LAUSR

Many calls to action have appeared in recent years for academic physicians to address climate change in clinical practice, administration, research, and educational activities [1–5]. The national dialogue on climate change has intensified, and the daily news frequently mentions natural disasters or plans to combat climate change. Research on the intersection of climate and health has multiplied exponentially, with the number of original studies increasing 11-fold from 2007 to 2020 [6]. A strong evidence base is available on climate change and mental health, forming the core of knowledge around which educators can build curricula [6–9]. Yet there is still a dearth of health professions curricula focused on the impact of climate change on human health in general, and onmental health in particular. Up to 40% of US medical students graduating between 2009 and 2013 reported they had received inadequate education on climate change, and in response, a third of medical schools were planning to incorporate this topic in their curricula [3]. According to one estimate, however, most institutions had not yet done so by 2020 [10]. Similarly, a recent international survey of students from 2817 medical schools located in 112 countries also found that only 15% of schools included climate change and health topics in their curricula [11]. There are several curricular efforts, although few full curricula on climate change in health care settings [10, 12–17]. For example, the University of California, San Francisco, School of Medicine, has included climate health education content in the first-year core curriculum since 2016 [12]. Oregon Health & Science University incorporated climate health education elements into the core medical and nursing school curriculum in 2020 and launched a 10-week interprofessional course on climate change and human health in January 2021 [13]. A team at Rowan University created an interactive medical student curriculum composed of six 2hour small group sessions, culminating with the development of an infographic and podcast [14]. Recently, a strategy was outlined for integrating climate health education content into the existing curriculum at Cleveland Clinic Lerner College of Medicine [15]. The New England Journal of Medicine has published a modular curriculum that can be adapted for local use [18]. There are proposals for core objectives for sustainable health care education, as well as a comprehensive graduate medical education framework on climate change, including learning objectives, teaching strategies, and suggested assessment methods [19–21]. Yet, published examples of curricula are few, let alone those focused on mental health. Moreover, we know very little about how well, if at all, curricula met their specific goals and objectives. In this editorial, therefore, one of our goals is to identify possible barriers to curricula design and teaching as a first step to overcoming this gap. The barriers we outline below are cognitive bias, climate-related anxiety, lack of facility with climate science methods and findings, lack of local experts, insufficient curriculum space, insufficient resources, and lack of evaluation data. A second goal is to propose solutions so that psychiatrists will be better able to advocate for, plan, and effectively implement climate change and mental health curricula. An overall goal is for our profession to become better informed about how to protect patients and the wider public from climate adversities and to better manage their responses to those adversities.