Alisha Patel: Why sustainability should be important to medical students

Alisha-Patel_picMedical school can feel like a production line of future doctors, equipping us with the skills to diagnose and manage patients with a vast number of illnesses. But if we are not engaging in issues related to sustainability along the way, then will we really be able to fully fulfil our duty as health professionals?

The concept of sustainable healthcare was briefly introduced to me in my first year of medical school. I was surprised to realise the extent to which the NHS is affected by environmental change, and that it is also contributing to it too as the largest public sector emitter of carbon emissions. A sustainable NHS, which delivers high quality of care while meeting financial, environmental, and social demands is clearly important, given both the funding problems within the NHS and the global impacts of climate change.

Increases in the prevalence of malaria and dengue fever, flooding which destroys lives, droughts that starve populations, mental illness caused by conflicts arising from resource scarcity—these are all consequences of climate change. This is a health problem and it is happening now, but this frightening reality can seem removed from medical students and doctors in the UK.

Among medical students and doctors, the word “sustainability” is becoming overused, its meaning getting lost as it becomes another NHS buzzword. There’s also the risk that we think we don’t need to give attention to this niche area considering our oversaturated time commitments already. But if we are to work in healthcare, we will be facing the challenges that environmental change presents—potentially without being equipped with the knowledge to deal with it. By engaging in sustainable healthcare, we can help build strategies (small or large scale) that aid the health of communities, populations, and even the planet. If students aren’t involved now as the future generation of new doctors, then who will come forward to act on sustainability in healthcare and point out the inextricable links between our health and our environment?

With that thought in mind, I became involved in adapting our medical school curriculum to integrate more climate change teaching, making it relevant to clinical medicine within lectures and problem based learning (PBL). For example, emphasising how the prevalence and distribution changes of infectious diseases result from ecological disruption, which in turn puts a larger burden on health services. Renal physicians teach students about the Green Nephrology project and there is now a student selected module on sustainable healthcare, which gives students the opportunity to run their own projects. It’s a shame that it’s not always a popular addition among the students, although it hopefully stimulates a more open minded attitude about how the environment is directly related to medicine and health.

There are sustainability initiatives already taking place in specialties, such as renal medicine (Green Nephrology techniques to reduce waste in renal replacement therapy) and psychiatry (sustainable models of care have been developed, including sustainable prescribing, psychotherapy, and use of natural spaces). This means that the focus is on disease prevention, empowering patients, creating a leaner service, and then considering the carbon impact. This shifts the emphasis from treating individuals to treating whole communities.

Despite the barriers, I will continue to be involved in sustainability whichever specialty I decide to pursue. The GMC’s Tomorrow’s Doctors now includes sustainable healthcare learning outcomes for students, highlighting its importance. And with the UN Conference on Climate Change in Paris just around the corner, now is the time for medical students and doctors to step up, engage, and act.

Alisha Patel is a third year medical student at Norwich Medical School having completed a biomedical science degree at the University of Warwick. She has a keen interest in public health and mental health.

Competing interests: None declared.