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Hi, everyone. Um I'm I am, I'm an education fellow at the Center for Sustainable Health Care. Um I'm gonna be chairing this session today and I'm joined by James as well, James, if you want to introduce yourself. Good afternoon, everyone. Yeah, my name is James. I'm 1/5 year medical student at Brighton. I'm the co-director for the planetary health report card. So this is our session uh for medical education. Um We have five speakers today, so one of them is just running a bit late. We hope so. We're gonna start with Sterling Bright who is going to talk to us about the development and implementation of a longitudinal climate health medical school curriculum. So, over to you, Sterling. All right, I will go ahead and share my slides. Um So, yeah, it's nice to, to meet everyone virtually. My name is Sterling. I am a third year medical student at Vanderbilt University. He's coming here from Nashville, Tennessee. Uh And I'm gonna be talking to you about the development and implementation of the longitudinal climate health curriculum here at our med school uh which has largely been a student led initiative in both conception and implementation as long as well as with the the help of some lovely faculty members uh like Doctor Basinger, who I believe is here in the audience. So just as a background, II, think we all know that medical schools tend not to do a great job of teaching about planetary health and climate change. Uh Despite the fact that it seems as though students believe that this information is important and should be included in their core education. Um Now we here understand the threat that climate change poses to public health. Uh But we also think it's critical that all future physicians should come away from their medical training uh equipped to address the inequities that are both created and exacerbated by climate change as well. You know, regardless of their level of interest in the subject. Uh and that led us to uh create our proposal. And it really started back in 2022 when we did our first Planetary health report card here at Vanderbilt and got ad plus in the curriculum section. And at that point, uh students could really only engage in planetary health topics through an elective course offered to third year students. Um And there's no none of this material in the court curriculum. And so at the time, we decided to create a proposal based on a proposal in race and medicine that was being rolled out at the same time. And that really helped us to recognize and kind of preemptively combat some of the challenges that we knew we would face in implementing this proposal. Uh And so we presented that to our deans and our leadership in 2023 and got approval that same year. And so I've spent the last year or so uh trying to implement some topics from our proposal focused largely on the preclinical educational aspects of our medical school. And so far, had successfully integrated planetary Health education into three of our six preclinical blocks. So this is just a view of our initial proposal. Again, we focused really heavily on our M One curriculum, which is preclinical here. But we also tried to have a plan to expand into the clinical years of our medical school. And we're really hoping that students would be able to engage with this material again and again. Now, this is what's been approved and implemented so far from that initial proposal again, largely focused on the first year uh making some changes to our immunology course, our hematology, cardiology pulmonology course, as well as renal indigestion. Uh But something to point out is that we actually this year expanded into our clinical part of our education as well. And students were able to have a two hour conversation about health equity through the lens of climate change, uh really utilizing their own experiences in the hospital, which was a big success for us. And something that we're really excited to continue forward into next year. And so the next couple of slides, I just kinda wanna give some examples of how we pitched our changes to our lecturers and our doctors here. And so what we would do is we would find topics of interest largely highlighted by the planetary health report card as well as what other medical institutions here in the States uh were teaching in regards to the Planetary Health. Uh And we would connect those topics to preexisting lectures that our doctors were already giving and provide just a handful of primary resources to try to summarize the key points. Really just lay it all out in front of them so that it was as easy as possible to see the connection to the material that they were already teaching and really lower that education burden to help them feel comfortable integrating these topics into their lectures. So again, this is mostly about vector patterns and uh immunology as well as infectious disease. Uh This is another example, I'm gonna go fast through but just uh impacts of climate change on cardiovascular and respiratory health. And then again, for renal indigestion, looking at kidney injury, chronic kidney disease, as well as gi cancers and talking some about green endoscopy. And then these are some of the topics that we have pitched to our reproduction and endocrine block, as well as our brain behavior and movement, which is neurology, psychiatry, and musculoskeletal. Uh And we're currently in talks with them these are going to be incorporated uh to an unclear extent right now in the next year. But something that we're actively working on and trying to get into our uh curriculum here. So this slide shows just how we've changed in the past year uh from AD Plus when we initially began conceiving our proposal to A B minus just this past year. So really what changes that we made in one year have been able to really greatly increase our score with our biggest wins coming and educating about the health impacts of climate change, about medical sustainability, as well as a great increase of administrative support, which we've been really, really lucky to see. Um Now I wanted to spend some time talking about challenges, movement for students who may wanna do something similar, you know, duty hours here in the States, put a restriction on on how much classroom time students can have, which makes it really difficult to implement new lectures. And so what we had to do was identify old pictures where there was space available um and planetary health topics that connected well. And we had to really be flexible in the timing of our incorporation as well. Uh trying to get some things in preclinical and some things in clinical A and taking what we could get. Another big thing is that faculty members aren't experts, oftentimes in these topics and they don't always feel comfortable presenting something that they don't know a lot about. And so we tried to provide as many primary literature resources as possible, really make those links between the topics that they already teach. And our proposed changes very clear and make them uh have to do as little work as possible to put these topics into action. And then finally, students are overworked. We all know if we've gone through preclinical education at the medical school, just how rigorous it can be. And students don't want to learn superfluous information when they have to study for their boards and their exams. And so we've tried to