Integrating planetary health into medical training: Defining physicians’ roles in Malawi

Background: Planetary health (PH) is an emerging field gaining attention in medical education. However, the specific roles of physicians in low- and middle-income countries (LMICs) in addressing PH issues are not well defined. Aim: This study aims to identify the potential roles of physicians in PH in LMICs in order to design specific teaching content for medical doctors in these regions. Moreover, this study aims to explore student baseline knowledge and student learning priorities in LMIC settings to further tailor content of teaching material within the medical curriculum. Setting: This study was conducted in Mangochi District in Malawi, a LMIC. Methods: A cross-sectional convergent mixed methods study design, including seven in-depth interviews with district stakeholders and two focus group discussions (FGDs) with medical students explored the roles of medical doctors in PH. A survey assessed students’ baseline knowledge and learning needs. Results: Four main roles of physicians in LMICs within PH were identified: healthcare provider, hospital manager, community manager and advocate. While 61% of the students had never heard of PH, 82% supported its inclusion in the curriculum. Priority areas to be included in the curriculum were extreme weather events, links between PH and non-communicable diseases (NCDs), vector-borne diseases and mental health. Conclusion: Stakeholders identified essential roles for physicians to address challenges in relation to PH. Contribution: Key roles of physicians within planetary health, and medical students’ learning priorities were identified, and could aid in designing teaching material for medical students in LMICs.