Healthcare systems contribute substantially to climate change and environmental degradation. Beyond greenhouse gas emissions, pharmaceuticals are a major source of ecotoxic pollution, particularly in aquatic ecosystems, as many active pharmaceutical ingredients persist in the environment, bioaccumulate, or disrupt ecosystems, with long-term consequences for human and planetary health. In primary care, prescribing decisions strongly influence both the carbon footprint of healthcare and the environmental release of pharmaceutical residues. However, ecotoxicity remains largely absent from medical education and clinical guidelines, leaving general practitioners insufficiently equipped to integrate these considerations into routine clinical practice. Innovative educational approaches are therefore needed to translate complex environmental information into clinically relevant and actionable knowledge. We developed a serious game targeting postgraduate physicians and tested it under real-life conditions with early-career general practitioners.After participating in this serious game, participants will be able to: Identify how common prescribing decisions in primary care contribute to carbon emissions and pharmaceutical ecotoxicity. Integrate eco-responsible prescribing principles while maintaining evidence-based practice and patient safety. Critically reflect on their own prescribing habits and identify opportunities for improvement in daily practice.this serious game fits up to 40 participants divided into groups of 4 participants (1 group-1 game) Role-play using predefined physician profiles with distinct prescribing behaviors Case-based clinical decision-making using seven clinical scenarios, each available in three levels of increasing complexity; participants may progress through the scenarios according to available time and group dynamics Immediate feedback on clinical impact, carbon footprint, ecotoxicity, and economic cost Workshop schedule :  Introduction (5 minutes) Game session (45 minutes) Debriefing and discussion (10 minutes)<br>By the end of the workshop, participants will: Increase awareness of the environmental consequences of prescribing beyond climate impact alone. Develop practical strategies to deprescribe and promote safer alternatives. Better understand how ecotoxicity complements carbon footprint in sustainable healthcare. Experience a transferable educational model applicable to postgraduate medical training.This workshop demonstrates how a serious game can translate complex environmental concepts into practical clinical learning. By embedding carbon footprint and ecotoxicity into realistic primary care scenarios, general practitioners are empowered to practice medicine that protects both patients and the planet.