really demonstrate the connection between board exam material and climate, health topics uh to try and get students interested and also willing to learn this material. And I wanna talk as well about some lessons that we've learned. II think the biggest being that this is feasible, you know, in just one year, we've been able to really incorporate some exciting topics into our preclinical education and make great strides as measured by the Planetary Health report card. And so we're really excited to continue this trajectory going forward and to kind of summarize the rest of the bullets. I think the the big thing is that we've learned that you really need to be able to be creative, to be able to pivot and find, you know, different ways to appeal to faculty, to compromise about what gets included and to take small wins as wins, you know, for some blocks like renal indigestion. And we were able to incorporate far more than we initially thought in terms of planetary health education. But for others like infectious disease, where we thought we were gonna have a lot of success that was limited. Um And so just taking wins when you can get them and trying to be as flexible as possible. And now this is, I'm just gonna skip through this uh because I'm short on time, but just know that we're working on continuing our trajectory here and are excited about what we have in the future. And then just a big thank you to all of you for coming and especially to doctor Curtis Basinger and Doctor Eva Parker, um who have done a lot in our hospital network, educating their colleagues and have served as wonderful advocates for us as we've pushed this proposal forward and, and really made this possible for us and given us the, the strength to do so. Um So thank you all again and if you have any questions, I'd be happy to feel them at the end. Um And these are just our sources. So thank you. Thank you so much Sterling. It was really interesting. Um And it shows, you know, it takes a long time to make change and you guys have made some real change and been able to measure that impact. So if you have any questions for Sterling, then please put them in the chat we're gonna do all the questions at the end. Um, so I'm gonna hand over to our next speakers, Pra and Anna Dia, who are gonna talk about planetary health education in the Indian medical curricula. So, over to you both. Oh, yes. Hello everyone. Uh, I'm an, and, uh, I, uh, uh, graduated as a medical student back in 2019. And after graduating, uh, I came across an online course on climate change and health. And I was very surprised uh that India being such a vulnerable country. Uh We, like, I graduated and I had no idea about like that how um climate change is basically impacting health. And I found out uh uh so I presume you're doing the slide, so just feel free to like move it to the next one because uh I'm just going to talk through. Um So, uh um yeah, so, uh and it was quite surprising that this being the greatest g global threat in the um uh greatest threat to global health in the 21st century and still like me or my, uh you know, uh fellow medical students, nobody was aware of this. So I found it quite surprising and uh uh and then, uh I was curious and I looked at the research uh on what uh plans are there. And actually the Indian government, at that point point already had like a national uh action plan on climate change and health. And one of the objectives was to, you know, uh train medical students on it. And I, and that was like that uh they had already had the plan from 20 17 and the objective was to achieve it by 2021. So it was a five year plan. And uh the um then again, I was surprised that like, you know, it's already 2019, 2020 nothing has been done, which is how um I came across Planetary Health Report card and decided that it would be a great initiative to like just do like a needs assessment of medical colleges in India. Uh For reference, there's uh about like, I think 800 medical colleges all across India. And this includes like uh some which are owned by the government and some which are like private medical colleges. And uh that's how we introduced uh the plane tree health report card in India and it's started as a pilot with two colleges and now it has expanded uh to more and I'll just hand over to uh soon to like get it forward from there. He is the original lead for India right now. Thank you so much for your presence. Um Hi, everyone. I'm a medical student and the current regional need of the PC for India. So due to the time frames, I won't be able to cover all the metrics that uh we have analyzed in our study. So, yeah, let me just go to my slides. Yeah. So uh here we will discuss only a few key metrics across the five sections of the page. I see comparing the four Indian medical schools. Now, if someone's interested in the complete report cards, they can scan this QR code provided for more information. Uh but these metrics are enough to reach the conclusion that we are trying to reach the recommendations that have, that we have formed. So starting off with the curriculum integration, uh we found a wide variation, the integration of plan to have topics into the medical curriculum across the medical schools of India. For example, SC BMC H and S have significantly improved their focus on the healthy parts of extreme heat and pollution. Uh But F MMC and S JMC only touch briefly on these topics. Uh Similarly, when it comes to electives, JMC offers electives and plan has like the doctor program, but other schools lack such courses of electives. And uh again, CMC and K also have dedicated faculty to promoting and integrating plant health. But as C BMC and F MMC, don't and none of the schools addresses the healthcare systems, carbon footprint or the environmental impact of medi medical interventions. For that matter of fact, highlighting a closing gap now coming to the interdisciplinary research section uh SC in this, with faculty deeply involved in research. Now these, these are just the metrics that we studied and it's the same thing that I just discussed now in curriculum integration and this is the research section, so S DMC in this but uh CBC from university level documents, even though there is a clear discordance between projects carried out at the university level and the access of these opportunities to us medical students. Uh For example, we didn't even know in 2021 and 22 that these programs existed at the university level. So that is the level of disorders that we are talking about and uh has a comprehensive health website, uh SCC BMC website is outdated and does not include like plant health resources, the leaders in health that we have. So there is a lack of information and S DMC and F MMC lack dedicated websites altogether. Now, when it comes to community outreach uh in the CBCBM CCC do actively engage in community facing events. Well, FMC has minimal outreach. Now, uh let's talk about uh student uh support for student initiatives. So CMC offers robust support for student L uh projects with grants and dedicated uh organizations. However, C BMC H provides research opportunities but there is definitely a lack of funding for student initiatives at C BMC H and uh King size Univer University support for cli climate change research. But again, the medical school itself offers limited support. Now, when it comes to F MMC, there is clearly a lack of support for student