Medical students are demanding their schools include the climate crisis as a core component of the curriculum, as the intensifying climate emergency highlights the corresponding health crisis. Hannah Chase, a final year medical student at Oxford said the sense of urgency hit home recently when a fellow student confessed they didn’t believe in climate change. “It just shows that we make such assumptions,” said Chase. “It’s needed, this education.” Extreme weather events, including heatwaves, wildfires, floods, storms and droughts, are increasing in frequency and intensity – widening existing health inequalities, traumatising victims and precipitating the loss of food security, homes and livelihoods. Climate change and its fossil fuel-powered drivers, such as urbanisation and intensive agriculture that encroach on wildlife habitats, are encouraging pathogens to jump from animals into humans. Meanwhile, anxiety about the fate of the Earth is affecting mental health, especially in the young. Disturbed by the lack of teaching on climate change in her course, last year Chase stumbled upon an assessment tool designed by a group of US students to inspire medical schools to adopt climate change and sustainability goals: a report card judging the school’s green credentials. Despite the strain of the pandemic, Chase managed to make the concept work in the UK. She and her colleagues convinced 30 out of the 33 medical schools to publish the grades given by their own students on a handful of criteria, including the curriculum to community outreach and campus sustainability. The findings were stark: the scores given for the incorporation of climate change and sustainability in the medical school curriculums ranged from 7% to 74%. “There are some medical schools that don’t even really teach it as an elective,” she said. The majority of schools scored an overall C or thereabouts – suggesting that more focus on climate change and sustainability would be welcome. Keele University in Staffordshire topped the list with a B, while Cardiff medical school came bottom with an F+ grade. The scorecards have sparked some change in curriculums, she said, noting that at Oxford, for instance, classes on the subject are planned for first- and second-year medical students beginning in 2022. By taking the Hippocratic oath, health workers pledge to protect life – and therefore there is a duty of care to patients to discuss the health effects of climate change, said Ali Rowe, former mental health nurse and climate health activist. “What we need is mandatory training [for health professionals] – it can’t be optional any more. We can’t have people on medical courses who don’t think the climate crisis is a thing. How can we educate the public if we don’t have that level of understanding?” And the focus can’t just be on medical students – the gravity of the health effects of this crisis needs to be highlighted to the current workforce as part of postgraduate and professional education, said Dr Chris Newman, an NHS GP and co-founder of Doctors for Extinction Rebellion. Right now, there is barely any training available, and even this is entirely optional and not easily accessible, he noted. “You can’t just educate medical students [on climate change] – because they’re going to battle against the seniors who often don’t know enough.” Dr Abbie Festa, a junior doctor, has been helping with a voluntary lobbying effort to get NHS trusts to declare a climate emergency. Of the 233 trusts in the England, roughly about 10% have so far done so, she said. Before getting involved, Festa said she believed the reason change had been slow to come was because “we hadn’t shouted loud enough about it”. Once people knew, she presumed, they would get on with it. But the reality has been a bit of a wake-up call – things aren’t changing quickly enough, she said. Polls suggest that nurses and doctors are seen as the most trustworthy professions in the UK. “If you had every NHS worker informed fully on how bad climate change is,” said Newman, “it would really help move things on a political level, just because I think people wouldn’t stand for it.”