Students help shape medical education to keep up with the times
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* Edward Xie
* Jennifer Hulme
* Courtney Howard

Wendy Glauser’s recent article outlined barriers for medical curricula to meet emerging health challenges.1 However, trainees are helping to reshape education from the ground up to address an increasingly complex practice environment. Complexity should be embraced, as it reflects our richer understanding of illness processes, social adaptations and myriad determinants of health.

Early introduction of emerging issues avoids blind spots that could perpetuate systematic neglect of important determinants of health as doctors progress in their careers.2 Luckily, there are many new models for innovative medical education that can effectively integrate policy, public health and clinical medicine to better prepare future leaders to tackle complexity with analytical and problem-solving skills.

For example, in August 2018, the International Federation of Medical Students’ Associations launched their vision for climate health curricula in every medical school, worldwide, by 2020.3 With ample foresight, the Canadian Federation of Medical Students pushed for faculties of medicine to “comprehensively address” topics on climate health in all curricula with their 2016 position paper.4

The Global Health Emergency Medicine group at the University of Toronto is working with journalism fellowship graduates to lead several initiatives to study and scale up practical, hands-on advocacy skills for medical trainees.5 Elsewhere, public health residents at McMaster University in Hamilton, Ontario, have partnered with faculty at the University of Toronto to develop an interactive simulation that explores solutions to the opioid crisis where health care intersects with policy-making, community engagement and law enforcement.

Given the long lead time to practice change, early exposure to these topics is critical. Sluggish knowledge translation to doctors who have graduated, as indicated by Dr. Chan,1 underscores the importance of introducing emerging concepts as soon as possible. This is especially urgent when some topics, such as climate change and health, have been supported by a robust evidence base for decades.

To gain maximal effect, we must avoid compartmentalizing these issues as “special interest” topics for continuing medical education. Broader understanding of health outcomes will lead to improved quality, access and equity of care for all patients.6

## Footnotes

*   **Competing interests:** None declared.

## References

1.  Glauser W. Are medical schools keeping up with the times? CMAJ 2018;190:E996–7.
    
    [FREE Full Text](http://www.cmaj.ca/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiRlVMTCI7czoxMToiam91cm5hbENvZGUiO3M6NDoiY21haiI7czo1OiJyZXNpZCI7czoxMToiMTkwLzMzL0U5OTYiO3M6NDoiYXRvbSI7czoyMzoiL2NtYWovMTkwLzUwL0UxNDg2LmF0b20iO31zOjg6ImZyYWdtZW50IjtzOjA6IiI7fQ==) 

2.  McGregor M, Bryan S, Brasher P, et al. Why is Canada so behind in research on climate change and health? Health Debate.ca 2018 July 25. Available: [http://healthydebate.ca/opinions/climate-change-and-health](http://healthydebate.ca/opinions/climate-change-and-health) (accessed 2018 Aug. 8).
    
    

3.  Statement of the International Federation of Medical Students’ Associations at the Sixty-fifth Session of the WHO Regional Committee for the Eastern Mediterranean on Agenda item 5 (c): Draft WHO global strategy on health, environment and climate change. Amsterdam: International Federation of Medical Students’ Associations; 2018. Available: [https://ifmsa.org/wp-content/uploads/2018/10/IFMSA-Statement-5c\_health\_environment\_climate\_change.pdf](https://ifmsa.org/wp-content/uploads/2018/10/IFMSA-Statement-5c\_health_environment_climate_change.pdf) (accessed 2018 Aug. 8).
    
    

4.  Saraswat M, Lau K, Mazze N, et al. Climate change and global health: training future physicians to act and mitigate. Ottawa: Canadian Federation of Medical Students; 2016.
    
    

5.  Health Equity Committee. Toronto: Global Health Emergency Medicine; 2018. Available: [http://ghem.ca/project/health-equity-committee/](http://ghem.ca/project/health-equity-committee/) (accessed 2018 Aug. 8).
    
    

6.  Beavis AS, Hojjati A, Kassam A, et al. What all students in healthcare training programs should learn to increase health equity: perspectives on postcolonialism and the health of Aboriginal Peoples in Canada. BMC Med Educ 2015;15:155.