led plant health coms. Now, finally, in campus sustainability uh game stand out with a sustainable transport plan and ambitious net zero goals between 2050 as GMC and F MMC focus on renewable energy resources like wind, solar and hydro electric power. And the CMC, it emphasizes sustainable building practices, but most of its power supply comes from fossil foods. So as a summary, uh let's uh summarize this because I don't have time to discuss more topics. Uh But as a summary, we found out that the National Medical Commission's efforts to integrate health into the curriculum are insufficient and there is an over reliance on independent lecturers for the integration of health, consistent and dedicated strategies are needed to embed uh plant health education uniformly across medical schools. Now, this is the main section that we are talking about, which is the key recommendations that we have formed. So as we wrap up, it's clear that integrating health into medical education is crucial for addressing future environmental challenges. Our review of Indian Medical Schools by the PRC highlights both significant gaps and promising areas for improvement. Uh First step is the development of dedicated plan, primary health coursework. The NMC should introduce specific courses and electives on health, focusing on climate change impacts and sustainable health care practices. So I have provided the references to the UCSF School of Medicines electives in the last slide for guidance because uh they, they really inspired me to, you know, uh talk about this topic. So the next is the uh we like. The NMC is recommended to establish clear graduate outcomes resembling those uh outlined by the GMC in the UK. So again, I have provided differences to that in the last slide and it is suggested that the NMC surpassed the GMC S aspirations by not solely encompassing sustainable healthcare, but also advocating for the broader integration of planetary health and climate change into these outcomes. Now, our next recommendation is to promote planetary health research. There is a need to support and centralize research on environmental health links which can be done by creating dedicated research community committees to foster a strong uh research culture akin to Newcastle University Medicine Malaysia's approach. So I want that in the slide. Now, uh next step is centralized websites for resources uh that uh we must set up to centralize everything related to health. And uh yeah, so and our awareness education matters for patients must be available at the medical schools. So I'm out of time. So I'm kind of uh sliding through my slides. And uh yeah, so uh so here are some final thoughts that I wanted to say. Um incorporating Planetary Health into medical education is not just about adding to the curriculum, but it is essential for building a resilient and sustainable healthcare system in India as future health professionals. It's our duty to advocate for comprehensive education in these issues, engage in meaningful research and support initiatives that promote sustainability. By following these recommendations, we can better prepare ourselves to tackle the complex relationship between human health and the environment and sharing a healthier planet for future generations. And yeah, that's my time. Thank you for having us and these are the differences that I was talking about. So, yeah, thank you so much. Thank you so much for seeing you had so much to cover and so many interesting points as well. So I'm sorry, you had to speed through it, but hopefully we can pick up on some of that um in the questions at the end. So thank you and stick around. So, uh next up, we have Sanu me to who's going to talk about um Oh Jennifer, you've got. So, so we're gonna go for Sun May. Um She's gonna talk about education for sustainable healthcare and plant health and the launch of the education for sustainable healthcare, J ISC network for all UK medical schools. So Sania May, if you're happy to share your screen. Thanks very much AOA and yes, um I'm saying May turn and I'd like to talk um from about the um UK uh network uh about um embedding education for sustainable health care and planetary health into the curriculum of all across all of the UK medical schools. And this is the actual curriculum document that we are encouraging medical schools to use and helping them and supporting them to do. So, this is an innovative planetary health and sustainable healthcare curriculum. It's adaptable to different contexts because it doesn't have levels of learning outcomes. It just has statements uh for each item, it's fully endorsed by the Medical Schools Council, which is the umbrella body of all of the U KS Medical Schools and the GMC, the General Medical Council who is our medical Regulator and Overseas Education. Um It's freely available on the website, it's published by the Medical Schools Council and uh I'd like to thank uh the um national working group who developed this. Uh And um the Emma is also on the on this call. So developing the curriculum, the Medical Schools Council hosted a conference um for all the UK medical schools on education for sustainable health care and planetary health. And then we formed a working group across the UK of medical educators who developed the curriculum. It was done through a series of consultations, discussions, review processes and then the medical schools councils, education leads advisory group fully reviewed it and endorsed the curriculum. The GMC has included the curriculum in its list of documents that informs delivery of its outcomes for graduates. And the GMC has also stated that the curriculum will inform future in iterations of not only outcomes for graduates but other related guidance. And the contents include uh curriculum design, key foundations of ES H the health impacts of climate uh uh uh ecosystem crisis, the impacts of the crisis on healthcare systems and healthcare's impact on the environment as well as a breakdown of medical specialisms and sustainable um clinical practice. But the most important part of the curriculum in terms of the an ecosystem crisis is the part about professionalism, leadership and achieving structural change. And this is what we want to train our students to do so that when they become professionals or even while they're still students that they can help to change the system, to give us a chance at a more sustainable future. Using the Esh curriculum should be very easy because it's self explanatory as far as possible, it's user friendly across lots of curricular structures. We've kept it very concise and we put in hyperlinks to high quality sources of information so that learning outcomes can be easily drawn up for different contexts. So what we did with the G network, which is uh joint information systems uh Consortium was the original name for it, but GIS is um sort of a shorthand for the official mailing list network in higher education. We aimed to form a national network to support all UK medical schools to integrate the curriculum into their existing teaching. So under the umbrella of the Medical Schools Council, we set up the G platform and invited all the medical schools and every medical school in the UK has now nominated faculty representatives to this network. The network supports in mentation of the curriculum. Uh We do this by sharing resources or talking about challenges and good