Surgical training in the age of climate crises: preparing green future surgeons

The healthcare sector contributes approximately 5% of global greenhouse gas emissions, with operating rooms (ORs) representing one of the most energy-intensive hospital environments. Their carbon footprint is enhanced by high energy consumption, disposable reliance, and variable anesthetic gases. Meanwhile, damage to infrastructure, disruption of supply networks, and higher health hazards, such as postoperative infections, are due to climate change that compromises surgical care. Notwithstanding this reciprocal interaction, surgical training rarely covers sustainability. While anesthetics, such as desflurane, have particularly high warming potential relative to other safer alternatives, ORs use more energy per square meter than any other hospital space. Still, there are few lifecycle analyses and formal instruction on waste reduction, anesthetic choices, or environmentally friendly products. Combining sustainability into surgical education mirrors the ethical responsibility of "do no harm" and provides practical advantages, including institutional credibility, patient trust development, and cost reduction. Training prospective surgeons in waste separation, low-impact anesthetic use, and leadership roles, such as "sustainability champions," will help drive long-term change. Preparing environmentally aware surgeons in the age of the climate crisis is both a moral imperative and a practical necessity for the healthcare sector. Entrenching sustainability within surgical training represents a population-level public health intervention that can reduce healthcare-related emissions while strengthening climate-resilient health systems.