Hospital.Help

Bonn – In view of the increasingly pressing environmental problems, university medicine wants to focus more on tackling the consequences of climate change for human health. The medical faculties also believe that the effects on the content of the training and continuing education of young doctors should be given greater consideration.

“Teaching and research will have to focus more on how climate change puts strain on the human organism and how morbidity and mortality as well as the epidemiology of diseases are changing and shifting,” said the President of the Medical Faculty Conference (MFT), Matthias Frosch, at this year’s 85th Ordinary Medical Faculty Conference (oMFT) in Bonn.

Frosch is convinced that the issue of prevention, which is currently becoming increasingly important for many diseases, is also becoming increasingly important in dealing with heat-related health problems. “One of our tasks in university medicine is therefore to embed this topic in the curriculum,” says Frosch. Not all of the effects of climate change can be avoided. This makes it all the more important to prepare members of all health professions for this challenge. Since many medical faculties are currently driven by the desire and will to equip future health professionals with the specific knowledge and necessary skills that can help address the interplay between climate change and human health, the 85th oMFT in Bonn discussed the topic in a focus panel.

It is urgently necessary to sensitize doctors to the topic of climate change and health and to show ways of integrating the topic into the teaching of medical and medical-related courses, confirmed Claudia Hornberg, chairwoman of the German Advisory Council on the Environment (SRU). Environmental and climate-related illnesses are becoming increasingly common – also in Western Europe, said the professor at Bielefeld University and dean of the medical faculty there.

As a direct consequence of climate change, the increased occurrence of extreme weather events will mean that more patients will have to be treated for heat stress, dehydration, injuries and post-traumatic stress disorder, said Hornberg. But the indirect effects, such as supply deficits or social unrest, should not be underestimated. In combination with increasing global tourism activities, climate change also promotes the spread of vector-borne infectious diseases.

“Almost all medical disciplines are concerned with climate change,” Hornberg explained. “That is why we must continue to push the issue of climate protection and discuss climate adaptation in the health care system.” She cited air pollution as another example: The contamination of the air with pollutants such as fine dust, nitrogen dioxide or ozone is also linked to climate change. High ozone concentrations, for example, could place an increased burden on people with pre-existing respiratory diseases, global warming and increased CO₂Concentrations led to an extended pollen season and the emergence of new species, which is particularly relevant in allergology.

Training medical staff

Medical staff must be trained at an early stage, said Hornung. This is already happening at various congresses and conferences. “The topic is present there. That’s right.” In Hornberg’s opinion, however, more interdisciplinary approaches should be promoted, including at universities. “Climate protection is health protection,” Hornberg quoted the President of the German Medical Association (BÄK), Klaus Reinhardt. “So far, however, the topic of climate has only been a marginal issue in medical training and continuing education,” she regretted. “More must be included in teaching.” The first good approaches in this direction are already visible, for example at the universities of Cologne, Augsburg and Bielefeld.

Eva-Maria Schwienhorst-Stich, head of the Climate and Planetary Health working group at the University of Würzburg, was optimistic: The topic is currently receiving increasing attention in medical teaching, she reported. In 2021, for example, a cross-chapter catalog of topics and subjects on “Planetary and Global Health” was created as part of the National Competency-Based Learning Objectives Catalog (NKLM). Although this is not yet included in all curricula, there are already good concrete approaches in this direction at many universities.

For example, her faculty in Würzburg has already had good experiences with integrating the topic into the longitudinal curriculum, said Schwienhorst-Stich. “It doesn’t take a lot of resources to establish the topic,” she explained. However, a coordinated process is necessary. It is important to look with commitment for each subject to see where the topic could be incorporated.

Such activities are well received by students: “The topic of climate and health has been increasingly discussed among us in recent years,” confirmed Shaleen Paschke, Federal Coordinator for Public Health at the Federal Association of Medical Students in Germany (bvmd). The students had already written a position paper on the topic of One Health years ago and called for a sustainable and comprehensive integration of the topic into medical training, the medical student recalled. “Now it is important to actually bring these approaches together into the curricula.”

Paschke said that they do not want teaching to be turned upside down. “A large part of the content is already included in the curricula in some form.” However, the emphasis must be re-set in the context of climate change. “As medical teaching is currently being shifted more towards prevention content, now is a good moment,” she said. Her generation must deal with the consequences of climate change. But many of the students are unsure about their future roles as doctors in the field of climate change and health. “That is what we want to learn.”

Medical teaching again took up a lot of space at this year’s annual meeting of representatives of the faculties. The focus in Bonn was on medical didactics in particular: on the occasion of the 20th anniversary of the Master of Medical Education, the professionalization of medical teaching that has now been achieved was recognized.

Another topic at the 85th oMFT in Bonn was China’s innovative strength and the opportunities and risks for German and European university medicine resulting from scientific cooperation with Chinese partners. The participants unanimously agreed that these must be carefully weighed up in the institutions on a case-by-case basis. A state clearing house was rejected. © ER/aerzteblatt.de