Climate change and health impacts "through undergraduate medical students' eyes": a cross-sectional study in Greece

Climate change poses one of the greatest current global health threats, and physicians will be central both in managing its clinical consequences and in advocating for systemic responses. This study assessed knowledge and perceptions of undergraduate medical students, from all six years of study, by gender and age through a cross-sectional, descriptive and observational study. Among the 484 participants, 95.7% affirmed the reality of climate change. Females expressed significantly greater concern (42.8% vs 25.5% p < 0.001), and stronger endorsement of its importance (49.1% vs. 39.1%, p < 0.001) compared to males. The majority recognized physicians' responsibility to inform both the public (84.9%) and policymakers (80.9%), while limited knowledge and lack of time were frequently reported barriers. Qualitative analysis of open-ended questions identified five themes on envisioned future physician roles: i. Increasing environmental health literacy; ii. Specialized prevention and treatment of climate-related illness; iii. Direct environmental protection adjustments in healthcare practices; iv. Advocacy for political action and v. Active citizenship. Medical students, especially females, display strong awareness and motivation to address climate-related health impacts. Embedding planetary health competencies in medical curricula and continuing education is essential to prepare future physicians as effective clinicians, communicators, and advocates in the era of climate crisis.