Is the Future Green? Assessing Environmental Health Confidence in Internal Medicine Residents

Background Despite global awareness of the impacts of climate change on human health, assessment of resident physicians' confidence in environmental health is limited. Lack of confidence in explaining environmental health topics can affect both patient education and advocacy efforts. Objective To determine how confident resident physicians are in their environmental health training and their ability to explain climate health topics. Methods An online survey was distributed to internal medicine residents at a large university-affiliated program in 2023. Self-perceived confidence levels in explaining various environmental health topics to a peer were measured using a Likert scale (from 1=not confident at all, to 5=completely confident) and a subsequent rank-order analysis of the response means. Results The response rate was 56% (62 out of 110 residents). A mean confidence score of 2.22 was reported on all topics, with hazardous waste (m=1.73), endocrine disruptors (m=1.76), water quality (m=1.9), toxicology (m=2.02), and environmental justice (m=2.04) representing lowest scores. Highest mean scores were reported in food security (m=2.71) and emerging infectious disease (m=2.92). Twenty-seven of 62 (44%) residents reported no confidence at all in their ability to discuss environmental justice concepts, with 17 of 62 (27%) reporting slight confidence in doing so. Conclusions Physician trainees report low confidence levels regarding their ability to explain multiple environmental topics to their peers. Forty-four of 62 (71%) residents report either no or slight confidence in their ability to explain environmental justice to a colleague.