Survey of One Health programs in U.S. medical schools and development of a novel one health elective for medical students

Abstract

Lessons learned from recent pandemics, such as SARS-CoV-2 have illustrated that education and training in a One Health approach, which recognizes the interdependency of the health of people, animals and the environment, are essential in improving preparations for and responses to disease outbreaks. For this reason and others, there is a critical need to provide One Health (OH) training to medical professionals early in their careers. 133 U.S. medical schools were surveyed for the incorporation of OH learning activities. Results showed that 56% of surveyed programs included OH-related subject matter, primarily in the context of preclinical classroom learning. This supports previous findings that OH education efforts in medical schools lag behind veterinary schools, with many veterinary schools already including OH as a central part of their curricula. A two week OH elective course for third year medical students was developed and implemented at Georgetown University School of Medicine. Topics such as emerging infectious diseases, zoonoses, vector-borne diseases, epidemiology, emergency preparedness, the human-animal bond, and effects of climate change on public health were discussed. The 21 participants were surveyed before and after the course regarding their knowledge and understanding of OH. Participation in the course enhanced the students' knowledge of OH and furthermore, the students' perception of the importance of incorporating OH within the curriculum and in their future careers changed significantly. This study provides clear evidence that successful integration of OH material is achievable at low cost through interdepartmental and interdisciplinary collaboration. A more holistic approach to health care that takes into consideration environmental, wildlife, and domestic animal factors, and introduction of concepts such as OH into the medical school curriculum, can help close the educational gaps identified in the surveys.

Keywords: Curriculum; Medical education; Medical school; Multidisciplinary; One Health; Survey.

Fig. 1

Student survey responses before participation in the One Health elective when asked to rate the value of early warning, epidemiological investigation, coordination and communication and emergency preparedness in the detection of zoonotic disease outbreaks Chi square test analysis of the Likert rating scales (very important to no value at all) showed statistical significance (p < 0.05).

Fig. 2

Student survey responses before participation in the One Health elective when asked to rate the value of a One Health approach in: p patient-centered care, drug discovery, improving public health systems and emerging infectious disease outbreaks. Chi square test analysis of the Likert rating scales (very important to no value at all) showed statistical significance (p < 0.05).

Fig. 3

Student survey responses before participation in the One Health elective when asked if a patient presented with a disease of unknown etiology, how likely they thought the primary care physician would be to ask certain questions as shown. Chi square test analysis of the Likert rating scales (very likely to very unlikely) showed statistical significance (p < 0.05), except for responses to the question regarding whether the patient has pets at home.

Fig. 4

Comparison of student survey responses rating the importance of incorporating One Health activities, before and after participation in the One Health course. Wilcoxon signed rank test analysis of the Likert rating scales (very important to not important) showed statistical significance (V = 28; p-value = 0.01471).

Fig. 5

Comparison of student survey responses to a question regarding relevance of One Health to their future career as a medical professional before and after they participated in the one health course. The Wilcoxon signed ranks test analysis of the Likert rating scales (strongly agree to strongly disagree) showed statistical significance (V = 21; p-value = 0.02627).