Dresser Caleb, Wiskel Tess, Giudice Catharina, Humphrey Kimberly, Storr Latoya, Balsari Satchit
is Assistant Director, Fellowship in Climate Change and Human Health, Assistant Professor, Harvard Medical School, and Instructor, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.
is a Fellow, Climate Change and Human Health, Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.
J Grad Med Educ. 2024 Dec;16(6 Suppl):129-134. doi: 10.4300/JGME-D-24-00110.1. Epub 2024 Dec 13.
Climate change is affecting health and health care, but most physicians lack formal training on climate change. There is a need for graduate medical education (GME) programs that prepare physician leaders to address its health impacts. To describe the development and iterative piloting of a GME fellowship in climate change and health and to assess fellows' academic output and public engagement before and after fellowship matriculation. A GME training program was developed and implemented at an emergency medicine department in a US teaching hospital in collaboration with affiliated academic centers. Participants consisted of emergency physicians from the United States and abroad. Program duration and format were adjusted to meet individual career goals. Outcomes assessed include program completion, postgraduation professional roles, and academic outputs and public engagement before and after fellowship matriculation (2019-2023), compared via paired tests. Five fellows have matriculated; 2 have graduated, while 3 remain in training. Costs and in-kind support include salaries, faculty time, research support, travel to conferences, and tuition for a public health degree. Fellows averaged 0.26 outputs per month before matriculation (95% CI 0.01-0.51) and 2.13 outputs per month following matriculation (95% CI 0.77-3.50); this difference was significant via 2-tailed test (alpha=.05, =.01). Subanalyses of academic output and public engagement reveal similar increases. Following matriculation, 186 of 191 (97.4%) of outputs were related to climate change. For the 5 fellows that have enrolled in this GME climate change fellowship, academic and public engagement output rates increased following fellowship matriculation.
气候变化正在影响健康和医疗保健，但大多数医生缺乏关于气候变化的正规培训。需要有研究生医学教育（GME）项目来培养医生领导者，以应对其对健康的影响。描述一个关于气候变化与健康的GME奖学金项目的开发和迭代试点，并评估奖学金入学前后学员的学术产出和公众参与情况。在美国一家教学医院的急诊科与附属学术中心合作开发并实施了一个GME培训项目。参与者包括来自美国和国外的急诊医生。项目时长和形式根据个人职业目标进行了调整。评估的结果包括项目完成情况、毕业后的职业角色，以及奖学金入学前后（2019 - 2023年）的学术产出和公众参与情况，通过配对检验进行比较。已有五名学员入学；两名已毕业，三名仍在培训中。成本和实物支持包括薪资、教师时间、研究支持、参加会议的差旅费以及公共卫生学位的学费。学员在入学前平均每月产出0.26项成果（95%置信区间0.01 - 0.51），入学后平均每月产出2.13项成果（95%置信区间0.77 - 3.50）；通过双尾检验，这种差异具有统计学意义（α = 0.05，P = 0.01）。对学术产出和公众参与的子分析显示了类似的增长。入学后，191项成果中有186项（97.4%）与气候变化相关。对于参加这个GME气候变化奖学金项目的五名学员来说，奖学金入学后学术和公众参与产出率有所提高。