practice and progress. And um at every meeting, we actually ask what are the priorities of our members and what would, what would they like us to cover? And then we do our best to um share that and um try and um uh fulfill those, those needs. So the meetings we've had so far, we've had the inaugural meeting and now a second meeting and these meetings have been beyond expectations because they have been so well attended, The majority of the medical schools have attended the meetings. And if you think about how um pressed for time, faculty are, we've had heads of school attending. Um it's been very lively and productive and so the NG network has um clearly fulfilled a need. But I'd like to know talk, talk to you also about what we mean in within this curriculum, about sustainable health care and, and this conference is all about sustainable healthcare. But there's a specific definition that we are using um in medical education about it being about the improvement of health and better delivery of healthcare so that there are benefits to patients and the ecosystems on which human health and all of life depends so that we can have high quality health care now without compromising the ability to meet the health needs of the future. And this um definition has been taken up by ae the International Association for Health Professionals Education. It's been taken up obviously by the Medical Schools Council and now the General Medical Council, the GMC has included it in its documents that supports the new sustainability duty. And I'd like you to um take note of the priorities within sustainable health care. We talk a lot um about um low carbon al alternatives and so forth. But that is right at the bottom of the pyramid. We have to start with prevention so that we don't have the people coming to us as patients needing care. When we have good planetary health, we will have good prevention and we will not have so many patients. And that is the most sustainable way of having sustainable healthcare, patient agency and self care and then lean care systems. And when all of those have been addressed, then we can think about low carbon alternatives. So I'd like to address a few things that came up from time to time when I talk to people. Um what sustainable healthcare is not and what it is. So it's not about depriving people of uh of of healthcare that they need. It's about good medical practice. It's not about imposing unwanted changes. It's about listening to what matters to patients and prioritizing that. It's not mainly about recycling plastics, inhalers even though those are essential and we have to do it. But it is about more attention to enabling good health preventing disease. And most of all it is the opposite of defensive medicine. We need skilled clinical reasoning and we need to allow our students who become doctors and other health care professionals to learn and have confidence in skills, clinical reasoning so that we do not do too much or the wrong things at the wrong time. And we don't employ in defensive um ways of doing medicine. So I mentioned the GM C's new sustainable duty. So there's a new du duty of sustainable health care which came into effect in January of this year. And um there is a, a must duty and a should duty. So the must duty is compulsory. Um You must make use of um your uh re resources with responsibilities to your patients and also to the wider population. The wider population is very important and then uh solutions that uh reduce the environmental impact of health care. So beyond the, the UK medical education system, the curriculum has informed other health professions and other levels of um uh training and in other countries around the world planetary health report card, you know all about. So the summary is that this G networks meets a need for medical schools to come together to share ideas, resources and strategies for the inflammation of the uh ES H curriculum. And there's been interest from other health professions at, at, at, at, at postgraduate levels which may indicate potential for similar parallel networks to be set up in the UK and possibly further afield and I think I can stop there. So thank you. Thank you so much. So it's really interesting to hear about that, especially when we work in a sustainable education. So it's great to see a little bit of teaching on the prioritization of prevention. Definitely. Um So again, if you've got any questions, please put them in the Q and A or in the chat and we can put them to San Mae at the end. Uh So our next talk is by Jennifer Timpani. So she's going to talk to us about sustainable healthcare education and quality improvement projects and forming a junior doctor sustainability group. So welcome Jennifer. Hi, everyone. My name is Jennifer. I currently work as a core surgical trainee in Northern Ireland. But last year I completed a clinical teaching fellow year in NHS Ayrshire and I, where I led a project to set up a junior doctors, clinical sustainability group. And that's what I'd like to talk to you about today. So why was this group set up? It was clear from talking to a number of other doctors that they were keen to practice sustainable health care, but the platform just wasn't there to do so. I also noticed that doctors felt they hadn't got the relevant education to be able to enact their ideas. And what I also recognized was that from a doctor perspective, we need quality improvement projects, audits, teaching opportunities and leadership opportunities to be able to progress in our career. So I wondered whether it was possible to try and combine all these ideas into one and create a platform to do just that. So the aim of this quality improvement project was therefore to support junior doctors throughout the trust in undertaking local sustainable health care pro projects while also providing a synchronous teaching program. At the same time, with the idea to improve doctors, confidence and knowledge in this area. And this would be supported on a more leadership level by the realistic medicine team, which is a group of consultants and allied healthcare professionals with an interest in sustainable health care and practicing holistic medicine. And the overall idea was to try and be able to provide doctors with this education but also to reduce the carbon footprint of the trust in terms of methods. I started by meeting up with the realistic medicine team and coming up with a strategy as to how we could formulate the junior doctors clinical sustainability group. Following this, a survey was sent out to all doctors across the trust to try and gauge interest and see who was keen in getting involved within the group. And we also worked on how the group would be formulated and what the strategy of the meetings would involve. So following the information following the survey and information webinar was held which outlined the aims of the group. And also during this, we were able to brainstorm with those who attended to come up with a range of potential quality improvement projects that could be undertaken during this meeting, we were able to also formulate six subgroups comprised of doctors at different stages throughout their career. Some more junior up to some senior regs and these subgroups were then able to undertake different quality improvement projects. Once the groups were formed, we were then able to have monthly meetings which were then used as brainstorming and troubleshooting methods to push the quality improvement projects along. And there was also a teaching component to these as well. There was a presurvey questionnaire at the beginning of the formation of the junior doctor sustainability group. And then one at six months to try, try and quantify progress in terms of results. What we found was that there was 36 junior doctors who registered interest in the group initially and 30 attended the online webinar following that there were 25 doctors who committed to joining the group. And I think that that's quite a significant number for a relatively small trust which shows that doctors are keen to practice sustainable healthcare um as well as this. So what we can also see there was a range of grades, there was mostly half were from foundation doctors. 