Diploma in Mountain Medicine - A Look Back At Scottish Winter 2020

Posted by Tom Yeoman on Jan 26, 2021

In March 2020 I was sat in a cavernous snowhole on the side of a mountain, overlooking the beautiful Glencoe valley. I was surrounded by fellow mountain-medics, celebrating the completion of the Scottish Winter Skills module of the Diploma in Mountain Medicine.

As I gazed at the beautiful winter scenery, my mind was filled with the promise of more outdoor adventures over the next few months. I had little idea that this would be the last time I would see the mountains in 2020. Like so many of us, to return to work was to enter some of the most intense, exhausting and often tragic times of my medical career.

I had originally wanted to post this blog piece earlier in the year, but being swept up by the pandemic, I put it to the back of my mind.

Now winter is upon us again,with little chance of winter climbing. So I thought I would look back at last season’s icy antics, and share with you my experience of the DiMM winter skills module 2020:


With Scottish winter climbing marred by a succession of warm and wet storm systems in January and early February, we were blessed with the return of cold and snowy conditions for our week in Fort William. The Scotland module is focused on the development of mountain craft in cold environments, and the application of medical skills in the face of hostile conditions.

Having only climbed a handful of Scottish winter routes, I was lucky enough to spend the prior week ‘acclimatising’ in the Cairngorms with friends from last year’s DiMM cohort; all of whom are now diploma holders and therefore highly accomplished mountaineers(!)

I found this time invaluable for getting my Scotland ‘system' sorted.  After quickly bagging Blencathra in its full winter glory on the journey north, we spent the week in the Cairngorms, taking in Beinn a Chorainne’s East Ridge, and climbing The Runnel at Coire an Sneachta in the Northern Corries.


On the last pitch of The Runnel

I finished the week with a 2-day winter mountaineering course at Glenmore lodge, which coincided with some fairly wild weather. After an initial day of practicing the basics, and with a poor avalanche forecast for the corries, we headed out for an attempt on the Fiacaill ridge.

We were met with deteriorating blizzard conditions, and after battling up to the base of more technical ground, we made a team decision to turn around. In total whiteout and 50mph wind, our ‘learn winter mountaineering course’ had fast become ‘refresher in winter navigation’.

I learned some valuable lessons on this wild first week. Firstly, goggles and spare gloves are non-optional. It pays to 'winterise' the zips on your jacket, and it’s much easier to use a compass if you walk with a single pole.  Verbal communication is difficult in high winds and if you do need to 'leap-frog' navigate, using visual signs can be more effective. 

To climb Scotland’s mountains safely in winter, you need as much information as possible about the snow pack history, avalanche forecast, and a variety of appropriate route choices. There is a wide range of easily accessible information nowadays, including the excellent SAIS website. Heading out towards your objective, it is important to tally the forecast conditions with the weather on the day. Particularly temperature, wind strength and direction - due to the ever-constant avalanche threat.

Flexibility, and the willingness to back-off if conditions aren’t right, are key to keeping you safe. But that doesn’t mean you shouldn’t head out, as waiting for a good day will mean you rarely climb. This was the case on Beinn a Chorraine, where we experienced a micro-climate of light winds despite 50mph+ being forecast locally.

Another lesson was making sure that all members of the party take responsibility for the navigation, and don’t just blindly follow-the-leader, even if they do have ‘winter ML', and they assure you it’s this way, when it’s clearly that way... What happens on the summit stays on the summit!

Driving over to Fort William for the diploma course I was struck by the contrast of climates. Having being used to the cold, dry blast of the Cairngorms, it became clear the week ahead would be an altogether damper affair. And so it was, as we set out in the rain for day one: a romp to the top of Buachaille Etive Beag – and a chance to test out our waterproofs!

Steve, Sophie and Pieter sort the nav on Bidean nam Bian

The old adage ‘be bold start cold’ may be all well and good when starting in minus 4, but for Monday’s conditions ‘get damp, try to stay warm, don’t get blown over’ felt more appropriate. With high winds and strong gusts, just standing up was a challenge at times. We got a chance to practice navigation and ice axe arrest, thought this was difficult in the soft snow.

Just as we were settling in to our little jolly and thinking about the fire at the Clachaig inn, course instructor Mike Greene fell over. And broke his wrist. And so started the first in a succession of rescue simulations! In the following days, many a survival shelter-come-spinnaker sail would be wrestled with on cold and windy hillsides. We would snow-belay confused hikers from cliffs, dig out avalanche victims and even rescue various faculty members from the only crevasse in Scotland (conveniently located above the Aonach mor ski lifts).

