Teaching Environmental Carcinogens and Environmental Medicine in Medical Schools: Current Scope, Educational Strategies, and Opportunities for Curriculum Reform

Abstract

Background: The global disease burden due to environmental risk factors such as Environmental Carcinogens (EC) is significant; but these exposures are not comprehensively covered in the medical school curricula. Meanwhile, physicians should have the ability to recognize exposure-related diseases, obtain environmental exposure histories and counsel patients.

Methods: A review of peer-reviewed studies, institutional reports and opinion pieces that discuss teaching ECs in medical schools was conducted.

Results: ECs are usually taught within the larger framework of environmental and occupational health modules. The content of courses varies widely; and emerging issues such as endocrine disruptors, the exposome, and environmental carcinogens are typically absent. In the US, less than 1 in 7 students believe they have been adequately trained in environmental medicine. Schools have followed various teaching methods for this content, including interactive, longitudinal programs to improve knowledge and self-efficacy, modules and several weeks of experiential learning to improved students’ ability to counsel on environmental risks, elective courses and independent units on environmental topics. There are reports about evidence-based training on occupational carcinogens producing better test scores than learning impacted through peer teaching or small group discussions.

Conclusion: Integrating knowledge about ECs into the medical school curriculum is vital in preparing future doctors, together with working methods based on active and continuous competency development. At the same time, programs must address emerging environmental challenges, and equip doctors with adequate skills for counseling patients. Environmental medicine education is particularly useful for the prevention of exacerbating problems caused by the health impacts of environmental carcinogens.