Our Metrics

Our 2021-2022 metrics were developed over the course of several months with the help of many faculty experts across the world, including physicians, educators, researchers, and advocates. We chose to focus on five main areas: planetary health curriculum, interdisciplinary research in health and the environment, university support for student planetary health initiatives, community outreach centered on environmental health impacts, and sustainability. While they are not comprehensive, these metrics are intended to establish what students and faculty felt were minimum criteria for adequately addressing the importance of planetary health in medical education.

Translations

As we expand globally, we are working to make the report card accessible with translations. Thanks to Gabriel Prévost-Marcotte and Anna Mumm for all their hard work translating the report card into French and German, respectively.

Planetary Health Curriculum Metrics

MetricDescriptor
1.1 Did your medical school offer elective courses (student selected modules) to engage students in Education for Sustainable Healthcare or Planetary Health in the last year?
3 points: Yes, the medical school has offered more than one elective whose primary focus is on ESH/planetary health in the past year.

2 points: Yes, the medical school has offered one elective whose primary focus is ESH/planetary health in the past year.

1 point: The medical school does not have any electives whose primary focus is ESH/planetary health, but there are one or more electives that include a lecture on planetary health.

0 points: No, the medical school has not offered any electives on planetary health or electives that include ESH/planetary health topics in the past year.

1.2 Does your medical school curriculum address the relationship between extreme temperature health risks and climate change?
3 points: This topic was explored in depth by the core curriculum.

2 points: This topic was briefly covered in the core curriculum.

1 point: This topic was covered in elective coursework.

0 points: This topic was not covered.

1.3 Does your medical school curriculum address the impacts of extreme weather events on individual health and/or on healthcare systems?
3 points: This topic was explored in depth by the core curriculum.

2 points: This topic was briefly covered in the core curriculum.

1 point: This topic was covered in elective coursework.

0 points: This topic was not covered.



1.4 Does your medical school curriculum address the impact of climate change on the changing patterns of infectious diseases?


3 points: This topic was explored in depth by the core curriculum.

2 points:
This topic was briefly covered in the core curriculum.

1 point:
This topic was covered in elective coursework.

0 points:
This topic was not covered.



1.5 Does your medical school curriculum address the respiratory health effects of climate change, including air pollution?


3 points: This topic was explored in depth by the core curriculum.

2 points:
This topic was briefly covered in the core curriculum.

1 point:
This topic was covered in elective coursework.

0 points:
This topic was not covered.

1.6 Does your medical school curriculum address the cardiovascular health effects of climate change, including increased heat?
3 points: This topic was explored in depth by the core curriculum.

2 points:
This topic was briefly covered in the core curriculum.

1 point:
This topic was covered in elective coursework.

0 points:
This topic was not covered.


1.7 Does your medical school curriculum address the mental health and neuropsychological effects of environmental degradation and climate change?


3 points: This topic was explored in depth by the core curriculum.

2 points:
This topic was briefly covered in the core curriculum.

1 point:
This topic was covered in elective coursework.

0 points:
This topic was not covered.




1.8 Does your medical school curriculum address the relationships between health, individual patient food and water security, ecosystem health, and climate change?


3 points: This topic was explored in depth by the core curriculum.

2 points:
This topic was briefly covered in the core curriculum.

1 point:
This topic was covered in elective coursework.

0 points:
This topic was not covered.



1.9 Does your medical school curriculum address the outsized impact of climate change on marginalized populations such as those with low SES, women, communities of color, Indigenous communities, children, homeless populations, and older adults?

3 points: This topic was explored in depth by the core curriculum.

2 points:
This topic was briefly covered in the core curriculum.

1 point:
This topic was covered in elective coursework.

0 points:
This topic was not covered.



1.10 Does your medical school curriculum address the unequal health impacts of climate change globally?


3 points: This topic was explored in depth by the core curriculum.

2 points:
This topic was briefly covered in the core curriculum.

