Climate Change Curricula in Family Medicine Residency Programs: Program Directors' Perspectives From a CERA Survey.

BACKGROUND AND OBJECTIVES: Climate change is a major threat to the health of people worldwide. The health care system deals with the immediate health-related effects of climate change and, at the same time, is a major emitter of greenhouse gas. This study aimed to investigate (a) the awareness and perception of climate change among family medicine residency program directors, and (b) the state of climate change education in family medicine residency programs. METHODS: The Council of Academic Family Medicine Educational Research Alliance (CERA) conducted a cross-sectional survey of family medicine program directors in the United States in April 2023. We analyzed anonymous data using descriptive and bivariate statistics. RESULTS: We analyzed responses from 284 family medicine residency program directors (response rate 41.1%). Of these, 56.8% indicated not having any lectures/seminars dedicated to climate change and no plans to introduce such curricula, with considerably higher rates in East South Central United States (92.8%). A majority considered principles of climate change, carbon emissions emitted by the health care system, and discussion of climate change with patients of lesser importance for residency program education. CONCLUSIONS: While climate change is an emerging topic affecting health and the provision of health care worldwide, our study suggests that many family medicine residency programs do not teach about it. Family medicine trainees may not always receive sufficient education about the risks posed to their patients by climate change, which could lead to them having limited knowledge and skills when discussing this topic with their patients in the future.

Primary Care Clinicians' Attitude, Knowledge, and Willingness to Address Climate Change in Shared Decision-Making.

BACKGROUND: Climate change poses a threat to the health of people worldwide. Little is known about the awareness of primary care clinicians toward climate change and if they are open and prepared to address climate change issues with their patients. As pharmaceuticals are the main source of carbon emissions in primary care, avoiding the prescription of particular climate-harmful medications is a meaningful contribution to the reduction of greenhouse gases. METHODS: This is a cross-sectional questionnaire survey among primary care clinicians in West Michigan conducted in November 2022. RESULTS: One hundred three primary care clinicians responded (response rate 22.5%). Nearly 1/3 (29.1%) were classified as climate change unaware clinicians who perceived that global warming is not happening, or expressed that it is happening but not caused by human activities or is affecting the weather. In a theoretical scenario on a prescription of a new drug, clinicians tended to prescribe the less harmful drug without discussing options with patients. Although 75.5% of clinicians agreed that climate change aspects have its place in shared decision-making, 76.6% of clinicians expressed a lack of knowledge to advise patients in this regard. In addition, 60.3% of clinicians feared that raising climate change issues in consultations may adversely affect the relationship with the patient. DISCUSSION: Although many primary care clinicians are open to addressing climate change in their working environment and with their patients, they lack knowledge and confidence to do so. In contrast, the majority of the US population is willing to do more to mitigate climate change. Although curricula on climate change topics are increasingly implemented in student education, programs to educate mid- and late-career clinicians are lacking.