A Graduate Medical Education Fellowship in Climate Change and Human Health: Experience and Outcomes From the First 5 Years.

Background Climate change is affecting health and health care, but most physicians lack formal training on climate change. There is a need for graduate medical education (GME) programs that prepare physician leaders to address its health impacts. Objective To describe the development and iterative piloting of a GME fellowship in climate change and health and to assess fellows' academic output and public engagement before and after fellowship matriculation. Methods A GME training program was developed and implemented at an emergency medicine department in a US teaching hospital in collaboration with affiliated academic centers. Participants consisted of emergency physicians from the United States and abroad. Program duration and format were adjusted to meet individual career goals. Outcomes assessed include program completion, postgraduation professional roles, and academic outputs and public engagement before and after fellowship matriculation (2019-2023), compared via paired t tests. Results Five fellows have matriculated; 2 have graduated, while 3 remain in training. Costs and in-kind support include salaries, faculty time, research support, travel to conferences, and tuition for a public health degree. Fellows averaged 0.26 outputs per month before matriculation (95% CI 0.01-0.51) and 2.13 outputs per month following matriculation (95% CI 0.77-3.50); this difference was significant via 2-tailed t test (alpha=.05, P=.01). Subanalyses of academic output and public engagement reveal similar increases. Following matriculation, 186 of 191 (97.4%) of outputs were related to climate change. Conclusions For the 5 fellows that have enrolled in this GME climate change fellowship, academic and public engagement output rates increased following fellowship matriculation.