The Academic Practice of Wilderness Medicine?

The recent Society for Academic Emergency Medicine Annual Meeting just concluded after several fun and learning filled days in Boston.  I was fortunate to be able to attend and learn from the best and the brightest.

One of the presentations that stands out in my mind was a panel discussion about the "Academic Practice of Wilderness Medicine."  Wilderness medicine probably got me into medicine to begin with.  In my teen years, I was a member of a Venture Crew and spent many hours learning to climb, kayak, and haul a pack.  Our leader was a former paramedic and encouraged several of us to pursue training as EMTs to be better prepared for handling emergencies in the outdoors.  Thus began my love of emergency and wilderness medicine.

Being in a community academic site, I've always put wilderness medicine onto the back burner thinking that I didn't have the skills or resources enough to make it into a viable niche.  This presentation, given by Sanjay Gupta, N. Stuart Harris, and Michael Millin, was a nice summary of the growing field and has rekindled my interest in wilderness medicine.

First, what is wilderness medicine?

At its most basic, it is the practice of medicine in austere environments.  While generally thought to represent the out-of-doors, this can encompass military settings, event medicine, disasters, and other less than ideal settings.

How do you start in wilderness medicine?  

There are many ways to get started.  As an academic, we're always looking to cement our niche.  Probably the most basic way to do this is training.  Fellowships now exist in many places that are dedicated to wilderness medicine or wilderness medicine and EMS.  For those who have already graduated, there are any number of courses, seminars, and experiences available to build your expertise.  The Wilderness Medical Society even has a fellowship track for physicians to demonstrate a level of expertise within the field.

But what makes it Academic?

Here is where the presentation got interesting.  I've always thought of academic practice within this field as being research based; high altitude medicine, tropical diseases, etc.  Like many academic pursuits, there is so much more to practicing wilderness medicine.  You can, for example:

• Become the faculty mentor for a wilderness medicine interest group
• Teach at medical schools, residencies, or CME courses
• Become a military, expedition, or event consultant
• Serve as a medical director for a search and rescue team
• Serve as a travel medicine consultant
• Actually become a researcher
• Participate in the leadership of Wilderness Medicine oriented committees, interest groups, or the WMS

At SAEM, we became a fully fledged interest group at the meeting.  We even were able to head to the nearby quarry for an afternoon of learning the basics of high angle rescue.  The excitement on the participants faces as they took that first uncertain step into the air during their rappel was a priceless reminder of why I love teaching and emergency medicine.

Having had my assumptions challenged and realizing that there are opportunities for developing an academic niche in wilderness medicine even at a community site, you can expect to see more on various topics related to Wilderness Medicine in the future!



I would like to thank N. Stuart Harris for his leadership over the last year, his vision to start the interest group, and his willingness to share his rope, local crag, and experience with us this past week.