Experiences of introducing planetary health topics to medical school curricula: A meta-ethnography

<h4>Introduction</h4>Future doctors will need to adapt to the impact on health caused by the changing climate, whilst developing more sustainable practices to decrease the burden of healthcare on the environment. Planetary Health (PH) is emerging as a crucial subject area in medical education. This systematic review synthesises evidence on integrating PH into medical school curricula globally, focusing on experiences of medical students and educators.<h4>Methods</h4>MEDLINE, ERIC, and EMBASE were systematically searched to identify qualitative research studies focusing on experiences of medical students and staff in PH integration into medical school curricula. We included articles published in English and in peer-reviewed journals, from 2010 onwards. Articles were assessed for quality using the CASP checklist for qualitative research. Fourteen studies were identified and synthesised using meta-ethnography.<h4>Results</h4>This review identified a strong consensus on the necessity to incorporate PH into medical school curricula. Three inter-related third-order constructs shaped our synthesis. The first was challenging existing norms, as PH represented atypical scenarios with flattened medical hierarchies and reliance on student and faculty enthusiasm and advocacy. The second was a recognition of a moral dimension, with an ethical obligation to teach PH and a responsibility to manage 'climate anxiety' that can emerge in students. The third was an enthusiasm to innovate and influence, reflecting the importance of embedding PH longitudinally in teaching and assessment.<h4>Discussion</h4>Whilst some factors that shape PH implementation into medical curricula are consistent with other new subject areas, PH integration also raises unique considerations and dynamics. These include a power and knowledge shift away from staff, and a central notion of ethical justice linked to PH education. Medical education leaders should be mindful of these when embedding and growing PH as a core topic in the medical curriculum.