary health and sustainable healthcare principles are embedded in medical education.

Despite the links between climate and health – and the appetite among students to learn more about these links – there is very little emphasis in UK medical training on the ways in which our environment impacts our health and how the healthcare sector impacts the environment.

Working with PHRC

In 2022, representatives of the PHRC contacted us to discuss how climate change and planetary health are included in the standards we set for undergraduate medical education.

The PHRC wants all healthcare professionals to be taught three core topics:

  • The effects of climate change and ecological destruction on human health.
  • Healthcare’s contribution to climate change and ecological destruction.
  • Planetary health as a professional value and behaviour.

On working with the GMC, Hannah Chase, PHRC Interdisciplinary Coordinator, said:

‘Working for the GMC is a fantastic opportunity. As medical students we are deeply concerned about environmental degradation and climate change, the greatest threat patient health.

‘The lack of climate change or planetary health in our current education is very disappointing. Changes to education policy are the most powerful way to catalyse the educational shift required. It has been a positive relationship so far and we are very grateful to the GMC for listening to us.

‘We remain optimistic that a ‘Statement of Purpose’ discussed at our focus group, outlining the GMC’s increased commitment to planetary health and climate change in their education policy documents, can still be published in the near future.’

Looking ahead

The GMC’s professional standards for doctors, Good medical practice (GMP) included a new sustainability commitment. We are looking at how to apply the aims of our planetary health project into medical education and practice, building on the sustainability commitment in the updated GMP.

We intend to engage and consult on this approach as we review our education standards and outcomes, starting in 2024. This includes our Outcomes for Graduates framework which currently says that doctors must demonstrate awareness of basic principles of global health including governance, health systems and global health risks.

We will also review the postgraduate equivalent, the Generic professional capabilities framework, which sets out the essential capabilities that underpin professional medical practice in the UK and forms an integral part of all postgraduate training programmes.

In addition to our work around Planetary Health, we will work with MSC to explore the impact of the ESH curriculum and will consult with other stakeholders about the role of medical education in the delivery of ESH.

Through our continued work with the PHRC and other stakeholders, we are positive that our review of standards and outcomes will have a greater emphasis on planetary health, climate change and sustainability. 

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