1 point:
This topic was covered in elective coursework.

0 points:
This topic was not covered.



1.11 Does your medical school curriculum address the reproductive health effects of industry-related environmental toxins (e.g. air pollution, pesticides)?


3 points: This topic was explored in depth by the core curriculum.

2 points:
This topic was briefly covered in the core curriculum.

1 point:
This topic was covered in elective coursework.

0 points:
This topic was not covered.



1.12 Does your medical school curriculum address important human-caused environmental threats that are relevant to the university’s surrounding community?


3 points: This topic was explored in depth by the core curriculum.

2 points:
This topic was briefly covered in the core curriculum.

1 point:
This topic was covered in elective coursework.

0 points:
This topic was not covered.



1.13 To what extent does your medical school emphasize the importance of Indigenous knowledge and value systems as essential components of planetary health solutions?


3 points: Indigenous knowledge and value systems are integrated throughout the medical school’s planetary health education.

2 points:
Indigenous knowledge and value systems as essential components of planetary health solutions are included briefly in the core curriculum.

1 point:
Indigenous knowledge and value systems as essential components of planetary health solutions are included in elective coursework.

0 points:
This topic was not covered.

1.14 Does your medical school curriculum address the outsized impact of anthropogenic environmental toxins on marginalized populations such as those with low SES, women, communities of color, children, homeless populations, Indigenous populations, and older adults?
3 points: This topic was explored in depth by the core curriculum.

2 points:
This topic was briefly covered in the core curriculum.

1 point:
This topic was covered in elective coursework.

0 points:
This topic was not covered.



1.15 Does your medical school curriculum address the environmental and health co-benefits of a plant-based diet?


3 points: This topic was explored in depth by the core curriculum.

2 points:
This topic was briefly covered in the core curriculum.

1 point:
This topic was covered in elective coursework.

0 points:
This topic was not covered.



1.16  Does your medical school curriculum address the carbon footprint of healthcare systems?


3 points: This topic was explored in depth by the core curriculum.

2 points:
This topic was briefly covered in the core curriculum.

1 point:
This topic was covered in elective coursework.

0 points:
This topic was not covered.

1.17 Does your medical school curriculum cover these components of sustainable clinical practice in the core curriculum? (1 point each)– Waste production within the healthcare system and strategies for reducing waste in clinical activities, such as in the operating room
– The impact of inhalers on the healthcare carbon footprint and the environmental benefit of dry powdered inhalers over metered dose inhalers.
– The impact of anaesthetic gases on the healthcare carbon footprint and ways to reduce anesthesia environmental impacts, such as total intravenous anaesthesia or choosing less environmentally anaesthetic gas options with reduced greenhouse gas emissions
– The environmental impact of pharmaceuticals and over-prescribing as a cause of climate health harm. Alternatively teaching on de-prescribing where possible and its environmental and health co-benefits would fulfill this metric.
– The health and environmental co-benefits of non-pharmaceutical management of conditions where appropriate such as exercise or yoga classes for type 2 diabetes; social group activities such as gardening for mental health conditions; active transport such as bicycle schemes for obesity. This is commonly known as social prescribing in the UK.
– The health and environmental co-benefits of avoiding over-medicalisation, over-investigation and/or over-treatment


1.18 In training for patient encounters, does your medical school’s curriculum introduce strategies to have conversations with patients about the health effects of climate change?



2 points: Yes, there are strategies introduced for having conversations with patients about climate change in the core curriculum.

1 point: Yes, there are strategies introduced for having conversations with patients about climate change in elective coursework.

0 points: No, there are not strategies introduced for having conversations with patients about climate change.


1.19 In training for patient encounters, does your medical school’s curriculum introduce strategies for taking an environmental history or exposure history?

2 points: Yes, the core curriculum includes strategies for taking an environmental history.

1 point: Only elective coursework includes strategies for taking an environmental history.

0 points: No, the curriculum does not include strategies for taking an environmental history.