39% were sh os and then 16% were regs. And it's quite nice having the split of different stages to be able to provide their knowledge. With regards to supporting the projects, members were from a wide range of specialties. The most common being medicine followed by surgery and then in terms of the actual topics covered. So what we can see was for the quality improvement projects. There was two groups that undertook a gloves off campaign. Two groups also looked into waste management. One group addressed reusable cups in the canteen. And another group looked into alcohol based handscrub because there was numerous groups that were across two hospitals. There were some groups that undertook the same project, but just in different hospitals then considering the teaching program aspect of the meetings, there was a wide range of topics covered which you can see on the screen. And the idea here was that there was something for everyone and that once the knowledge was learned, we could try and enact that in our clinical jobs in terms of the preproject questionnaire. What we found was that 86% of respondents felt that they had an adequate education on sustainable health care throughout their medical training. And 100% would like to practice more sustainable health care at work. 89% were interested in attending a teaching program based on the principles of sustainable health care. And that this survey was one of the main drivers that gave us the initiative to set up the teaching program. So following the teaching program and also the quality improvement projects being instigated, we undertook a repeat survey at six months and following setting up the group. And what we found then was that two thirds of the subgroups had completed two cycles of their quality improvement project. 84% of the respondents felt that they strongly agreed their knowledge and sustainable health care had improved and 92% agreed that the teaching program had contributed to this. So just in conclusion, what does this quality improvement project show? Well, it shows that junior doctors are passionate about sustainable health care. They just need to have a platform to be able to practice it. I think it also shows that when you bring a collective group of people together with uh passionate ideas, you can make a real difference and it's having the leadership there to be able to make these ideas possible. So, thank you for listening to my talk. I'm happy to take any questions at the end. Thank you, Jennifer for that. Um So our last uh presentation is um with Philip and Alex, I think are here um on advanced inflammatory health in medical education at UC Berkeley. Um Jennifer, if you're able to just stop sharing your slides so that they're able to share theirs. Thank you. Great. Thank you. Um Yeah, my name is Alex and I'm here today with Phillip. Um We are both third year medical students from um the joint medical program um between UC Berkeley and UCSF. Um It's just a little bit more about the program. Uh since not a lot of people know it's a dual degree program um where we both get a uh master's and an MD. Um And it's a collaboration between the UC Berkeley uh School of Public Health and the UCSF School of Medicine. And today we'll be presenting our findings from um the PH RC evaluation. So to go into a little background, um you know, climate change has become an increasing problem in the world. Um uh Most of you probably have heard that India has been through a record breaking a year with the heat wave and um its effects on human health are presenting like a just growing challenges for adaptation. So according to a recent report by the Intergovernmental Panel on climate change, approximately 3.6 billion people reside in regions considered highly vulnerable to climate change. And researchers only anticipate this number um to rise in both mortality and morbidity in in the next few decades. So, um because of this prioritizing sustainability is is of the utmost importance to address this climate crisis and improve planetary health. So, um the Ph RC or Planetary Health report card was a tool that we use to evaluate our own institution to um incorporate and prioritize planetary planetary health principles. And this year marks the uh joint medical programs which I will refer to as the J and P. Um the J and PS fifth consecutive year participating since uh the HR CS inception in 2019. And um we, I think we've been doing pretty good. Um Throughout those five years, we've been our lowest score was like A B. Um So, yeah, we've consistently achieved high scores across um the various PH RC metrics. And uh this shows our um institution's commitment towards sustainability and um just advancing PR C initiatives uh as for the methods, um we use the PH RC evaluation template um And we use that to assess the J and P across the, the five key domains which are listed on the slide. Um So one curriculum to in interdisciplinary research, three community outreach and advocacy for support for student led initiatives and five campus sustainability. And the data was gathered through faculty interviews, uh review of the UC Berkeley School Public Health uh website, as well as analysis of UCSF and UC Berkeley's uh Offices of Sustain Ail um annual reports. And uh here in figure one is a snapshot of one of the um scores of the PHRC. So this one is regarding uh the J and PS curriculum and we gave it a three and then the score explanation is, is um detailed in that uh bottom half there. And based on these findings, uh recommendations for improvement um were made. And um I think Philip will go into that in later slides, Alex. So my name is Philip, I'll be going over the results and then discussing some of those results. So like Alex said, the J MP has historically scored pretty well on the planetary health report card. But one thing that Alex and I noticed was if you look at historical trends uh which are also shown in our poster, which you should definitely check out. Um There's a lot of fluctuation year by year in how the J MP gets graded. Um So I'll go over these first and then I'll go ahead and talk about why. Um like we discovered that is so when it comes to curriculum, this is the JM P's lowest score. And we found that because we're a two year program, it can be difficult sometimes to incorporate aspects of planetary health into our curriculum. So we have a problem based learning curriculum, which is where students get access to um some uh like simulated or imaginary cases where you, you learn from a patient's clinical presentation. So out of 33 different problem based learning