Robin Barraclough on 'Gutless', Ben Nevis

All of this was achieved while taking in some of the region’s finest mountain routes including Stob Dearg via Curved Ridge, Bein a'Bheithir via Schoolhouse Ridge, Stob coire nan lochan via Dorsal Arête, and for the Scottish winter veterans: ascents of The Curtain and Gutless on Ben Nevis.

Breezy conditions on Aonach Mor, heading up for some crevasse rescue

The author desperately fiddling with Prusiks, while guide Garry shakes his head 

A nice sheltered spot for a lunch break

None of this would be possible without our expert guiding team, under the leadership of Graham McMahon. To take a disparate group of medics with wide ranging winter experience and produce safe, quality days out (in combination fresh snowfall creating challenging avalanche forecasts), was no mean feat.

Steely, professional mountaineers

Ian Hey guides us on Curved Ridge, with more fresh snow than we'd hoped for

Judging from the smiles on the faces of the returning climbers every evening, it had clearly been a storming success. A personal thanks must go to the guides I was out with, including Garry SmithIan HeySteve Long and Libby Peter. All the guides went to great lengths to pass on the benefit of their experience to us, even patiently working on crevasse rescue ropework back at the hotel. 

A gorgeous day on the zigzags, Glencoe

One of the aims of the module was to reinforce that when practicing medicine in the mountain environment, you are a mountaineer first and a medic second. In sub zero temperatures and on dangerously exposed cliffsides, ensuring your team is safe, securing injured climbers with quick and efficient ropework and protecting vicims from environmental injury should be early priorities. 

Some key lessons I learned from the climber rescue scenario:

  • Make your casualty safe early with your own protection; Never assume the victim’s harness and gear are set up correctly.
  • Use the casualty's own warm gear when available
  • Before descending to an injured climber, think about how to make them safe and also work effectively. For example, putting a ‘Y' shaped double clip-in point on the rope before descending can help keep the casualty upright and keep the rescuer in a good position to provide care
  • Italian hitches are a simple and effective way of quickly lowering a climber, and can be operated at a distance from the anchor point
  • To communicate with the rescuer once lowered, a prusik can be used on the static rope to get closer to the edge while staying safe. 

The final day was spent in Glencoe, for a combination of avalanche rescue and snow survival techniques. We were introduced to avalanche transceivers and given the chance to experience search and rescue.

Even in a simulation, the enormity of the task facing a rescue team searching for missing avalanche victims became quickly apparent. Even with the aid of transceivers, you are in a race against time, knowing the victims’ survival chances are slipping away with every minute under the snow.

I got the chance to lead one of the avalanche rescue scenarios. I arrived on scene to be told there were potentially seven casualties lost under the snow. I had seven team members. Each casualty required location, extraction, triage and frequently, resuscitation. It quickly became apparent there were far too few of us! After initially trying to coordinate from the sidelines, the urge to help with the rescuing became too strong and I got involved with the digging.

Keeping tabs on which casualties had been located, and their clinical status quickly became impossible. We saved some lives, but by the end it felt pretty messy. Let’s just say it was character building stuff! I have massive respect for the guys that get out there and do this every winter. After the avalanche carnage of the morning,  I was glad of the afternoon R&R: building snowholes followed by glissading down the slopes, saying our goodbyes and heading home to impending lockdown. 

Party in the snow cave

The diploma may be starting to feel like a distant memory, but we will be back together again, and the mountains will be waiting for us.

In the meantime stay healthy and stay safe!

University of Central Lancashire (UCLan) run the Diploma in Mountain Medicine. More information can be found here. Want to know what the DiMM entails? Read this! 

Interviews with faculty members - Karen Greene and Stuart Allan are well worth a look!

If you would like to find out more about mountain medicine why not join the British Mountain Medicine Society? See this link for details.

1 thought on “Diploma in Mountain Medicine - A Look Back At Scottish Winter 2020

David Hillebrandt commented 7 months, 2 weeks ago
Tom, I really enjoyed reading this blog. inspirational at a time when snowy hills are out of bounds for most of us. what really inspired me was the week before the diploma spent with friends from previous modules. Getting out with friends and making your own decisions is the real spirit of the course. Thank you also for mentioning our guides who have been inspiring diplomats for many years. Legends.

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