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Wilderness Medicine

Opportunities for Residents

Residents in emergency medicine often find themselves working 60-plus hour weeks, living a circadian rhythm seemingly devised by Thelonious Monk, and living on a salary that is more satire than subsistence. And in the midst of these intense 3 to 4 years of training, they pose the question, "How do I get involved with Wilderness Medicine?"

Here is a list of potential opportunities for electives in wilderness medicine that should fit well with a resident’s time constraints and budget. Plan ahead, and any of these electives could provide a unique hands-on experience to supplement your training while placating a concerned EM Residency Director.

Grant Lipman, MD
Past Section Chair

This list was last updated in January 2017. If you know of additional elective opportunities for residents interested in wilderness medicine, please send the information to wilderness.medicine@acep.org.  

  

Program Carolina Wilderness EMS Externship 
Location Burke County, rural western North Carolina
Dates August-September (every summer for one month)
Contact Info Seth Collings Hawkins MD, EMD, FACEP, FAEMS, MFAWM
info@hawkventures.com
Open To Be enrolled as a 4th year medical student or resident physician in an accredited medical school or residency program. DO and MD programs are both acceptable. Resident physicians must have or obtain a NC resident physician license prior to the first day of the Externship.
Other Requirements See requirements section on website below
Additional Info Website: http://www.hawkventures.com/externship/
Applications submitted online
The Carolina Wilderness EMS Externship is dedicated to training the future physician leaders of wilderness EMS. It represents a unique collaboration between a private company (Hawk Ventures), a community EMS system (Burke County Emergency Services), a community hospital system (Carolinas HealthCare System Blue Ridge), a community college (Western Piedmont Community College), and an international research university (Wake Forest University‘s Department of Emergency Medicine). It differs from most wilderness medicine electives in that the emphasis is almost entirely on EMS activities, rather than general wilderness medicine. As such, the focus of the Extern is spent on learning the systematic response to and management of wilderness emergencies, rather than general environmental medicine and individual patient care. Particular attention is paid to hands-on and field training. Every effort is made for Externs to be learning their skills from actual field providers and in the field, rather than in a classroom from lecturers. This philosophy is exemplified by our motto: “esse quam videri”, or “to be rather than to seem.”

 

Program Big Sky Medical Clinic 
Location Big Sky, Montana
Dates Year Round
Contact Info Jeff Daniels, MD
jdaniels@docsky.us
Open To Students (4th year) and Residents
Other Requirements See requirements section on website below
Additional Info Website: http://www.docsky.us/ 
Applications submitted online

  

Program    Racing the Planet
Location  Multiple races and destinations around the world
Dates Variable: see schedule on website
Contact Info http://www.4deserts.com/contact
Open To Senior EM residents and fellows
Other Requirements Fit enough to hike 10 to 20km and camp for 7 days; must obtain your own malpractice insurance
Additional Info                                                The 4 Desert Races is a series of 7-day, 250-kilometer footraces across the world's largest and most forbidding deserts including the Sahara in Egypt, the Atacama in Chile, the Gobi in China, and Antartica. Dr Krabak heads an international team of physicians to provide medical care for all athletes and staff.
Physicians with an interest in providing sports medicine care in remote areas of the world would gain invaluable experience on the care of endurance athletes and logistics for coordinating such care. Flight costs are supplemented, and lodging is paid.
See website (www.4deserts.com) for registration, and send a CV and 2 letters of reference to Dr. Krabak

  

Program Telluride Medical Center Emergency Department 
Location  Telluride, CO
Dates Dec-Apr (every winter for one month rotations)
Contact Information          Daniel Hehir, MD
danielhehir@hotmail.com
Open To Senior level EM residents
Other Requirements Contact for specifics 
Additional Info A clinical rotation in Emergency Medicine. During ski season we see a high proportion of orthopedic related ski injuries requiring primary reduction and altitude related cases such as Acute Mountain Sickness and High Altitude Pulmonary Edema. Opportunities exist to work directly with ski patrol and search and rescue and to work with the Institute for Altitude Medicine. Telluride Medical Center is a level 5 trauma center located 70 miles from the nearest inpatient facility and residents will gain experience with the challenge and rewards of practicing in a rural but modern Emergency Department.

