Climate Change in Undergraduate Medical Education: Gaps, Needs, and Opportunities for Curricular Reform

Abstract Background: Despite recognition of climate change as a key determinant of health, medical education on climate-health largely remains fragmented, elective-based, and focused more on knowledge than skills. At our institution, the Climate Change in Medicine elective course reaches only a small subset of students. To capture both course-specific outcomes and broader curricular needs, we paired an elective evaluation with a Community Strengths and Needs Assessment (CSNA) and subsequent focus groups. Methods: A mixed-methods study was conducted at a Mid-Atlantic medical school between September 2024 and May 2025. Pre- and post-course surveys were administered to students enrolled in a climate-health elective course to assess changes in knowledge, attitudes, and agency. A CSNA was distributed to the entire student body, and respondents subsequently participated in focus groups. Quantitative data were analyzed using paired t-tests and descriptive statistics; qualitative data were thematically analyzed. Results: Course participants (n = 14) demonstrated significant improvements across multiple domains. Self-reported knowledge increased from 4.21 to 5.28 on a 6-point Likert scale (p