Article about providing training in health advocacy. Published in the Medical Observer June 2013

As one of thousands of junior doctors needing to choose which residency job to next apply for and therefore which career path to follow, I am in a minority of the readership of this magazine.   However, you may remember what this time of your life felt like – to have such diverse opportunities in front of you, yet be so immersed in the challenge of acquiring the skills of a profession as soon as is possible.  

I ask you to reflect on how you felt about your future and the future of the planet at that time.  There has been no shortage of challenges to human health around the world in past decades whether it be through national security threats, new epidemics or global environmental damage.  It seems however that not until recently have there been such urgent calls from leading scientific authorities for widespread radical changes in patterns of resource use, consumption and greenhouse gas production in order to avoid rendering the Earth potentially uninhabitable for future generations.

The Climate Commission last year released its report “The Critical Decade: International Action on Climate Change”, highlighting that the next 10 years are crucial for reducing greenhouse gas emissions and mitigating against the well published impacts of climate change, including severe human health impacts both in Australia and around the world.

Doctors are constantly bombarded by calls to arms as a crucial line of defence against the myriad of diseases and risks to the health of our patients.  We are pulled in all sorts of directions in providing time-critical interventions; such as myocardial reperfusion, reduction of a fracture, prevention of diabetic complications or antibiotics for a febrile neutropaenic patient.  And yet the call for action on climate change within this “critical decade” seems without precedent.

At a time when the number of junior doctors is rising beyond available training positions, there is a better opportunity than ever before to strengthen our profession’s ability to shape public policy towards achieving healthier outcomes by providing training in health advocacy.  Climate change is one (albeit probably the biggest) of many issues on which a medical voice in the public discourse has the potential to save lives and improve health.

Training doctors to appraise big picture influences on health and become advocates has not been a high priority in the past, but should become a core part of continuing medical education from medical school upwards.  In outlining the core competencies for medical graduates, the UK General Medical Council states “it is not enough for a clinician to act as a practitioner in their own discipline…they are also expected to offer leadership, and to work with others to change systems when it is necessary for the benefit of patients.”

Australia needs to have its medical colleges, training organisations and medical schools prioritising the education of doctors of all levels to be effective health advocates for a range of causes. This should include opportunities both in hospital and community-based jobs to critique and improve upon healthcare systems where they are not meeting the needs of patients.

Junior doctor jobs are not always made up of exciting, life-saving stuff. In between the reams of paperwork and plugging holes in knowledge of anatomy or pathophysiology, it can be difficult to remember that the end game in medicine is meant to be better health for our community.  With the health threats of climate change becoming more apparent, there is now a bigger call than ever for doctors to defend health by joining those bringing about and advocating for urgent cuts to greenhouse gas emissions.

Whilst I’ll be joining many of my junior doctor colleagues in finding ways to ensure that our planet gets the time-critical intervention that it needs to halt the advance of life-threatening climate change, I have deep concern that there is not time for this to be left to my generation.    


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