curriculums that um students get exposed to, only three of them had any real mention of planetary health or sustainability or environmental health. So that was one thing that we wanted to work with our faculty pretty closely on with regards to sustainability. We also found that the J MP doesn't currently uh or didn't have any kind of sustainability measures surrounding consumables such as reusable food wear or single use plastics or waste disposal. And that's something that we did get to work with faculty on later on the other categories, the J MP has done pretty well on and continues to do well on. So in terms of interdisciplinary research. We have a lot of students that are working on planetary health and environment related projects and those often also intersect with other fields such as dermatology or um obstetrics and gynecology. And the same goes for community outreach. We often partner with community organizations to uh for example, um improve student education or improve uh like the way that homeless shelters. Her one next slide. Excellent. So what we found was because um every year the person in charge of the Planetary health report card changed, we often weren't able to see through um or rather make sure that the faculty were able to see through the changes that they had promised to make. So, for instance, uh with regard to curriculum, there is an over that was uh being scheduled for the fall of 2023 that our report card had taken uh into account for. But because of some uh logistical issues, this was moved over to fall of 2024 and the faculty were very transparent about this and we got to work with them to figure out exactly what uh would be covered in those kinds of meetings and what the goals were uh planetary healthwise moving forward. So, in order to address this, um Alex and I helped uh the faculty to establish a permanent Planetary Health student position. So um this is significantly more structured and official than this position was in the past. And it means that we're going to be able to make sure that any kinds of changes that we make are going to be um sustainable and um like saw through in the future. So this entire process uh made me think about this like spiral curricular approach that um my program likes to reiterate very often and basically, um at, at the core of it, um it means that in order to, to really understand something and really put it into practice, you need to see it over and over and over again. And this definitely applies to sustainable change as well. If you want sustainable change, it's good to have sustainable policies. Um And for instance, like a sustainable position where you're making sure that transitions into future years go smoothly and people that take over um initiatives that you're leaving before have all the information they need to be successful. Um And that's something that we're really proud of um that we accomplished this year. And aside from that, we also got to work with the faculty on uh improving like the campus sustainability measures that I talked about in the earlier slide. And I think I'm at time. Uh that's all I've got. Thank you, Alex and Phillip. Um So that concludes all of um the presentations if I can ask all the presenters just to pop your cameras on, so we can have a bit of a roundtable discussion. I'm wondering James, do we have any questions in the chat. I don't, I think they were all replied, they were quite specific but they've all been replied to at the moment. Yeah. All right. Um, I have a question. Uh, I probably a, a few of you guys would be able to answer this but I see a lot of you are sort of on the ground student that, um, sort of initiatives to push to include things into curricular change. Did you find that it kind of um triggered a domino effect of more people becoming interested and maybe wanting to expand? For example, sterling, you had this whole list of places where you could embed sustainable health care. Although you'd started just in a couple, did that trigger those faculty members then thinking about other ways that they could embed sustainable health care. I'm not sure either Sterling or pursuing a whether you came across any examples of that. Yeah, I think for us, there was a bit of a, a hurdle at the beginning just trying to figure out how to pitch sustainable change to in our curriculum to our lecturers, especially because here at Vanderbilt, our, our preclinical uh program, which is what we really targeted is condensed to one year. And so our time is really limited. Uh II think the biggest thing that we've seen is that once we were able to get a little bit of buy in and we were able to show to our other lecturers, our deans and our doctors that it's feasible that people become more and more willing to make these changes along with them. Um, and that's something we've seen just over the past year and now going into next year, we're seeing not only f lecturers and doctors being receptive to the changes, but being really engaged. And so people are coming to us with ideas and we are getting more and more things approved and it's growing much faster, I think than we anticipated at first. Um And so it really is for us, at least just about getting that initial foot in the door and proving that it is feasible with, you know, minimal effort and burden on the lecturers and our deans. Um And once we were able to prove that it, it really garnered some interest and also receptiveness from everyone kind of around the medical school, I feel did the rest of you have similar experiences? Um I can go next. Yeah. So I think uh initially when we started off, uh when we did the pilot in India, I think it was like really difficult first of all, like um to like engage with not just the faculties but especially like from the admin side of things, like, I think the hospitals were very like uh uh I mean, it was intimidating for them to like, you know, sign up to something which is like going to score them and they knew they would not get great score. So it was just a very tiring process to like, you know, get all that sorted where they uh finally like were ready to have the results published. Um And uh I think especially I II think it matters also like the faculty and the group of students who are doing the groundwork and how uh motivated they are. Because like in some instances, for example, Saint John's Medical College in Bangalore, the faculty was very interested and they've now introduced like uh planetary health specific electives, they've done like uh uh conferences. So like they've done a lot of things because of their motivation, purely their motivation. So I think it also, it's very subjective like from uh who is involved in on the project, I would say, and I wonder s you may from the perspective of people, lecturers doing the teaching, did you find a similar thing when, because you said that from every medical school two people got appointed was, was that, did you find a lot of people had self a pointed or were kind of pushed that you need to do this? And how did they then progress? Yeah. So what we did was we sent an invitation via the Medical Schools Council to each uh UK medical School suggesting that they might like to nominate um a member of faculty um to the, the, to our network. And um some, we obviously had to chase and some we had um connections of people who we knew already were interested. But I think the more that they knew