The Rehab Neural Engineering Labs earned a “green lab” certification, thanks to practices like the use of reusable materials in their robotic arm testing rigs. The labs’ Michael Boninger (left in left photo) is leading sustainability initiatives for Pitt's schools of the health sciences in a new role. (Photos by Tom Altany/University of Pittsburgh.)

Melissa Bilec (center in right photo), special assistant to the provost for sustainability, and Pitt Med students take part in a sustainable cooking class at Phipps Conservatory with Noe Woods (right in right photo), assistant dean for sustainability. Students in the Pitt Med elective learned about the carbon footprint of food, what makes food sustainable, and how purchasing and eating sustainable food can help farmers and farmland. (Photos by Aimee Obidzinski/University of Pittsburgh)

Education at a university typically flows from professor to student. But when it comes to environmental health, the model is sometimes flipped, says Michael Boninger, an MD Distinguished Professor in the Department of Physical Medicine and Rehabilitation at the University of Pittsburgh.

In a recent example, a student became interested in disposable stethoscopes “and in a way that only students can do at times,” Boninger says, “reached out to a leader at UPMC and said, ‘I want to get rid of disposable stethoscopes, can you help?’”

“It really opened up a further dialogue between the University of Pittsburgh and UPMC on infection control and sustainability, on how we can all work together to move the agenda forward.”

Boninger, who is also chief medical sustainability officer for UPMC, Pitt's clinical partner, was recently named associate dean for the new Office of Sustainability in the Health Sciences.

He says that when Anantha Shekhar, John and Gertrude Petersen Dean of the School of Medicine and senior vice chancellor for the health sciences, decided to create the office, his vision was for the “School of Medicine to be a national leader not only in educating our students about the impact of climate change on health, but in innovating ways to decrease the impact of climate change on health and our own footprint.” (The new office was launched at an Earth Day event in April.) 

Health care and associated research are responsible for approximately 10% of U.S. greenhouse gas emissions and represent the second-largest industry contributing to landfill waste worldwide.

“The School of Medicine, through its research operations, has a surprisingly large carbon footprint of its own,” Boninger says. Among his goals, he says, is making sure Pitt Med is on track with the University’s sustainability plan that includes achieving carbon neutrality by 2037.

For Noe Woods, an MD assistant professor of obstetrics, gynecology and reproductive sciences and assistant dean for sustainability, education is the key to that change. It will span students’ foundational learning, clinical work and electives.

“Every student graduating should be able to tell you the effects of climate change on their patients. It is going to be, according to the [World Health Organization], the greatest health threat of the 21st century.”

Current medical students have a different understanding of climate from the previous generation, Woods says.

They tend to think about its effects in their daily lives, she notes, while it wasn’t a consideration during training for many faculty members. 

An elective Woods already offers on sustainability in medicine had a deep impact on Divya Natesan (shown below), a student in the physician scientist training program at Pitt Med. She finished her second med school year and is currently in a research year, studying ovarian cancer.

“That class really inspired me to continue to find ways to contribute to sustainability in medicine.”

She became involved with Pitt Students for One Health, part of a larger organization aimed at balancing the health of people, animals and ecosystems.

“I learned about an initiative out of the University of California, San Francisco, called the Planetary Health Report Card,” which offers a rubric for medical schools to evaluate their curriculum across five categories, she says.

She brought it to Pitt Med last year, and has since become the program’s regional lead, expanding the efforts to all medical school groups in the Northeast.

Natesan also works with the Climate Resources for Health Education Initiative out of Columbia University, developing an open-access, free repository of learning exercises and slide decks related to planetary health.

“Med schools don’t have to reinvent the wheel or create new content for their students,” she says. “We already are creating it, and all they have to do is pull from this website.”

Natesan sees opportunities in existing courses for discussions like how environmental factors such as air pollution often have a higher impact on people of color.

Although the sustainability office for the health sciences is new, Natesan says she learned that the University already has a wide-reaching sustainability plan in place with dozens of triumphs and goals.

Likewise, according to Boninger, the wheels are turning on several projects at UPMC: Leaders are weighing more sustainable approaches to scrubbing for surgery and considering reusable blood pressure cuffs versus disposable blood pressure cuffs. Similar discussions continue about the stethoscopes that the student highlighted.

 “This drive toward disposability ignores the impact on the planet,” Boninger says. “And we do that at our own peril.”