  

Program NAHEC Grand Canyon Clinic 
Location  South Rim Village of Grand Canyon National Park, AZ
Dates Anytime (Apr-Oct are best), 4-6wks in length
Contact Info Sean Clendaniel, MD
(928)779-7245
sclendaniel@northcountryhealthcare.org
Open To 3rd year residents in EM, IM, or FM
Other Requirements         Contact for specifics
Additional Info Housing provided

  

Program                         St. John's Emergency Department and Wilderness Medicine Rotation
Location  Jackson, WY
Dates June-Sept, Dec-Mar for 4 weeks
Contact Info Will Smith, MD
willmd911@mac.com
(307) 699-0230 

AJ Wheeler, MD
whellerdoc@mac.com
(307) 699-2287  
Coordinator: Jody Holzinger, CPCS, RHIT, jholzinger@tetonhospital.org                                                                                                                                                                                                                                                                                                                                                                Rotation
Open To Senior EM Residents
Other Requirements Must be approved by your home institution and insurance must be provided.  Housing must be arranged separately.
Additional Info

www.tetonhospital.org  St. John’s Medical Center (SJMC) is a progressive, remote, rural 48-bed hospital facility,
with a 5-bed ICU, state-of-the-art radiology department and surgical departments, and also includes a 60-bed long
term care center. SJMC has well-trained physicians in most of the general specialties including, emergency medicine,
internal medicine, family practice, pediatrics, surgery (general and plastic), OB/GYN, psychiatry, OMFS, dermatology,
ENT, orthopedics, and urology. St. John’s has an 11-bed Emergency Department (ED), which includes special
resuscitation, ENT, OB/GYN, orthopedic, and psychiatric rooms. The Emergency Department has a census of about
10,000 patients per year, but with significant seasonal variation. Although St. John’s Medical Center is a rural facility,
we do provide limited emergency medicine elective rotation opportunities. Our 4-week elective rotations are open
to senior EM Residents in good- standing only. To provide the best possible rotation we only offer rotations during
our busiest months, generally June-September and December-March. Residents will spend time with the Emergency
Medicine team as cases are treated and spend ten to twelve 12-hour shifts in the emergency department.
With the opportunities of the area, other learning opportunities exist with pre-hospital EMS, wilderness medicine.

  

Program University of Massachusetts
Location  Fly in/out of Salt Lake City, UT
Dates 3 weeks during the spring semester. 
The 2012 Elective dates are April 28 - May 16, 2012.
Contact Info                              Kerri O'Keefe
kerri.o'keefe@umassmed.edu  
Open To EM residents and medical students
Other Requirements  
Additional Info http://www.umassmed.edu/wildmedintro.aspx
The course is organized into three different parts or “evolutions”: alpine, swift water, and desert. In each environment we teach how to travel and live in that setting while maintaining safety and comfort. We believe that, in order to be able to care for patients in a wilderness setting, you must first understand how to care for yourself, to quote the pre-hospital provider maxim: “a dead rescuer saves no one.” We then learn about medicine that is specific to that environment via daily lectures by faculty and students (each student prepares and gives one lecture with faculty guidance) and scenarios designed to reinforce topics covered in the previous days.

Wilderness travel skills that are covered include (but are not be limited to): ice axe/crampon use, climbing techniques, avalanche awareness/avoidance, topography/orientation, boat-based/swift water rescue, and drinking water management.
Medical topics to be covered will include: altitude, hypothermia, frostbite, orthopedics of the upper and lower extremities, lightning injuries, submersion, wound care, traveler’s diarrhea and water treatment, eye injuries, heat injuries or burns, and stings and bites. There is significant one on one teaching as well as realistic mock scenarios that utilize students, faculty, and river-guides as patients which incorporate moulage and other tools.

  

Program                     Desert RATS
Location  Fruita, CO to Moab, UT
Dates Annually in June
Contact Info Dr. Jeremy Joslin
joslinj@upstate.edu  
Open To EM Residents
Other Requirements  
Additional Info Fly in/out of Denver, CO                                                                                                                                                  
Five days of remote wilderness fun embedded with dozens of happily exhausted racers, 148-mile stage race through gorgeous canyons, mountains, and deserts. Learn remote medicine planning, wilderness first aid, and gain appreciation for the working environment of expedition medicine.