that others were doing it, they were keen to do it too. So that's the requirements from the GMC. So, you know, there's the requirements from the GMC, there's the new sustainability duty. It's the Medical Schools Council, which is the umbrella body of all of the UK medical schools. So it's them, actually, it's the schools themselves that have endorsed and published this curriculum. And therefore when we're offering for the schools also to be implementing this curriculum, it's just we're giving them help. So we're giving them help and advice and resources and so it helps them if they come along and if they join in, and I think they were all very surprised at how much help it was giving them, you know, mutual support. And um so they were all very um happy to, to um nominate representatives. So each school, 12 or even some schools, three representatives. Um and they've been turning up uh to, to the meetings and uh very engaged with what it is that they feel that they need in order to help them to progress with this implementation. Yeah, that's great. And I think it's what we see also in clinical practice that people have the motivation, but they don't have either the capacity or the capability and the background and expertise of knowing where to do things. And we all work in really busy health systems you want to make it as easy as possible. People want to be able to easily adopt things. Yes. And it has been mentioned already that faculty do find it challenging to have to um turn to something that they're not familiar with. I mean, they're experts in their own field, in their own subject matter or specialty. And here is something else that comes along that's fairly new to them. And you know, the students are saying we want to know about this to prepare us for our future. And um the regulatory bodies are saying, you know, you've got to do this in the UK, there is the NHS net zero commitment. So when we're producing doctors to work in the health service, they need to know about this. And so there's all of this requirement as well as the peer pressure of other medical schools are doing it. The Ph H RC is fantastically important in all of this. And um I didn't have time to go into it, but in the slide, I said that increasingly the curriculum is aligned with PHL C. So in parallel, what's what's contained in the, the PH RC, the metrics which and the metrics are validated by a fantastic comprehensive literature review. So it's all scientifically based, everything in the PH HLC is, is based on evidence and science. And so because it's um you know, sort of being developed almost in parallel with the PLC, really, it's, they couldn't you know, so they couldn't do better. And then the curriculum document itself is um has got links to um sort of almost vetted links to resources for, for the educators and also of course for the learners. So I think that they're finding it surprisingly helpful and of course collegiate because we're working on this together, we're talking about the problems and the challenges. We've got a curriculum that is very, very crowded. So how to, how do we um put this into an already crowded curriculum? Put it into already existing learning um elements and um you know, get al also all our other colleagues on board. I think there are a few questions in the chat, James. I wonder if you want to share any of those? Yeah, there's a couple. Um so n has asked about challenges and enal getting students involved in for and I suppose other efficacy. And um I think Jennifer, your work seems to be evidence that there's interest in the younger generation of doctors in this work. So I wondered if you might perhaps not from a student perspective, but also others will ask others. But what are the enablers for getting doctors and students involved in this work? Um Yeah, I think, you know, from having listened to what everyone said today, my reflections or thoughts are I wish when I was in medical school that there was this platform where we were taught about sustainable health care. So that we didn't kind of have to find ourselves and go through all the nitty gritty difficult aspects of it that I definitely found that I went through and was lucky actually to have senior support to facilitate and help me through it. But the biggest thing that I found was that it's very, very clear, you know, there's passion from junior doctors, from medical students coming through that we want to learn how to practice sustainable healthcare, we want the facilities there to do that. And I think from a leadership perspective, there needs to be a real focus on that, on enabling that for all of us. Um I think, you know, from a doctor's perspective, part of it is having the time to be able to make those changes, to be able to work with a junior doctor sustainability group that I set up. And I was lucky last year in that I was doing a clinical teaching fellow role. So I had no one calls and I did have quite a bit of time to put into it. Whereas now that's unfortunately just not the case. So I think having the time, the support and just the resources to be able to work on the idea because we have the ideas here. We just need the support and a more senior perspective to enact those. Um And I'm hopeful that in the future and especially, you know, being here today, it's quite clear that there's a lot going on and 1020 years from now, things will hopefully be a lot easier for us all. Yeah. I think the time is, you know, we rely in this field so much on people volunteering their time and with the report cards as well, it's all done voluntary. But actually what they're doing at the nursing school in Brighton is there's allocated time for the students to do this project as part of their studies. Phillip and Alex, I wonder if your experience of being part of the report card in a different country setting? Do you get allocated time for this kind of work or is it all similar voluntary set up? Um Yeah, it's definitely on a volunteer basis, whatever free time we have, we can work on the report card and it's up to us to really schedule the meetings with faculty members. Um regarding is it new or um question on uh like how to enable students to get involved? Um If like their main concern is the lack of time is I think definitely having um a team or at least a partner. Um I don't think I would have signed up for this if uh Phillip hadn't agreed to work alongside me. So if anything out, no, I think you summed it up uh very well and I agree, I think having uh someone to keep you accountable is, is really important. And I also think that um if medical schools were able to kind of budget time for these extracurricular pursuits. It would make it definitely a lot easier um, to get involved. I can see there's um, another question for you Jennifer. Um, Amy Davies. She's saying that she wants to do uh a junior doctor platform as well where she works. And do you have any information on how to do this properly and above board and who you need to speak to? Um, hi, Amy. I'm more than happy to get in contact with you after I can send you over some resources as well. But yeah, for me, I was lucky in the sense that there's a realistic medicine team in Scotland who have quite a keen initiative or drive to practice sustainable health care. So I was able to contact a number of the consultants in that team and they were extremely supportive. I think when you've got an idea and you're willing