Medicine and Mountain Leadership

Posted by Jeremy Windsor on Mar 10, 2020

Dr Pete Colledge recently got in touch to tell us about completing the UK Mountain Leader qualification. Here's what he had to say...

"Like many junior doctors applying to competitive national training programmes, I'm always trying to distinguish myself from other candidates and make my CV more appealing. Publishing papers and designing audits carries so much weight, but I want to meet competencies and pre-requisites whilst having fun and showcasing the person behind the CV as well.

The UK Mountain Leader qualification is a well-respected certificate that allows you to take groups of people into the mountainous regions of the UK and Ireland. No doubt it is familiar to most existing and aspiring 'wilderness' or 'mountain' medics and is worth thinking about if you have a passion for being in the hills whilst developing your CV in a slightly more unique way.

It is built around the premise of gaining experience leading groups of people in the hills and then proving your competence to do so. Evidence of this starts with keeping a digital logbook of 'Quality Mountain Days' (QMDs). QMDs are loosely defined but should include aspects of planning and leadership, navigation skills, attention to safety and the day should generally last 5 hours or more and take in a substantial peak.

Once you have logged 20 QMDs you can attend a 5-day training course which aims to apply and build on your previous learning and skills. This will help to fill in knowledge gaps, reinforce good practice and get you ready to take the assessment. A typical course might be broken down as follows:

Day 1 - Planning and logistics, including interpreting weather forecasts which will be reinforced at the start of each day when considering the day's objectives.

Day 2 - Introduction to access and conservation coupled with a day focused on route finding and navigation in the mountains. Each participant has the opportunity to lead the group.

Day 3 - Further navigation with visual route finding taking the lead, managing movement through rocky terrain during a Grade 1 scramble, if appropriate.

Day 4 - Security on steep ground. This includes simple anchors, direct and indirect belay techniques, as well as helping people up and down steep terrain.

Day 5 – Expedition, including a wild camp, night navigation and mountain safety and emergency procedures.

Day 6 – Continuation of expedition and improvised rescue techniques and river crossings.

A further 20 QMDs must then be logged, giving a total of 40 in order to obtain the qualification. Assessment takes a similar form to the training, usually including a 5-day course with a 2-day expedition. Candidates are then assessed on navigation skills, including at night and during poor visibility, timing and pacing to estimate distances, contour interpretation, camp craft, first aid and emergency scenarios. Also, there is a strong emphasis on group leadership, route choices over steep ground and party management. For more information on the requirements the Mountain Leader logbook can be found here.

The Mountain Leader qualification represents a great opportunity to demonstrate a wide range of much sought after skills highly valued in medicine – good organisation, communication and sound leadership skills are clearly relevant, but the really interesting parts are more subtle! The mountains are inherently dangerous places and the thought processes behind leading a group over mountainous terrain are nuanced and complex. Risk in the mountain environment is continually evolving and will depend on the environment – both the difficulty of the terrain and the potential for severe injury as well as your assessment of the competencies of a group and when they may require further support or reassurance.

Continual risk assessment is something that we do all the time, it makes us better at our jobs. We consider things, rule things out and make informed decisions. We take into account the differential diagnoses and plan accordingly. We arrange further tests and follow up depending on the potential adverse consequences and we revise our plans for all manner of reasons, a change in the NEWS, some blood results, a worse than expected chest x-ray, etc.

Leadership skills and acting within one's own competencies or a defined set of parameters to ensure the safety and comfort of clients is central to mountain leader training. Again, the overlap with medicine is clear in terms of when to seek senior help, refer to specialist teams, or enlist the help of other team members. The decision-making processes are similar and I think that experience and comfort in one would likely be beneficial to the other. Because of that, I believe that the Mountain Leader training scheme could be a great distinguishing factor on your CV and may help you to achieve your wilderness medicine aspirations. It’s a lot of fun into the bargain as well!"

Thanks Pete! If you'd like to write for the blog please get in touch!

Pete's previous post on managing osteoporosis in the mountain environment can be found here. Meanwhile, his account of presenting a poster at last year's BMMS Science Day can be found here.

Interested in mountain medicine? For more details take a look at this!

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