1.20 Is your medical school currently in the process of improving Education for Sustainable Healthcare (ESH)/planetary health education?
4 points: Yes, the medical school is currently in the process of making major improvements to ESH/planetary health education.

2 points: Yes, the medical school is currently in the process of making minor improvements to ESH/planetary health education.

0 points: No, there are no improvements to planetary health education in progress.

1.21 How well are the aforementioned planetary health/Education for Sustainable Healthcare topics integrated longitudinally into the core curriculum?
6 points: Planetary health/ESH topics are well integrated into the core medical school curriculum.

4 points: Some planetary health/ESH topics are appropriately integrated into the core medical school curriculum.

2 points: Planetary health/ESH is not integrated and is primarily addressed in (a) standalone lecture(s).

0 points: There is minimal/no education for sustainable healthcare.

1.22 Does your medical school employ a member of faculty to specifically oversee and take responsibility for the incorporation of planetary health and sustainable healthcare as a theme throughout the course?
1 point: Yes, the medical school has a specific faculty/staff member responsible for overseeing curricular integration of planetary health and sustainable healthcare

0 points: No, the medical school does not have a specific faculty/staff member responsible for overseeing curricular integration of planetary health and sustainable healthcare.

Interdisciplinary Research in Health and the Environment

MetricDescriptor


2.1 Are there researchers engaged in planetary health research and healthcare sustainability research at your school?


3 points: Yes, there are faculty members at the School of Medicine who have a primary research focus in planetary health or healthcare sustainability.

2 points: Yes, there are individual faculty members at the School of Medicine who are conducting research related to planetary health or healthcare sustainability, but it is not their primary research focus.

1 point: There are planetary health and/or healthcare sustainability researchers at the institution, but none associated with the medical school

0 points: No, there are no planetary health and/or healthcare sustainability researchers at the institution or medical school at this time.
2.2 Is there a dedicated department or institute for interdisciplinary planetary health research at your institution?3 points: There is at least one dedicated department or institute for interdisciplinary planetary health research.

2 points: There is not currently a department or institute for interdisciplinary planetary health research, but there are plans to open one in the next three years.

1 point: There is an Occupational and Environmental Health department, but no interdisciplinary department or institute for planetary health research.

0 points: There is no dedicated department or institute.
2.3 Is there a process by which communities disproportionately impacted by climate change and environmental injustice give input or make decisions about the research agenda at your medical school?3 points: Yes, there is a process in which community members impacted by climate and environmental injustice have decision-making power in the climate and environmental research agenda.

2 points: Yes, there is a process in which community members impacted by climate and environmental injustice advise the climate and environmental research agenda.

1 point: No, but there are current efforts to establish a process for community members to advise or make decisions on the research agenda.

0 points: There is no process, and no efforts to create such a process.
2.4 Does your institution have a planetary health website, or a website centralizing various campus resources related to health and the environment?3 points: There is an easy-to-use, adequately comprehensive website that centralizes various campus resources related to health and the environment including all of the following: upcoming events, leaders in planetary health at your institution, and relevant funding opportunities.

2 points: There is a website that attempts to centralize various campus resources related to health and the environment, but it is hard-to-use, not updated, or not adequately comprehensive.

1 point: The institution has an Office of Sustainability website that includes some resources related to health and the environment.

0 points: There is no website.
2.5 Has your institution recently hosted a conference or symposium on topics related to planetary health?
4 points: Yes, the medical school has hosted at least one conference or symposium on topics related to planetary health in the past year.

3 points: Yes, the institution has hosted at least one conference or symposium on topics related to planetary health in the past year.

2 points: Yes, the institution has hosted a conference on topics related to planetary health in the past three years.

1 point: The institution has not hosted any conferences directly, but they have provided financial support for a local planetary health event.

0 points: No, the institution has not hosted a conference on topics related to planetary health in the past three years.
2.6 Is your medical school a member of a national or international planetary health or Education for Sustainable Healthcare organization?
1 point: Yes, the institution has joined the Planetary Health Alliance and/or the Global Consortium on Climate and Health Education, but the medical school specifically has not.

