Over the next few months we'll be speaking to a number of people who provide qualifications for mountain medicine practitioners. The International Diploma in Expedition and Wilderness Medicine is run by the Royal College of Surgeons and Physicians of Glasgow and described as a, "must for any healthcare professional seeking to participate in, or lead expeditions in extreme and challenging conditions". We asked one of the course directors, Dr Jon Dallimore to tell us more!
Thanks Jon for talking to me about your diploma. Can I start by asking who is the course aimed at?
It’s a pleasure Jeremy. The International Diploma in Expedition and Wilderness Medicine, based at the Royal College of Physicians and Surgeons of Glasgow, was first launched in June 2016. It is aimed at postgraduate health care professionals who want to develop cognitive, leadership and practical skills to enable them to operate as a medic on an expedition. To date over 100 budding expedition medics have enrolled on the course and this includes doctors at all stages of their training and established consultants together with physios, paramedics and nurses.
Trekking in the Atlas Mountains - A recent diploma graduate Daniel Grace wrote, "I chose to study the diploma for several reasons. I had attended a short expedition medicine course previously, and wanted to learn more about how I could combine medicine with my love of the great outdoors. I was particularly interested in learning more about altitude and cold-related injuries, and I wanted to be able to put this knowledge into context..."
What have graduates gone on to do with the skills and knowledge gained from it?
Some of our course graduates have used their new skills and learning experience to take up expedition medic roles in many different environments from Greenland to the Himalayas. Other students have used their qualification in desert, jungle and maritime areas. After the final module in Morocco our diplomates have commented that they feel much more confident to deal with medical problems in any pre-hospital scenario. One of our students commented, ‘Course has been excellent. Thank you for all of your hard work as organisers; you’ve been exceptional and inspiring. I always go home enthused and excited about my career and interest in a way the NHS doesn’t instil’.
The Oxford Handbook of Expedition and Wilderness Medicine. In 2016, the first edition won the BMA Medical Book Award for Primary Healthcare. A third edition is due to be published soon!
The syllabus is aligned closely to the brilliant book - “Oxford Handbook of Expedition and Wilderness Medicine”. From looking through the book it’s clear that it’s a vast subject. Which aspects did you decide to focus upon?
The aim has always been to provide an introduction to expedition medicine in all theatres of operation – high altitude, jungle, desert, maritime, sub-aqua and polar regions. Naturally, many skills are relevant to all environments. We provide as much practical training as we can during the residential modules in the Cairngorms, on Dartmoor and in Morocco.
Was this a difficult process to complete?
It was long process identifying the learning objectives for each of the eight modules and then mapping these to the curriculum and assessments. In all, it took about 18 months from concept to delivery of the first residential module.
Teaching from Mountain Rescue Team doctors Mike and Karen Greene
Alongside the enormous fun to be had on your eye catching residential courses, there’s clearly a considerable amount of work to do. You tell students to set aside 12 to 14 hours for self study each week. Can you talk a little about the structure of the course and how the students are assessed?
There are eight modules, giving 15 credits each at master’s level. The modules are as follows:
Introduction, infectious diseases and global health
Tropical and maritime medicine (with an introduction to caving)
Expedition emporiatrics (travel medicine)
Cold and mountainous environments
High altitude and desert
Teaching methods include lectures, group discussions, tutorials, workshops and online learning which is accessible via the Royal College web site. Assessments include essays, presentations, navigation tests, formative and summative practical assessments such as rope work, movement on steep ground and casualty scenarios. Students also keep a logbook of mountain journeys completed during the course of the diploma. This is also assessed and graded.
Simulated casualty extraction from a vehicle
Your Diploma has now been running for 5 years. During that time what have you learnt about delivering it? How has it evolved?
James Moore and I spent a great deal of time preparing the course at the outset and there have been no major changes to the course delivery or assessment. Naturally, we respond to student feedback and this usually indicates that the practical aspects of the course are the most interesting and the best way for students to learn how to look after themselves and others in any expedition environment.
What do you think have been the greatest challenges that the students have had to face?
Students often struggle with the transition to academic writing at master’s level where critical appraisal of the published literature is essential and we try to prepare them for this in the introductory module. Detailed feedback is given by the course tutors and it is gratifying to see that students develop their writing skills during the course of the diploma. Many have found it difficult to balance their work and family commitments with the study requirements and this has been even harder for the most recent cohort of students who have also had to deal with the pandemic while trying to continue their learning. Sadly, several residential modules have been postponed but we are hopeful that there will be a return to face to face teaching in the next few months.
Scorpion spotting in the Agafay Desert - According to Daniel, "The course culminated in an expedition to Morocco, which we had been looking forward to since starting. Here we ... encountered simulated medical scenarios and navigation skills that we had learnt over the course of the diploma. This was followed by time spent in the desert, where we set up water stills, went night time scorpion watching and slept out under the stars..."
What have they enjoyed the most?
Our students learn so much from working with each other and from the experienced faculty, many of whom have professional outdoor qualifications as well as recent international expedition experience. Feedback from the residential modules is uniformly very positive and always highlights the learning opportunities in each different environment be that fast flowing water, in a cave, in the desert, the Cairngorms or while trekking at high altitude in Morocco. Most of all, they love learning with like-minded healthcare professionals and many have made lasting friendships.
What are your plans going forward in 2021?
My main focus is to get the Diploma back on track after all the disruption during Covid-19. Everyone on the Diploma team has missed teaching face to face in the outdoor environment that we all love so much.
Thanks Jon for speaking to us!
Thanks also to Ruaraidh Ellison for providing such a fantastic set of images and Daniel Grace for his permission to use extracts from his article on the International Diploma in Expedition and Wilderness Medicine. Daniel's excellent blog 'The Wilderness Medic" can be found here.
The Birmingham Medical Research Expeditionary Society (BMRES) and the British Mountain Medicine Society (BMMS) have joined forces to organise the 2021 Altitude Research Conference. The face-to-face event will take place in Birmingham on the 11th September. Speakers will include Peter Bartsch, Jo Bradwell and Chris Imray. There will also be presentations from members of the UK's leading research groups as well as ample opportunity for researchers, young and old, to present posters and short talks about their work.
Further details can be found here.
If you would like to find out more about mountain medicine why not join the British Mountain Medicine Society? See this link for details.