Factors influencing medical students’ knowledge and attitudes toward climate change: A cross-sectional study

PLOS One | https://doi.org/10.1371/journal.pone.0330875 October 10, 2025 2 / 12 attitudes. Most respondents (n=197, 63.3%) did not receive climate change educa- tion in medical school. Students who completed their education in the MENA region were the least likely to have received climate change education (16.75% vs. 46.94%; p <.001). Survey respondents who received education demonstrated significantly improved knowledge (β=1.23, p <.001). Having a higher knowledge composite score was positively associated with a higher composite attitude score (β=.71, p=.002). Conclusion Effects of climate change are particularly pronounced in the MENA region due to heat extremes, water scarcity, and air pollution. Recent medical graduates applying to res- idency programs in the UAE have had limited education in climate change. Medical schools around the world should prepare students to address the escalating health risks of climate change. This will require investing in faculty development, supporting student-led advocacy, adopting curriculum mapping tools, and most importantly, inte- grating clinical experience, such as project-based learning, simulations, and partici- patory action. Introduction Climate change is one of the biggest environmental challenges of the 21st cen- tury [1]. Over 3.6 billion people are estimated to live in areas vulnerable to climate change, with 23% of global deaths attributable to environmental factors. Projections suggest that by 2030, there will be 250,000 climate change-related deaths annually

[1]. Climate change can directly affect mental and physical health through severe weather events (respiratory and cardiovascular diseases, mental health disorders) and indirectly through the effects of environmental changes (vector-borne illnesses, food insecurity) [2–4]. Vulnerable populations, including young children, older adults, and low-income communities, disproportionately bear the health burdens of climate- related events [4]. Physicians are at the forefront of recognizing, preventing, and treating climate- induced health issues and serve as role models in supporting sustainable practices [5,6]. Studies show that healthcare professionals’ knowledge and attitudes toward cli- mate change directly reflect the care they provide to their patients [7]. Although phy- sicians should understand how environmental changes can affect human health and be comfortable counseling patients to mitigate the potential harm caused by climate change [7,8], several studies have documented a lack of knowledge and confidence in dealing with the health impacts of extreme weather events by medical students and residents [9–11]. Medical students believe neither they nor the healthcare sector are adequately prepared to address climate change [10]. Additionally, studies report that health professionals do not feel a sense of obligation to participate in climate change mitigation [12], as they perceive such efforts compromise their ability to care for their patients [13]. Competing interests: the authors have declared that no competing interests exist.