0 points: No, the institution has not joined the Planetary Health Alliance or the Global Consortium on Climate and Health Education.

Community Outreach and Advocacy in Environment and Health

MetricDescriptor
3.1 Does your medical school partner with community organizations to promote planetary and environmental health?
3 points: Yes, the medical school meaningfully partners with multiple community organizations to promote planetary and environmental health.

2 points: Yes, the medical school meaningfully partners with one community organization to promote planetary and environmental health.

1 point: The institution partners with community organizations, but the medical school is not part of that partnership.

0 points: No, there is no such meaningful community partnership.
3.2 Does your medical school offer community-facing courses or events regarding planetary health?
3 points: The medical school offers community-facing courses or events at least once every year.

2 points: The medical school offers courses or events open to the community at least once per year, but they are not primarily created for a community audience.

1 point: The institution has offered community-facing courses or events, but the medical school was not involved in planning those courses or events.

0 points: The medical school has not offered such community-facing courses or events.
3.3 Does your medical school have regular coverage of issues related to planetary health and/or sustainable healthcare in university update communications?
2 points: Yes, all students regularly receive communication updates dedicated to planetary health and/or sustainable healthcare.

1 point: Yes, planetary health and/or sustainable healthcare topics are sometimes included in communication updates.

0 points: Students do not regularly receive communications about planetary health or sustainable healthcare.

3.4 Does the institution or main affiliated hospital trust engage in professional education activities targeting individuals post graduation with the aim of ensuring their knowledge and skills in planetary health and sustainable healthcare remain up to date during their professional career?
2 points: Yes, the institution or main affiliated hospital trust offers multiple in-person or online courses relating to planetary health and/or sustainable healthcare for post-graduate providers, including at least one with a primary focus of planetary health.

1 point: Yes, the institution or main affiliated hospital trust offers one course relating to planetary health and/or sustainable healthcare for post-graduate providers.

0 points: There are no such accessible courses for post-graduate providers.



3.5 Does your medical school or its primary affiliated hospital have accessible educational materials for patients about environmental health exposures?


2 points: Yes, all affiliated hospitals have accessible educational materials for patients.

1 point: Some affiliated hospitals have accessible educational materials for patients.

0 points: No affiliated medical centers have accessible educational materials for patients.

3.6 Does your medical school or its primary affiliated hospital have accessible educational materials for patients about climate change and health impacts?
2 points: Yes, all affiliated hospitals have accessible educational materials for patients.

1 point: Some affiliated hospitals have accessible educational materials for patients.

0 points: No affiliated hospitals have accessible educational materials for patients.

Support for Student-Led Planetary Health Initiatives

MetricDescriptor
4.1 Does your institution offer support for medical students interested in enacting a sustainability initiative/QI project?
2 points: Yes, the institution either offers grants for students to enact sustainability initiatives/QI projects or sustainability QI projects are part of the core curriculum.

1 point: The medical school encourages sustainability QI projects (to fulfill clerkship or longitudinal requirements) and offers resources to help students succeed in these projects, but there is no student funding available and there is no requirement to participate.

0 points: No, the institution does not offer opportunities or support for sustainability initiatives or QI projects.

4.2 Does your institution offer opportunities for medical students to do research related to planetary health and/or sustainable healthcare?
2 points: The institution has a specific research program or fellowship for students interested in doing planetary health/sustainable healthcare research.

1 point: There are research opportunities for students to perform research related to planetary health/sustainable healthcare but these require student initiative to seek these out and carry them out in their spare time.

0 points: There are no opportunities for students to engage in planetary health/sustainable healthcare research.

4.3 Does the medical school have a webpage where medical students can find specific information related to planetary health and/or sustainable healthcare activities and mentors within the medical school? For example, projects achieved, current initiatives underway at the medical school and/or contact of information of potential mentors.
2 points: The medical school has a webpage with specific information related to planetary health or sustainable healthcare that includes up-to-date information on relevant initiatives and contact information of potential mentors.

