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Guest blog

Expedition medicine - saving lives and going places

Publication date: 12 Oct 2017

Claire Grogan and Mark Hannaford of World Extreme Medicine explain how you can combine a career in medicine with your love for the great outdoors.

Expedition medicine - saving lives and going places
It’s 5am, just before sunrise in the Himalayas. We wake to heavy snowfall, which has slowed our progress to the summit of Kala Patar. It soon becomes clear we will have to wait for the weather to improve. 
I am the medic with a group of students and staff from special educational needs schools from across the UK. We hunker down for the day and occupy ourselves playing games while we await a weather window.
The role of a medic on expedition has many faces, from doctor to chef, photographer, teacher, pot-washer, latrine-digger and counsellor. You have to earn your salt as a fully-fledged team member, which means being able to fulfil all of these roles and comfortably complete the expedition itself.
For me, expedition medicine offers an exciting combination of the two things I love: medical practise and the outdoors. I have worked all over the world in some incredible places, from Iceland to Belize, the Philippines to Tanzania, Nepal and the Arctic. But it can be challenging combining this with working in the NHS. 
So how do you go about working abroad as an expedition medic? 
Expedition medicine - saving lives and going places
Find expedition medicine opportunities
There are a multitude of options for medics to accompany expeditions or projects overseas. Companies running charity trips often seek medics, and there are also expeditions organised by universities, aid or relief work, commercial expeditions and TV work, although this is harder to come by.
Opportunities are advertised in a variety of ways. I was working in a small emergency department in the north of Scotland when I was contacted about a job in Nepal at short notice, but it is also worth following World Extreme Medicine’s Facebook page for the latest opportunities.
Expedition medicine - saving lives and going places

What qualifications do you need? Are there any personal qualities that help?

Doctors usually need to be at least two years qualified; other medical professionals should follow guidance from their governing body. You need to attend an expedition medicine course, to learn how to apply your medical skills in remote environments. World Extreme Medicine run courses several times a year all around the UK and abroad.

Experience in emergency medicine and general practice stand you in good stead to deal with the wide range of medical problems on expedition, and the former is usually a prerequisite.

You should have a good working knowledge of managing fractures, wound management and dressings, so spending time learning from nursing staff in your department cannot be underestimated.

Crucially, you need to make sure you possess all of the technical skills required of the expedition itself, from winter mountain skills to simple camp-craft, to ensure you are comfortable operating in extreme environments.

It helps to be naturally sociable and able to fit easily into a team, and it goes without saying that you need to be physically fit.

When is a good time to take time out of a career? How do you ensure you will get a job on your return?

There are natural career breaks in the traditional training paths in medicine and it is now common for doctors to undertake an 'FY3' year to pursue a particular interest. Some people warned me that taking time out could pose problems for job applications on my return, but my experience was that these were unfounded concerns. 

At interviews I was often asked more about what I had learned from my experiences as an expedition medic than other details on my CV.

Now I work full-time in the NHS, and it is possible to get away on trips within annual leave restrictions with some creative rota management and a few swaps here and there.


Expedition medicine - saving lives and going places

What kind of situations might you face?

Most problems on expedition are minor but occasionally full casualty evacuations need to be carried out, so it is worthwhile ensuring you have a robust system in place for this eventuality. My biggest tip is try to anticipate the unexpected.

In spring 2015, I was volunteering at a high-altitude rescue post in the Gokyo Valley in the Himalayas, running awareness talks on altitude sickness and providing medical assistance to trekkers and porters. A colleague and I had just finished the Saturday morning clinic when a 7.8 magnitude earthquake struck. We knew immediately what was happening and ran outside to safety. Bad visibility masked our view but we heard avalanches roaring in the valley around us.

Over the coming days we established communication with home and our colleagues further up the valley, and helped our local community get back on to its feet. Our rescue post became a place for people to gather and support each other.

Earthquakes had been one of the risks we discussed before leaving the UK, and we had agreed to always have a grab bag with water, passports and food ready to go in an emergency. It seemed like overkill at the time, but that small amount of forethought really helped. Now I have a grab bag on every expedition, and always keep a head torch by my bed in case of emergency.


Expedition medicine - saving lives and going places
How can I gain additional qualifications or experience for this kind of work?
Mark Hannaford, founder of World Extreme Medicine, said: “In 2002 we introduced World Extreme Medicine as a training provider of expedition, wilderness and remote medicine courses for medical professionals. It was around a campfire in Namibia we coined the phrase ‘World Extreme Medicine’ as an umbrella term for all practices of medicine outside of a clinical environment. 
“We run courses in the UK and also in a number of carefully selected locations around the world, including the Everest base camp. World Extreme Medicine provides quality training for medics who want to work in remote environments. Our courses are suitable for expedition doctors, paramedics, nurses and individuals providing medical cover in inhospitable locations. The courses enable participants to become valuable medical practitioners in a range of environments. 
“Through this we have created the World Extreme Medicine Conference and Expo. Since 2012 we have brought together healthcare professionals across four disciplines: disaster and humanitarian medicine, extreme, expedition and space medicine, human endurance and sports medicine plus prehospital medicine. At the Conference and Expo these professionals showcase and share the latest developments in extreme environment healthcare and educate others in what they can do differently. 
In conjunction with University of Exeter Medical School, WEM also runs a Masters in Extreme Medicine which may be of interest to those looking to pursue a formal qualification or research in this area.
The World Extreme Medicine Conference, in Edinburgh from November25 – 27, 2017, is set to be a brilliant gathering. I love going because it is a chance to meet, share experiences and learn from world-renowned experts in the medical fields of pre-hospital care, expedition, endurance, disaster and humanitarian medicine, and sport, space and extreme medicine.
Claire Grogan teaches at World Extreme Medicine and we run courses in expedition and wilderness medicine in the UK, as well as environment-specific courses all over the world, such as polar medicine in Arctic Norway, jungle medicine in Costa Rica, and mountain medicine in Nepal. It is a fantastic way to learn when you are immersed in the environment. 
Expedition medicine - saving lives and going places

Claire is an emergency medical doctor, honorary clinical lecturer in Extreme Medicine at the University of Exeter Medical School and fellow of the Royal Geographical Society. She is on Twitter, @grogan_claire

More information about World Extreme Medicine can be found at the following links:

Courses - www.expedition-medicine.com
Conference - www.extreme-medicine.com
Facebook - www.facebook.com/ExtremeMedicine
Twitter - @extremeexpo and @expedmedicine

If you are interested in studying a MSc in Extreme Medicine at the University of Exeter Medical School, visit: www.exeter.ac.uk/postgraduate/taught/medicine/extrememedicinemsc/

World Extreme Medicine is holding a conference in Edinburgh from November 25-27. 

Now in its sixth year, the World Extreme Medicine Conference is a platform for inspiring medical minds to meet, share experiences and promote cross-disciplinary working.

Find out more here.

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