Wilderness Med et al

AmoryBlaine said:

I've been hearing more and more people (on SDN and in life) talk about how their career plans are "wilderness medicine" or less commonly "aerospace medicine" or even "tactical medicine."

Now I know that there are fellowships available out there for these things. My question is does anyone really do this for a living? To me they seem largely like an extracirricular interest magically transformed into a fellowship. It all seems sort of silly to me.

Does anyone know a doc who is working in the wilderness?

For the attendings, does having a fellowship in wilderness make a candidate more attractive to hire?

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There was a thread about this a few months ago - try searching.

I think that thread discussed books and programs on wildnerness medicine. Not specifically AB's question on job prospects vs. extracurricular interests. So, I'd like to hear some input to if anyone has any.

Cal2Lane said:

I think that thread discussed books and programs on wildnerness medicine. Not specifically AB's question on job prospects vs. extracurricular interests. So, I'd like to hear some input to if anyone has any.

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Here's a start:
http://forums.studentdoctor.net/showthread.php?t=369553&highlight=wilderness
http://forums.studentdoctor.net/showthread.php?t=364092&highlight=wilderness

The thread you mentioned:
http://forums.studentdoctor.net/showthread.php?t=342974&highlight=wilderness

Normally I put my snarkiness away, but I can't resist here. If you are going to tell someone they are wrong, at least do a search and confirm that he/she is, in fact, wrong. Search function - live it, learn it, love it .

well, aerospace medicine itself is a branch of preventive medicine with a few civilian fellowships available (PM if you want more info). but the field also focuses on the technical and clinical aspects of aeromedical transport - both removals and tranfers. being an EP requires proficiency or at least familarity in the latter aspect of aerospace medicine . . . but being an "aerospace physician" does not necessarily involve emergency medicine. so if someone says they want to do aerospace medicine, ask them to clarify in what capacity and at what level?

wilderness med also kind of confuses me . . . and i'm a member of the Wilderness Medicine Society!! i guess we're just a bunch of outdoor junkies who want to integrate work and play so badly we speak the idea into existence . . . man, if only grizzleys and coyotes were insured . . .

I asked the tactical medicine question a couple weeks ago, and I'll try and sum up what the answer was.
1) Several EM residencies have tactical medicine opprotunities, where you basically get "deployed" with a SWAT team and act as front line medical control. Some of the docs (I think Cinci) actually participate in the breach with the PD, which others (Hopkins) are all dressed up but are in what ammounts to an armored ambulance.
What I can't figure out is, the two tactical MDs I know are both Trauma surgeons. You can easily convince me that EM residents (especially after intern year) have time for SWAT training, but when do trauma surgeons do it?
2) I don't think there are places (besides for the FBI/Secret Service) that have full time, paid, docs. It is my understanding that those docs are more medical control, like a state medical director, for the medics who actually get to "play".
3) Dallas SWAT has a full time doc on their SWAT team, he's a fellowship trained Trauma Surgeon who works at Parkland. I think he basically carries a beeper and leaves the hospital if he can (if he's not the primary surgeon on call).

People who actually do this, please correct anything I said that is wrong.

I think most people interested in Wilderness or Tactical medicine want to work on those areas in their spare time, rather than have them be full-time jobs. Examples would be the various EPs that have come on here mentioning being a member of their municipality's SWAT/ERT/HRT/random TLA, while also working regular hours in the ED. Examples of Wilderness Med would similarly be people working in that area on their off-time. I posted an example in one of the threads SoCute mentioned of an FP I know who is the physician for a mountaineering group, while working primarily in a practice in Wisconsin. Other WM jobs would probably include teaching classes to medics, residents, and students.

psychbender said:

I think most people interested in Wilderness or Tactical medicine want to work on those areas in their spare time, rather than have them be full-time jobs. Examples would be the various EPs that have come on here mentioning being a member of their municipality's SWAT/ERT/HRT/random TLA, while also working regular hours in the ED. Examples of Wilderness Med would similarly be people working in that area on their off-time. I posted an example in one of the threads SoCute mentioned of an FP I know who is the physician for a mountaineering group, while working primarily in a practice in Wisconsin. Other WM jobs would probably include teaching classes to medics, residents, and students.

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I know Loma Linda has a program where you can be deputized . . their PD may be a good person to ask about how their residents use this training (and if they are trained in tactical medicine). Also, Stanford is conducting some studies on intubation in the battlefield . . I think their EMS guys are doing this. So far, it seems like positions are limited but you can always get involved in academics with these fellowships.