1 point: There is a medical school webpage that features some information on projects and mentors within planetary health and sustainable healthcare within the medical school, but it lacks key information.

0 points: There is no medical-school specific webpage for locating planetary health and/or sustainable healthcare projects or mentors.

4.4 Does your medical school have registered student groups dedicated towards fostering a culture of planetary health engagement, scholarship, and advocacy on campus, supported by faculty advisors?
2 points: Yes, there is a student organization with faculty support at my medical school dedicated to planetary health or sustainability in healthcare.

1 point: Yes, there is a student organization at my medical school dedicated to planetary health or sustainability in healthcare but it lacks faculty support. 

0 points: No, there is not a student organization at my institution dedicated to planetary health or sustainability in healthcare. 

4.5 Is there a student liaison representing sustainability interests who serves on a medical school or institutional decision-making council to advocate for curriculum reform and/or sustainability best practices?
1 point: Yes, there is a student representative that serves on a medical school or institutional decision-making council/committee.

0 points: No, there is no such student representative.

4.6 In the past year, has the institution had one or more co-curricular planetary health programs or initiatives in the following categories? (1 point each)
a) Projects where students are able to gain experience in organic agriculture and sustainable food systems, such as gardens, farms, community supported agriculture (CSA), fishery programs, or urban agriculture projects.

b) Panels, speaker series, or similar events related to planetary health that have students as an intended audience.

c) Events in which students learn directly from members of a local environmental justice community about the climate and environmental challenges they face, and how health professionals can partner with their community to address these exposures and impacts.

d) Cultural arts events, installations or performances related to planetary health that have students as an intended audience.

e) Local volunteer opportunities related to building community resilience to anthropogenic environmental impacts.

f) Wilderness or outdoors programs (e.g., that organize hiking, backpacking, kayaking, or other outings for students)


Sustainability

MetricDescriptor
5.1 Does your medical school and/or institution have an Office of Sustainability?
3 points: Yes, there is an Office of Sustainability with multiple full-time staff dedicated to campus sustainability. If the Office of Sustainability serves the entire campus, there is at least one designated staff member for sustainability at the hospital and/or medical school.

2 points: There is an Office of Sustainability with one or more full-time staff dedicated to campus sustainability, but no specific staff member in charge of medical school and/or hospital sustainability.

1 point: There are no salaried sustainability staff, but there is a sustainability task force or committee.

0 points: There are no staff members or task force responsible for overseeing campus sustainability.

5.2 How ambitious is your medical school/institution’s plan to reduce its own carbon footprint?
4 points: The institution has a stated goal of carbon neutrality by 2030 or earlier and the medical school / institution has a well-defined and adequate plan in place to achieve this goal.

3 points: Yes, there is a stated carbon neutrality goal by at least 2040 and the medical school/institution has a well-defined and adequate plan in place to achieve this goal.

2 points: Yes, there is a stated carbon neutrality goal by at least 2040, but the medical school/institution has not created a plan to reach that goal or the plan is inadequate.

1 point: There is a CO2 emission reduction goal, but it is not one of carbon neutrality.

0 points: There is no stated goal for reduction of CO2 emissions.

5.3 Do buildings/infrastructure used by the medical school for teaching (not including the hospital) utilize renewable energy?
3 points: Yes medical school buildings are 100% powered by renewable energy

2 points: Medical school buildings source >80% of energy needs from off-site and/or on-site renewable energy.

1 point: Medical school buildings source >20% of energy needs from off-site and/or on-site renewable energy.

0 points: Medical school buildings source  <20% of energy needs from off-site and/or on-site renewable energy.

