There is a critical need for low-carbon, environmentally-sustainable health systems in the climate crisis. Healthcare trainees can play a vital role in this process, and we have aimed to explore how they can be motivated and supported by faculties of medicine and health systems to pursue this ambition by conducting an exploratory, qualitative descriptive study of Canadian healthcare trainees engaged in healthcare sustainability initiatives.

Transcripts from individual in-depth interviews were analyzed to identify themes related to the actions that healthcare trainees can take to promote sustainable healthcare, as well as the motivators, barriers and facilitators of healthcare trainee engagement in sustainable healthcare.

Participants (N=17) engaged in a spectrum of healthcare sustainability initiatives, including education, quality improvement and advocacy. They were motivated to advance healthcare sustainability through positive role models, the health impacts of climate change, observation of unsustainable healthcare practices, and a sense of social responsibility. Participants articulated that supportive networks, access to resources and funding, and having a growth mindset were facilitators to their engagement, while the lack of institutional prioritization of healthcare sustainability, limitations of the trainee role, challenges finding allies, and the perceived futility of their individual actions were characterized as barriers.

Healthcare trainees could support healthcare decarbonization efforts if they are adequately supported by their learning environments. The study's findings can guide educational innovations and health systems transformations to motivate and empower healthcare trainees to reduce the climate impact of healthcare throughout their careers.