I am officially in love with wilderness medicine. Adventure, outdoors, and medicine… a perfect combination of so many of my loves. A better term would probably be ‘improvised medicine.’ All of the training is geared towards situations when a hospital is not readily available. You learn about improvised splinting, climbing accidents, snake bites, avalanche accidents, scuba diving medicine, etc. However, all of the techniques are very applicable when disasters strike and access to hospitals is limited. Therefore, very useful for all of the hurricanes we have had recently.
There are fellowships in wilderness medicine in Family Medicine and Emergency Medicine. Both of these specialties are more generalized and ‘jack-of-all-trade’ specialties that have training in adults, children, and obstetrics. Being able to treat all patient populations is really handy when there is no hospital close by.
However, any specialty of medicine can get involved in wilderness medicine! You don’t need a fellowship in it to be proficient, but it certainly helps. I recently took the AWLS (Advanced Wilderness Life Support) course. Similar to ACLS (Advanced Cardiac Life Support), it is a standardized course with a written and practical exam. Doctors, nurses, NPs, PAs, and EMTs can all take the AWLS course.
Advanced Wilderness Life Support (AWLS)
Hands down the best medical course I have ever taken. A whole weekend of learning how to manage patients in the wilderness doing fun adventurous things. The AWLS course is developed and certified by the University of Utah. You can find organizations to take the course through here. They are offer the course pretty often and in some very cool places! I took it through the Alabama Wilderness Medicine Association at Ruffner Mountain in Birmingham, AL. The certification lasts for 4 years and medical professionals can get CME credit for it. Students can also take the course at a discounted rate.
Ruffner Mountain has a beautiful classroom. They have a little lodge that is basically a tree-house in the woods with windows for walls. The patio outside also had twinkle lights around the railing; an added touch that I was all for.
During the three-day course, you learn about high altitude medicine, diving medicine, survival skills, what to do in an avalanche, and so much more. Basically, all sorts of improvised medicine skills. For example, diphenhydramine (Benadryl) can be used as a topical anesthetic. Similarly to lidocaine, it binds to inactivated sodium channels to inhibit nerve depolarization. You can just mix it up as a paste and apply it directly to the skin. It does take 30 min to take full effect.
Working in Wilderness Medicine
Making a full career out of wilderness medicine is not very common, but some people definitely do it! A lot of doctors work their normal job and do wilderness medicine on the side. Some intense trekking tour groups will actually hire a physician to come along on the trip and be the medical provider as well. Very high altitude and difficult hikes almost require a medical professional present. Or at least someone that has training in wilderness medicine that will be able to stabilize a patient until evacuation is available.
I want to do work in global health, so I will be practicing medicine in developing countries. Having training in wilderness medicine is helpful for this as well because a lot of developing countries are resource poor and don’t have access to expensive medical equipment. In this case, improvised medicine is essential. To learn more about wilderness medicine, check out the Wilderness Medical Society. They have student memberships available for $50 a year.
Now that I am in my clinical rotations, I am having SO much fun exploring all of the different specialties of medicine. Instead of narrowing down what I like, I find that I am falling in love with almost every specialty I have rotated in. Check out more posts here for more info on specific specialties like family medicine or surgery.