Integrating Ecohealth into a Medical School Curriculum: A Vision of the Future at the University of Hawaii John A. Burns School of Medicine

Abstract

University of Hawaii’s John A. Burns School of Medicine is undergoing an historical transition which has involved departmental reorganization and creation of several new departments including the Division of Ecology and Health. In establishing this new unit, the US medical school leadership recognized the importance of addressing the cultural and ecological dimensions of health in research and education programs toward achieving the medical school’s vision to become the premier US medical school in the Asia-Pacific region. The Division’s establishment also was compelled by school’s mission to serve the unique health needs of the people of Hawaii and the Pacific Islands, particularly those of indigenous populations with particularly high rates of chronic disease and significant community health issues. This especially depends on innovative, community-based, ecological approaches to research and practice, and integrating concepts at the interface of ecological and health sciences into the medical curriculum. Planning and beginning to implement this integration is one the Division’s early objectives. The approach being taken is based on the use of themes emerging from the new biomedical–behavioral synthesis and the application of ecological concepts, principles, and models. The former involves existing basic science subject matter already taught, which can be conceptually framed and interrelated in terms of the latter. Together, these themes and an ecohealth perspective will facilitate basic science learning by providing a more comprehensive and meaningful conceptual matrix to interrelate basic science concepts and facts. The opportunities and impediments to integrating ecohealth within the curriculum take the form of bridges and barriers. Opportunities exist where linkages can be, and already have been, made between disciplines and departments to encourage interdisciplinary learning and transdisciplinary problem-solving drawing on ecological themes and concepts. Apprehension toward unfamiliar scientific territory and competing demands represent significant barriers. These are nonetheless believed to be surmountable over time, especially by exploiting ecohealth’s transdisciplinary dimension to facilitate and enrich the learning experience, rather than adding ecohealth-related subject matter as a learning objective to an already full curriculum and student workload.