Table 1.

Climate and health learning objectives for preclinical medical education: linked to existing content.

Module	Teaching Format
Introduction to the Health Sciences
Climate and Environmental Health Introduction
● Define the Anthropocene, planetary health, and climate change.	Lecture
● Explain the unequal burden of climate change on the poor, the young, the elderly, communities of color, and those who have contributed least to carbon pollution.
● Outline a climate change-environmental exposure pathway through which climate change affects human health or disrupts healthcare delivery.
Discussion of the Climate Crisis and Human Health
● Delineate the relative contribution of aspects of healthcare delivery to healthcare’s carbon footprint.	Small Group
● Discuss how medical professionals advocate climate solutions among patients and colleagues.
Community Health & Social Determinants of Health
Case-Based Learning: Urban Health and the Built Environment
● Define urban heat islands, the built environment, and urbanization.	Case-Based Learning
● Articulate how the physical environment mediates behavior with implications for physical and mental health.
● Describe how racially discriminatory policies, including historical redlining, manifest in structural inequalities, the built environment, and risk of harm from environmental exposures (eg, heat).
Environmental Justice
● Define environmental justice and environmental racism.	Small Group
● Discuss the Flint Water Crisis and Dr. Mona Hanna-Attisha’s role in advocating change.
● Explore opportunities for medical providers and trainees to advance environmental justice.
Gerontology
Geriatric Preventive Health
● Apply the physiology of temperature regulation to extreme heat scenarios.	Lecture
● Explain the vulnerability of older adults to dehydration, heat exhaustion, and heat stroke.
● Differentiate between the epidemiology and pathophysiology of classic and exertional heat stroke.
Microbiology and Infectious Disease
Introduction to Microbiology
● Define “vector-borne disease” and “zoonotic disease.”	Lecture
● Articulate environmental factors that affect the spread of infectious diseases using a planetary health framework.
Case-Based Learning: Epidemiological Consequences of Climate Change
● Analyze changes over time in the seasonal and spatial epidemiology of a vector-borne or zoonotic disease and suggest implications for physicians’ differential diagnoses.	Case-Based Learning
● Evaluate how climate change contributes to seasonal and spatial changes in disease epidemiology directly and indirectly via host, pathogen, and environmental factors.
Dermatology
Atopic Dermatitis
● Describe the positive correlation between levels of ozone and particulate air pollution and exacerbations of atopic dermatitis.	Lecture
Skin Cancer
● Link human-driven atmospheric ozone depletion and levels of (UV) radiation exposure.	Lecture
● Connect the risk of UV exposure, climate change, and skin cancer.
Pulmonology
Asthma
● List sources of particulate matter pollution and differentiate between coarse (PM10) and fine (PM2.5) particulate matter.	Lecture
● Illustrate how particulate matter air pollution affects respiratory health in children and adults.
Case-Based Learning: Lung Disease
● Describe how environmental pollution compromises pulmonary function and lung development.	Case-Based Learning
● Analyze socioeconomic and racial disparities in lung health related to zoning, transportation, and other policies that result in disproportionate air pollution levels in communities of color.
Cardiology
Congenital Heart Disease
● Outline the risk of maternal ambient heat exposure for fetal development and congenital heart disease.	Lecture
Atherosclerosis
● Describe how air pollution exposure contributes to vascular remodeling and atherosclerosis through oxidative stress and inflammation.	Lecture
● Interpret how environmental stressors affect cardiovascular mortality and disease burden.
End-Stage Congenital Heart Failure and Cardiac Transplant
● Examine how natural disasters disrupt healthcare delivery.	Lecture
● Propose methods to support patients reliant on medical devices (eg, left ventricular assist device (LVAD) and hemodialysis) in extreme weather scenarios.
Gastrointestinal
Enteric Infections & Diarrheal Disease
● Explain the relevance of Water, Sanitation and Hygiene (WASH) infrastructure to enteric disease transmission.	Lecture
● Describe how precipitation changes and flooding influence the burden of diarrheal disease.
Renal & Genitourinary Systems
Pathology of the Upper Urinary Tract
● Link warming climate to increased incidence of urolithiasis.	Lecture
● Discuss how urolithiasis incidence impacts healthcare system costs.
Case-Based Learning: Renal Physiology
● Describe how the kidneys respond to heat stress to maintain temperature and water homeostasis and the implications of heat stress for renal function.	Case-Based Learning
● Define chronic kidney disease of unknown origin and the hypothesis of heat stress nephropathy.
Endocrine
Introduction to the Global Syndemic
● Define the “Global Syndemic” of obesity, malnutrition, and climate change.	Lecture
● Evaluate how food insecurity drives paradoxical epidemics of malnutrition and obesity.
Food in a Changing Climate
● Summarize the effect of climate change on food supplies via extreme weather and decreased micronutrient levels.	Small Group
● Articulate how some agricultural practices contribute to climate change, worsen food insecurity, and exacerbate noncommunicable disease.
● Integrate counseling on sustainable diets, emphasizing health and environmental benefits, into patient well-care scenarios.
Reproductive Health
Maternal and Fetal Health
● Explain how climate change exacerbates gender inequities and disproportionately harms women and girls.	Lecture
● Relate climate-associated environmental effects such as extreme heat, food insecurity, and an expanded range of vector-borne diseases to risks of adverse outcomes for maternal and fetal health.
Neurology
Cerebrovascular Disease
● Identify temperature extremes as risk factors for acute cerebrovascular accident.	Lecture
● Identify heat exposure and pollution as risk factors for cerebrovascular disease.
Psychiatry
Mental Health and Climate Change
● Illustrate the consequences of population displacement, food insecurity, and trauma on mental health.	Lecture
● Identify the mental health benefits of climate solutions (eg, bike and walk commuting, green space expansion, and reduced air pollution from clean energy).
● State how antipsychotic medications influence thermoregulation.
● Propose ways for communities to cultivate resilience in the face of climate change.