  

Program ParkMedics
Location                        Fresno, CA and Yosemite National Park
Dates every other January
Contact Info Lori Weichenthal, MD
Lweichenthal@fresno.ucsf.edu
Open To EM residents
Other Requirements  
Additional Info http://www.fresno.ucsf.edu/em/parkmedic/
A month-long training program held every other January provides certification for National Park Rangers to become paramedics (technically referred to as Park Medics). This is the only training program of its kind in the country. Residents interested in training paramedics and in learning wilderness EMS are encouraged to come to Fresno to help run the course.

  

Program                        Madigan Army Medical Center
Location  Washington State 
Dates  
Contact Info MAJ David Hile, MD 
Hile_16@yahoo.com or David.hile@amedd.army.mil    
(253) 968-1250  or (253) 968-3977
Open To 3rd and 4th year medical students, interns, and residents (any specialty)
Other Requirements No prior wilderness experience required. Cost is $250 for 3-week course (does not include room/board) + $1,800 for NOLS elective (all-inclusive). 
Additional Info This 4-week elective at MAMC includes trips to Mt. Rainier. Students will participate in a didactic course including certification in Advanced Wilderness Life Support (www.awls.org), multiple field training scenarios requiring teamwork and improvisation, practical skills workshops, simulation medicine, and weekly attendance at MAMC emergency medicine grand rounds.
This elective includes an optional field experience in the Olympic Mountains with National Outdoor Leadership School (NOLS) Pacific Northwest, focusing on teamwork, wilderness medical skills and leadership curriculum. 

  

Program Wilderness Medical Society and the Academy of Wilderness Medicine
Location  Great Smoky Mountains National Park, TN
Dates January 29 - February 24, 2012
Contact Info Liz Edelstein (215-955-6844 or Lizzard0202@me.com)
Tom Kessler (tkphs@yahoo.com)
Open To 3rd and 4th year medical students, residents, and allied health profession students from accredited schools
Other Requirements  
Additional                     Info http://wms.org/education/elective.asp
Small group discussions of wilderness scenarios
• Formal lectures of Wilderness Medicine principles and specific topics by leaders in the field
• Field and hands-on instruction in survival and pre-hospital patient assessment and evacuation
• Supervised five-day field-practicum incorporating medical assessment, treatment, evacuation, survival and improvisational techniques.
• 48 hour Wilderness First Responder Course
• Eligibility to sit for the Wilderness First Responder National Registry Examination (as applicable in home state) Educational Objectives: • Act as a medical group leader in backcountry or other remote settings
• Advise a wilderness travel group concerning care and evacuation of ill or injured members
• Plan for the medical support of wilderness and adventure travel experiences
• Manage common illnesses and injuries in an austere environment with limited resources
• Understand the physician’s role in search and rescue
• Identify and plan for special hazards in a variety of extreme environments
• Demonstrate basic competence in exotic travel and wilderness survival skills 

  

Program                      Helping Hands
Location  Nepal and Nicaragua
Dates Flexible 
Contact Info helpinghands@sannr.com  or toll free (888) 241-0710
Open To medical professionals, medical students and non-medical volunteers 
Other Requirements Complete application at www.helpinghandsusa.org 
Additional Info Helping Hands Health Education is a non-profit organization registered under 501(c)(3) status in 1992, with the main objective of bringing low cost quality medical relief services to people in rural villages of Nepal through the help of Western medical and non-medical volunteers.

  

Program                    Centro de Investigación en Medicina de Altura (CIMA) de Aconcagua
Location  22,841ft [6962m], Cerro Aconcagua lies on the Argentina-Chile border and is the highest mountain in Western Hemisphere 
Dates  
Contact Info info@cima-aconcagua.com
Open To Undergraduate students, medical students, paramedics, residents, physicians, researchers 
Other Requirements  
Additional Info www.cima-aconcagua.com/home
More information can be found on the organization's website or facebook page. 

 

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