I don't expect anyone to answer all these questions but there seems to be a large amount of interest in the topic so I thought I would string together what are likely common questions.
What made you do the wilderness medicine fellowship?
Are you doing anything now directly as a result of you wilderness medicine fellowship?
What sort of specific career opportunities have you seen for graduates of wilderness medicine fellowships?
What percentage of graduates you know continued to be active in wilderness medicine beyond the recreational level?
How has the fellowship affected your job opportunities?
Has the fellowship had an impact on your practice as an emergency physician?
What are your thoughts on a formal fellowship versus just working a job with a lighter schedule and spending a ton of time outdoors?
How much actual field experience did you get through fellowship?
How was your time in fellowship spent?
Can you think of any specific strengths or weaknesses of the various fellowships?
Some fellowships have blurred the line between wilderness medicine and global health, do you think this is a positive aspect or a loss of focus?
What does a competitive applicant look like?
How much outdoors/wilderness experience do you need to be a competitive applicant?
Sorry for the delayed reply folks! Have been on a string of nights. Here you go, let me know if you have other specific questions:
What made you do the wilderness medicine fellowship? I was deciding between wilderness medicine and global health, because i'm interested in both and am definitely at the intersection of the two. I ultimately chose wilderness med because I felt it was more flexible; many of the global health fellowships require doing an MPH and/or have specific things you have to do (i.e., work/teach at their global site instead of choosing your own). The wilderness fellowship gave me direction and resources, but I could more or less do my own thing.
Are you doing anything now directly as a result of you wilderness medicine fellowship? As a result of the fellowship, not really. I had to move back to NYC because of family reasons but am now in the process of relocating to Tahoe, where I'm going to be volunteering with the backcountry ski patrol and SAR. I have taught AWLS courses and gone on several international trips and expeditions, but the majority of those contacts were made by myself or through other professional contacts, not necessarily the fellowship. A lot of it is networking, so attending WMS and similar meetings goes a long way.
What sort of specific career opportunities have you seen for graduates of wilderness medicine fellowships? There aren't really "career opportunities" associated with wilderness med, as in paid jobs. Most of what you will want to do (SAR, ski patrol, medical support on expeditions, races, etc) are either volunteer posts with your expenses covered or nominally paid. Most of your salary is going to be by working EM shifts. The key is to get a flexible job, either academics or a 1099 contractor position, so that you can set your own schedule and block out time to do these things. I don't know anyone who makes enough money to support themselves doing solely wilderness med. If you end up doing academics, there's probably opportunity to carve out a niche for yourself as an elective or fellowship director so you can cut down on your clinical hours a bit.
What percentage of graduates you know continued to be active in wilderness medicine beyond the recreational level? If by "beyond the recreational level" you mean as a director of an organization or something in academics, then I would say most - you can be as involved as you want to be. As I said above, these positions generally don't pay or pay poorly, so you're going to have to find a clinical job that gives you enough time to pursue your wilderness med activities.
How has the fellowship affected your job opportunities? Not really. Medical directors will generally see you as a warm body who can fill shifts; if you're willing to teach, organize electives, etc., all the better, but unless there's a specific opening for a fellowship director it won't matter as far as getting a job. EM jobs are relatively easy to get, it's a buyer's market.
Has the fellowship had an impact on your practice as an emergency physician? Well, my specific interests going into the fellowship were remote medicine and critical care in remote/austere environments as well as environmental medicine/ climate change. Those are still my interests and my current projects, lectures and volunteering deal with those topics. Doing a fellowship gave me some extra time off to develop those interests further and a mentor to provide some guidance, but I wouldn't say that I obtained any specific skills or knowledge specifically because of doing the fellowship. Like many things in medicine (and in life), your learning will generally be self-directed.
What are your thoughts on a formal fellowship versus just working a job with a lighter schedule and spending a ton of time outdoors? I would say that unless you need hand-holding and a lot of guidance, go for the latter. Try to work a few shifts per month at an academic place to keep one foot in that environment and work as a 1099 the rest of the time - you'll make much more and have more say over your schedule. This is especially true if you're already involved in SAR, ski patrol, etc. There's also a DiMM offered through the WMS that's awesome (though probably overpriced) and many other courses through
http://www.theadventuremedic.com/
How much actual field experience did you get through fellowship? How was your time in fellowship spent? I did my fellowship at Stanford, and we got two months of time "off" to do whatever projects we wanted. I worked with the African Flying Doctors (flydoc.org), medical support in Jordan through Racing The Planet, and medical support to an emergency surgical group in Sierra Leone. I also taught for and trained with the Bay Area Mountain Rescue and did some teaching for the residency and med student elective at Stanford. The rest of my time was spent working clinically in the department.
Can you think of any specific strengths or weaknesses of the various fellowships? That's going to be pretty subjective - where do you want to live, what kind of focus do you want to have? Utah has an EMS focus; Denver pays the least; Stanford has the highest cost of living. GW sounds very interesting but it's in DC so not immediately in the wilderness. You really need to go and interview to see which program fits you.
What does a competitive applicant look like? How much outdoors/wilderness experience do you need to be a competitive applicant? I was offered a spot at every program that I interviewed at, but i'm not sure if I just got lucky or if there was something particular they liked about my application. My residency experiences (electives, research) were a mix of international and wilderness medicine. Certainly prior demonstrated interest in wilderness medicine goes a long way, as does showing that you can be self-directed and having a good idea of why you want to do the fellowship that you can articulate. Most programs have 1-2 spots and this is not exactly an interventional cardiology fellowship, so you should be able to get in somewhere if you're likable, have at least some experience, and can explain why you want to go there. As for how much wilderness experience you need, I don't think there's a quantifiable minimum, but you don't need to an Eagle scout, just show what you've done and how you want to expand on it during fellowship.
Any benefit to doing a formal fellowship as opposed to just knocking out FAWM? Honestly, probably not. If you'd rather just do an FAWM through lectures, attending conferences and courses., etc then that's great; you can also do a DiMM or similar course to get more experience. It's all about what you're looking to get out of it - as I stated above, most things like SAR, ski patrol, working at races etc., is going to be about you being willing to do it as they're primarily volunteer positions. Letters on a paper won't matter, just your experience and interest.
Let me know if you guys have any other questions!
? Thanks ahead of time!!