5.4 Are sustainable building practices utilized for new and old buildings on the medical school campus, with design and construction of new buildings and remodeling of old buildings conforming to a published sustainability rating system or building code/guideline?
3 points: Yes, sustainable building practices are utilized for new buildings on the medical school campus and the majority of old buildings have been retrofitted to be more sustainable.

2 points: Sustainable building practices are utilized for new buildings on the medical school campus, but most old buildings have not been retrofitted. 

1 point: Sustainable building practices are inadequately or incompletely implemented for new buildings.

0 points: Sustainability is not considered in the construction of new buildings.

5.5 Has the medical school implemented strategies to encourage and provide environmentally-friendly transportation options for students and reduce the environmental impact of commuting?
2 points: Yes, the medical school has implemented strategies to encourage and provide environmentally-friendly transportation options such as safe active transport, public transport, or carpooling and these options are well-utilized by students. Alternatively, the campus location is not amenable to unsustainable forms of transportation by default.

1 point: The medical school has implemented some strategies to provide environmentally-friendly transportation options, but the options are unsatisfactorily accessible or advertised.

0 points: The medical school has not implemented strategies to encourage and provide environmentally-friendly transportation options.

5.6  Does your medical school have an organics recycling program (compost) and a conventional recycling program (aluminum/paper/plastic/glass)?
2 points: Yes, the medical school has both compost and recycling programs accessible to students and faculty.

1 point: The medical school has either recycling or compost programs accessible to students and faculty, but not both.

0 points: There is no compost or recycling program at the medical school.



5.7 Does the medical school apply sustainability criteria when making decisions about the campus food and beverage selections (e.g. local sourcing, reduced meat, decreased plastic packaging)?
3 points: Yes, the medical school has adequate sustainability requirements for food and beverages, including meat-free days or no red-meat, and is engaged in efforts to increase food and beverage sustainability.

2 points: There are sustainability guidelines for food and beverages, but they are insufficient or optional. The medical school is engaged in efforts to increase food and beverage sustainability.

1 point: There are sustainability guidelines for food and beverages, but they are insufficient or optional. The medical school is not engaged in efforts to increase food and beverage sustainability.

0 points: There are no sustainability guidelines for food and beverages.

5.8 Does the medical school or associated institution apply sustainability criteria when making decisions about supply procurement?
3 points: Yes, the medical school has adequate sustainability requirements for supply procurement and is engaged in efforts to increase sustainability of procurement. 

2 points: There are sustainability guidelines for supply procurement, but they are insufficient or optional. The medical school is engaged in efforts to increase sustainability of procurement.

1 point: There are sustainability guidelines for supply procurement, but they are insufficient or optional. The medical school is not engaged in efforts to increase sustainability of procurement.

0 points: There are no sustainability guidelines for supply procurement.



5.9 Are there sustainability requirements or guidelines for events hosted at the medical school?
2 points: Every event hosted at the medical school must abide by sustainability criteria.

1 point: The medical school strongly recommends or incentivizes sustainability measures, but they are not required.

0 points: There are no sustainability guidelines for medical school events.

5.10 Does your medical school have programs and initiatives to assist with making lab spaces more environmentally sustainable?
2 points: Yes, the medical school has programs and initiatives to assist with making lab spaces more environmentally sustainable.

1 point: There are guidelines on how to make lab spaces more environmentally sustainable, but not programs or initiatives.

0 points: There are no efforts at the medical school to make lab spaces more sustainable.

5.11 Does your institution’s endowment portfolio investments include fossil-fuel companies?
4 points: The institution is entirely divested from fossil fuels and has made a commitment to reinvest divested funds into renewable energy companies or renewable energy campus initiatives.

3 points: No, the institution is entirely divested from fossil fuels.

2 points: The institution has partially divested from fossil fuel companies or has made a commitment to fully divest, but currently still has fossil fuel investments.

1 point: The institution has not divested from fossil-fuel companies, but faculty and/or students are conducting organized advocacy for divestment.

0 points: Yes, the institution has investments with fossil-fuel companies and there have been no efforts to change that.


 

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