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 8 / 12 Discussion In this study of the experiences and perceptions of medical school graduates from across the globe seeking residency training in the UAE, students reported limited climate change education in medical school and minimal clinical experience managing climate change-related health conditions. Our findings are consistent with studies showing that climate change education is often absent or insufficient in medical curricula worldwide [14–16]. For example, a review of medical school curricula in the United Kingdom found wide disparities in environmental health education, ranging from 35 minutes to 9 hours of coverage [26]. Similarly, in a survey of 600 US medical students, only 13% felt that their schools provided suffi- cient education on climate change [17]. Survey respondents in our study also reported that traditional lectures were the primary mode of education, with mini- mal opportunities for experiential learning. As a result, most were entering residency without adequate preparation to care for patients affected by climate-related health conditions. This finding aligns with global studies. In one study, for instance, only 6.3% of surveyed students felt “very prepared” to discuss the impact of climate change on health [17]. A notable finding is that students from medical schools in the MENA region reported the lowest rates of formal education on climate change. These gaps in knowledge and clinical preparedness are particularly concerning given

the region’s growing health challenges due to environmental change. While the MENA has adopted a National Adaptation Plan for Health and a Vulnerability and Adaptation assessment [27], and recently hosted the UN Climate Change Conference (COP 28) [28], our findings indicate that medical education has lagged behind in addressing climate-related health issues. Several factors may contribute to this gap. First, in an already crowded curriculum, emerging topics like climate change must compete with longstanding biomedical content. Additionally, a lack of faculty expertise can serve as a major barrier; many educators may not be adequately trained to deliver up-to-date, evidence-based climate health education. This challenge is further compounded by a broader lack of awareness and understanding of environmental issues across the region [29]. Moreover, medical content in the MENA region often places a stronger emphasis on traditional, discipline-based teaching, with limited interdisciplinary or public health integration [30]. The absence of national accreditation requirements that mandate climate health education may also contribute to its low prioritization [8]. One promising model for integrating climate and health education is to map relevant content onto existing curricular competencies and milestones. This can be accomplished through seminars, case-based learning, research opportunities, extracurricular activities, and clinical clerkships [7]. A recent review found that climate change-related competencies align

well with established domains such as systems thinking, resource stewardship, and social justice [31]. In the US, climate and health education has evolved from isolated sessions to more coordinated, curriculum-wide approaches [32], offering useful models for embedding content into existing public health, epidemiology, or community medicine courses. This inte- gration can help students understand the broader environmental context of diseases and health outcomes. Future curricula should go beyond theoretical knowledge and incorporate experiential approaches that actively engage students. Clinical rotations and internships are essential for building practical skills and deepening understanding [33]. Faculty development is also crucial to support this integration. Enabling student-led advocacy has shown promise in inter- national contexts and may offer a feasible entry point for institutions in the region. Our study showed that although survey participants received limited formal education, they still demonstrated good knowledge regarding climate change and its health impacts. The literature on physician knowledge of climate change remains inconclusive. While some studies have identified a lack of information among medical students [34], others report that students, physicians, and clinical leaders have a good general understanding of the health implications of climate change [22,35–37]. In a survey of 837 health professions students in Jordan, nearly 90% reported the internet and social

media as their primary sources of information on climate change [38]. This suggests that medical students may be independently seeking information outside formal curricula, relying on online and informal sources to fill gaps in their education- raising concerns about the consistency and credibility of these sources.