The World Health Organisation says that between 2030 and 2050, climate change is expected to cause approximately 250,000 additional deaths per year, from malnutrition, malaria, diarrhoea and heat stress.
Not only does the health sector have to meet that demand clinically, but it also needs to assess itself due to its considerable impact on the environment, contributing comparable greenhouse gas emissions to the airline or shipping industry, creating a paradoxical toll on the health of people in the UK and around the world.
The Faculty of Medicine has made a commitment to improving our sustainability in how we work but also in our curriculum to ensure our students have the confidence, knowledge and skills to meet the demand of healthcare in the 21st century and to do so sustainably.
We spoke to Professor Kalyanaraman Kumaran, Dr Inna Walker and James Bevan who are working together to embed planetary health and sustainability topics into the curriculum.
How are you making Population and Planetary Health (PPH) become a more visible theme? Is this a dedicated module all students have to complete?
Rather than being a specific module, the PPH is a longitudinal theme running through the Bachelor of Medicine (BM) programmes. During the 2022/23 academic year, we brought public health, global health, and planetary health and healthcare sustainability teaching under one umbrella, naming the theme Population and Planetary Health, or PPH. This has allowed us a more coherent approach to planning and delivering teaching under these closely related disciplines. Furthermore, an overarching name made them more visible, highlighting both their close relationship and longitudinal position within the BM curricula.
The logo we have created for PPH, which is used in teaching materials, is part of branding of the theme and increases its visibility. For example, with planetary health content being infused into teaching sessions in subjects outside of PPH, the use of the logo on the slides acts as a reminder that this is a continual theme.
We are also working to increase our visibility online, both in developing a dedicated Blackboard page and creating an external webpage, with help from the University Communications and Marketing Team.
What will the new theme include? What can students expect?
The theme brings together key concepts of public health, global health and planetary health, and threads these across the BM programmes. There will be greater coverage of global and planetary health than has been in the past, as well as new content incorporated where there may have been long gaps without these subjects being revisited.
We are also reviewing and updating learning outcomes to ensure they both are closely aligned with the GMC outcomes for graduates, as well as reflect the key learning that the students should take away from the theme.
Students can expect to develop a solid foundation in PPH and an appreciation of contemporary issues in the three disciplines, as applied both in the UK and globally. The recent COVID-19 pandemic has highlighted the importance of global health and how crucial it is for healthcare systems to be able to deal with issues as they arise. The scope of the theme will help the students prepare for challenges that confront the global community.
Why are you creating this new theme? Why are you introducing it now?
We have come together as a new team, with a range of complementary backgrounds and skills in academic and service public health, global health and planetary health. Our students show a keen interest in global health and environment sustainability issues, and this was a good time to review the curriculum and increase the scope of global and planetary health. These disciplines will be relevant in our students’ future careers, including when they face challenges similar to COVID-19.
How will you implement it in an already busy schedule for students?
The BM programmes are indeed already busy and demanding, which we recognise. So far, we have not sought additional slots, but rather focused on reviewing and updating pre-existing public health teaching sessions. We are also infusing planetary health content by contributing slides to be incorporated in non-PPH sessions, where relevant, and aspire to trial the same infusion approach with global health content in the future. We would like to encourage lecturers to teach common conditions using cases occasionally set in different populations or settings, as a way of integrating a reflective approach to global health. The overarching idea is to ensure there is a consistent theme throughout the BM programmes.
How will the students benefit from this new theme?
The new theme should enable our students to form a better understanding of the patient populations that they will be looking after in the future. The students will learn about the factors influencing patients’ health status from an angle that may not be covered by other subjects. Decolonisation of medicine and medical education is one example of a complex, yet vital, contemporary issue, which our theme will help dissect for the students. With increasing mobilisation of populations and globalisation of health and healthcare issues, our theme will help the students be better prepared for a medical career in a rapidly changing world. They should be better equipped to cope with the challenges of medical practice of the future and act as drivers of change on important questions, such as healthcare sustainability.
How will the Faculty benefit from the new theme?
As medical educators, we have a duty to prepare our students for the realities of their future practice, and fostering a deeper understanding of public, global and planetary health will help us fulfil this. The existence of the theme should attract potential applicants to the BM programmes who like to stay up to date on contemporary issues, as well as those who are interested in the topics that fall under the PPH realm. Exposure to the theme’s content can also encourage the students to develop and maintain an interest in the wider issues related to health, which can inspire them and improve student and patient satisfaction.
How has social situations (like COVID-19 or Russia’s war in Ukraine) impacted the development of the theme?
Population health issues can transcend geographical borders and travel globally within a short space of time. We are creating a curriculum that is responsive to important events and situations that affect global health, such as the COVID-19 pandemic or Russia’s invasion of Ukraine. This is important not only for students who may aspire to work overseas but also for those who will practise in the UK, where we see a significant effect of such issues on population health.
Is University of Southampton unique in developing a theme of this kind?
While other UK institutions may, to varying degrees, cover similar areas, we are not aware of others that combine public health, global health and planetary health in one single unified theme. In relation to planetary health teaching, we already compare very favourably on a global level to other universities that train future doctors. UoS was awarded an A rating on a scale of A-D, with A being the highest, in the 2022-23 summary report of the Planetary Health Report Card (PHRC), a pioneering student-led initiative that assesses medical schools’ performance against a range of planetary health metrics. Out of the 96 universities in 11 countries that submitted data, only four were awarded an A in this category, with UoS being one of them. This result is highly encouraging for our team and inspires us to continue our pursuit of improving the student experience under the PPH umbrella. More recently, we have set up a student-led planetary health group which has undertaken an audit of the current curriculum against the GMC learning outcomes for public/global/planetary health. We will continue to work with students to incorporate their suggestions and enhance their understanding of PPH issues.