to make a change, they just wanted to help me essentially. So I was able to sit down with them and just come up with an idea of how the junior doctors platform was actually going to work because as I said, I wanted to ensure that there was an educational component to it as well. Um But then a key part of it was trying to involve key stakeholders because we had a range of different quality improvement projects going on and there was different stakeholders needed for each of those. But having that leadership aspect was extremely helpful because they were able to identify the relevant people and then involve them in the meetings as well. Whereas II wouldn't have been able to have done that myself. Another aspect of it was um a good point that Alex made is having other people to help you. II had another junior doctor that was also keen to get involved and she took on some of the leadership role alongside myself. Um But it was definitely a learning process. Like anything, there was many things that didn't go to plan and lots of chasing people as well. But I did find that from being persistent and from motivating the other doctors within the subgroups that we, we were actually able to make meaningful change. But I will, I can contact you after Amy and more than happy to have a chat or send over any resources Jennifer. Do you have a like a greens champion um like network within your hospital, like any other wider multidisciplinary green team or is the foundation doctor is one of the main, one, foundation doctors was one of the main ones, but there was an anesthetics, one that I was aware of, although we didn't really link in with them as much as probably we could have done. Yeah, I'm just asking because II know my trust, we've got a Green champions group that's got loads of people, you know, nutritionists, dieticians, pharmacists, nurses and you know, it's all teamwork and we need to be as multidisciplinary as possible. But that's interesting to hear. Um Any other questions I'd like to just pop back to Amy's first question about the GMC medical school integration. The question is, it's great to see the official GMC and medical school integration and sustainability. Would you suggest that normal doctors and A HPS on clinical placement should integrate this type of thing or leave it to the official channels of the university? I think this is an interesting question because is it, you know, should we be waiting for our institutions to kind of adopt these things or should we all be trying to think? And there's been a lot of a de and men, the reference to the GMC and so may talk about the GMC and I'd be interested to hear everyone sports on how effective um you think that top down approach is because we've been trying to work with the GMC to try and get them to be much more rigorous on there inflammatory health requirements. But um it seems to be high praise for them at the moment. So you may perhaps if you can talk about that. Yeah, I mean, in my experience, the more pressure there is on the top down institutional set ups, the better they do respond to um public opinion, they do respond to what's happening out there. They do respond to pressure, especially to pressure I think. And it's a question of um timing and um how long, how long they take to do it. But I think if um that drive comes that requirement or um you know, the the perceived wish for for change comes from many different directions, then um they, they really do have to uh look at it uh quite carefully. And um II understand the, yeah, the GMC is unique in the UK for its sustainability inclusion. But um perhaps our American colleagues, is there, is there an equivalent um not mandated but an equivalent guideline from a sort of national body to include this sort of material? Is anyone aware of anything of that nature? There, there is nothing to my knowledge. II think at at least here at Vander dot We have actually been a lot more uh successful in incorporating things to the medical school. Uh But we struggle a lot. I think as uh our, our physician mentors can attest to, to incorporate any sort of uh sustainable change within the actual hospital system. Um II think that's where a lot of push back or just ambivalence comes when we talk about sustainable change, II think it's something that the students are are interested in and that interest helps kind of uh propel our efforts forward. But when it comes to actual implementation into the hospital setting and in our hospital network, uh as far as I'm aware, there's no sort of mandate or even guidance uh from a national level and there are, there are bodies that are interest groups a and created by physicians as far as I'm aware, but nothing um from a governmental perspective, nothing uh that has any sort of mandate or uh official guidance as to what sustainable healthcare should look like in our hospitals. Um A and that's definitely a challenge that we feel ongoing, especially because we're, we're learning about these things as medical students. Um but there, there seems to be a lot more barriers when it comes to actually implementing some of these things into clinical practice. Once we are practicing physicians, I would actually like to talk on this topic a bit like uh the perspective of this. So I'd like to share a story like my second year when I was starting to learn about health. So we went to the PD of Professor of House and asked him like, uh since you are like prescribing a lot and I learned this time of prescription and how it leads to increase in carbon impact of the work. So why are you doing this and why not uh you like, like test out uh evidence based medicine or, you know, like uh properly admitting patients into the wards and uh you know, uh decreasing the amount of antibiotics that you are giving. So he actually took us to the wards and that uh that was a time when we were never in the wards before and we went there and there like students uh like not students like patients actually lying on the floor. And ours is actually a very big hospital, like we have 3000 beds and we are adding 5000 more in next year. So it's like 7000 to 8000 bed at the hospital. And still there are patients lying on the floor because we do not have beds to admit them. So yeah, so that is definitely a challenge there. And uh the top down approach will actually help in it because the next year, only an MC actually made a few changes in its curriculum and it integrated a few plan topics into it. So our professors do not get time to, you know, uh research about this topic and to get them into the lectures. So the NMC guidelines actually help. And the next year only there are a lot of topics that to get into it, which will also visible in the results that we analyzed. So, yeah, that was the Indian. Um So we're at uh 350 now, which is the end of the session. I just wanna say a huge, huge thank you to all of our speakers and for sharing um your learning and your efforts from around the world and around the country. It's so important that we share this learning so that we can learn from each other and save people time because we don't have time to uh to redo this all over again. And thank you also to James. So I think there's now a break until four o'clock. Um, when the next sessions are gonna be started. Is that right, James? Yeah, everyone back to the main stage at four o'clock. Perfect. So, thank you, everyone. Have a nice break. Good.