Mosquito-borne diseases such as dengue and malaria will become a bigger part of the curriculum at medical schools across Europe in the face of the climate crisis.
Future doctors will also have more training on how to recognise and treat heatstroke, and be expected to take the climate impact of treatments such as inhalers for asthma into account, medical school leaders said, announcing the formation of the European Network on Climate & Health Education (Enche).
Led by the University of Glasgow, 25 medical schools from countries including the UK, Belgium and France will integrate lessons on climate into their education of more than 10,000 students.
Glasgow University's Dr Camille Huser,co-chair of the network, said: 'The doctors of the future will see a different array of presentations and diseases that they are not seeing now. They need to be aware of that so they can recognise them.'
This year was Europe's hottest summer on record and changes in climate are increasing pressures on health services.
Insects that spread diseases, such as mosquitoes, are expanding their range and being found in new areas, aided by changes in temperature and rainfall patterns. Chronic diseases such as cancer, heart and lung conditions, diabetes and mental illness can all be affected by factors such as extreme weather or air pollution.
The role of the climate in teaching at medical schools varies considerably, Huser said, and often consists of just a single module or lecture. The network envisages it being 'infused' throughout teaching in future.
'Climate change … doesn't necessarily create a whole new range of diseases that we haven't seen before but it exacerbates the ones that do exist,' Huser said.
'Diabetes, for example, is not something that people link to climate change at all, but the symptoms and complications become more frequent and worse for people who live in a world where the climate has changed.'
Antimicrobial resistance, in which pathogens evolve so existing drugs no longer treat them effectively, is also being exacerbated by climate breakdown and Huser said this should be reflected in teaching.
Students will also be taught to advocate for things such as active travel â€" walking or cycling rather than driving â€" and 'green prescribing', where patients are encouraged to take up activities such as community gardening and tree planting. Both offer health benefits to individuals, as well as being positive for the environment.
Encouraging people to look after their health had 'huge benefits for them personally', Huser said, but would also 'reduce emissions if they require less input from the health system'.
She added that many people did not realise the healthcare sector was responsible for as much or more greenhouse gas emissions than the airline industry. 'When you fly somewhere, you feel very guilty, but when you go to the doctor, you don't feel guilty.'
Students will be shown how changes in managing a condition can have an impact. Inhalers used to treat asthma emit greenhouse gases, so keeping the condition controlled not only benefits the patient but reduces inhaler use. Some patients may be able to switch to dry powder inhalers, which release fewer greenhouse gases.
While there have been piecemeal initiatives at institutional levels, network leaders said this was the first joint attempt around the teaching of undergraduate medical students. The network will also attempt to influence bodies that set national curricula, such as the General Medical Council in the UK, so that the climate crisis becomes a mandatory part of all doctors' education.
Huser's co-chair, Prof Iain McInnes, also of Glasgow University, said the network's aim was 'building the conversation into medical curricula so that the doctors of the future are literate in this conversation, they don't feel it's a campaign item.
'This is as pivotal and critical to their thinking as it is to manage obesity, smoking and other environmental challenges. It is simply part of the DNA of being a doctor.'
The World Health Organization (WHO) is supporting the initiative, along with private pharmaceutical and healthcare businesses, including AstraZeneca, Bupa, GSK, Novartis, Novo Nordisk, Roche and Sanofi, as members of the Sustainable Markets Initiative Health Systems Task Force, a public-private collaboration working on the decarbonisation of healthcare.
Enche will be a regional hub of the Global Consortium on Climate and Health Education (GCCHE) at Columbia University school of public health in New York.
Prof Cecilia Sorensen, director of the GCCHE, said: 'Climate change will impact all of us, everywhere but not equally and not in the same way. Regional networks are necessary to help health professionals prevent and respond to climate and health challenges which are unique to the communities where they practise.'
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