Can medical students learn and apply environmental health concepts in an online course?

Physicians receive little environmental health training, with reports of less than 6 contact hours in most curricula. Despite evidence that environmental factors are causative or contributory across the lifespan in many acute and chronic medical conditions, most medical students will not enter the physician workforce with almost no training or experience in the clinical application of basic environmental public health concepts. Online training in medical/clinical environmental health may provide a cost-effective, scalable to prepare the physician workforce to recognize and address environmental health concerns with patients. Now in its second year, "Medicine and the Environment" is a 2-credit elective for 4th Year Medical Students. Students in the MD/MPH Dual Degree program (34%) also receive credit for a 3-semester credit hour elective toward the MPH. The elective is taught completely online, over 5 to 6 months and requires students to write about and discuss topics including (1) Individual Susceptibility; (2) Indoor Air/Environmental House Calls; (3) Neurodevelopment and Exposures, and (4) Taking an Exposure History (based on ATSDR training modules). Students also summarize current events in environmental health with analysis of clinical relevance, choose one of several recent books on environmental health and report on it, and finish the course with written reflection on how their learning will affect their future practice. We will list the residencies selected by students enrolling in this elective, describe quantitative and qualitative results of course evaluation surveys, and explain instructor roles and time commitments for the course.