Wilderness medicine: a fellowship programme

The Fellowship of the Academy of Wilderness Medicine qualification (FAWM) was set up in 2005 by the Wilderness Medical Society based in America and currently has 640 candidates, and 176 Fellows. It provides a great opportunity to gain and demonstrate knowledge of expedition and wilderness medicine and to gain recognition for practical experience you have gained in this area. The Wilderness Medical Society also offers a number of other benefits to its members and continues to develop new services and qualifications year after year.

The Wilderness Medical Society

The Wilderness Medical Society (WMS) itself was created in 1983 by three doctors with the mission statement to ‘advance healthcare, research, and education related to wilderness medicine’. The international society has 2383 members, as of 13 August 2010 and publishes the peer-reviewed Wilderness and Environmental Medicine Journal and the more informal Wilderness Medicine Magazine.

The society is also responsible for creating and publishing the evidence based practice guidelines for wilderness emergency care. The WMS itself strives to not only embrace evidence based medicine, but also to add to the evidence base for wilderness medicine with high quality research. The WMS further supports the development of evidence based healthcare in remote environments by providing various research grants and awards for amounts varying from under US$500 up to US$7000.

These funds can be used towards research work conducted by institutions or individuals in the areas of: clinical or basic sciences, epidemiology, equipment provision or injury prevention. The research must of course aim to make a substantial contribution to the field of wilderness medicine and result in publication in a peer-reviewed journal.

In addition to its publishing and research activities, the WMS also runs regular international conferences. These conferences provide members with a great opportunity to network and hear from leaders in their field. The conferences also afford credits for those members of the WMS who are also studying for the fellowship. Membership of the WMS has many benefits for the more experienced or student healthcare professional. Membership currently includes free access to the society's peer reviewed journal and magazine, free access to online CPD activities and access, at a price, to a library of video lectures. For the more adventurous healthcare students, the WMS also offers its own elective programme in association with the Uniformed Services University of the Health Sciences.

Box 1.Summary of the programme

  • The fellowship is open to UK paramedics, EMTs, nurses and allied health professionals
  • There is a 5-year time limit in which to gain the FAWM qualification
  • The fellowship programme costs approximately £150 ($225 USD) for 5 years
  • The mixture of online learning and residential courses makes it easy to fit the fellowship programme around a full-time job
  • Once you have qualified for fellowship of the Academy of Wilderness Medicine you may use the letters FAWM after your name.

The elective programme is a truly amazing opportunity to learn more about wilderness medicine through both practical and theoretical sessions, while enjoying your stay in the Great Smoky Mountains National Park of Tennessee. The WMS also facilitates student interest groups (SIGS) from around the world, which provides a chance for medical and allied health students to work together and share experiences and questions about wilderness healthcare in an inter-professional and international setting.

The WMS also aims to foster a strong sense of international community involvement, indeed credits towards the FAWM can be gained from voluntary teaching and clinical practice in underserved areas or during disaster relief efforts. Furthermore, the WMS and its members have been involved in medical relief work around the globe; most publically in Haiti where members of the society provided medical care to those in need.

Fellowship of the Academy of Wilderness Medicine (FAWM)

The FAWM qualification is designed for practitioners with a special interest in wilderness medicine and offers a way of ‘combining your profession with your passion™. In the past, it has been a challenge to show evidence of knowledge and practical skills in this area and there has for a long time been a lack of accredited qualifications available for wilderness medicine enthusiasts. The WMS fellowship programme is designed for clinicians of all levels to gain an international qualification in the field of wilderness medicine and equip them for practice in this challenging area. Achieving the level of Fellow also permits the use of the post-nominals FAWM, allowing Fellows to easily demonstrate the high level of practical and academic work involved.

Currently, there are only 14 UK practitioners working towards the FAWM qualification with only 3 of those being non-doctors, of which the author is one. There have also only been two fellowships awarded to UK based professionals so far. It seems that currently, although the FAWM programme is open to all those with a special interest in wilderness medicine, very few paramedics have taken the opportunity to get involved in this exciting development.

There are, however, a growing number of healthcare providers from different professions and different countries, working towards fellowship. With the growing interest in adventure travel, there are more and more opportunities for medics to work with expeditions or with research teams in remote areas, and with the FAWM qualification UK paramedics can demonstrate their ability to fulfil this role.

The FAWM credit system

The WMS fellowship programme requires candidates to accumulate a minimum of 100 credits in various areas of wilderness medicine. These credits must come from core curriculum topics, elective topics and the experience report (Box 2, 3 and 4). The WMS have endeavoured to make the curriculum relevant and the core curriculum for the WMS fellowship programme was developed from a needs-assessment questionnaire sent to experienced practitioners of wilderness medicine.


Figure 1. The fellowship programme is an internationally recognized qualification in wilderness medicine.

Box 2.Core curriculum topics

  • Diving and hyperbaric medicine
  • Tropical and travel medicine
  • High altitude and mountaineering medicine
  • Expedition medicine
  • Field craft and equipment
  • Rescue and evacuation
  • Sports medicine and physiology
  • Preventative medicine, field sanitation and hygiene
  • General environmental medicine
  • Improvized and alternative medicine
  • Disaster and humanitarian assistance
  • Wilderness emergencies and trauma management.

This questionnaire identified the essential areas of practice which form the core curriculum used on the fellowship programme. These core topics are complemented by a number of elective topics, and a certain number of credits must be gained from both of these groups. The elective topics are those which are specifically beneficial for specialist work in a chosen area of remote healthcare, such as hyperbaric medicine or search and rescue work, and allow candidates to tailor their training to suit their individual needs.


Figure 2. The programme has the benefit of respecting paramedics as experts in prehospital care and accepting them as fellows of the society.

Box 3.Elective topics headings

  • Diving and hyperbaric medicine
  • Tropical and travel medicine
  • High altitude and mountaineering medicine
  • Expedition medicine
  • Field craft and equipment
  • Rescue and evacuation
  • Sports medicine and physiology
  • Preventative medicine, field sanitation and hygiene
  • General environmental medicine
  • Improvized and alternative medicine
  • Disaster and humanitarian assistance
  • Wilderness emergencies and trauma management
  • Wilderness medicine faculty department
  • Wilderness medicine research.

Alongside the accumulation of credits from the core and elective topics, candidates must provide an experience report demonstrating that they are also applying their knowledge in practice. The experience report covers a wide range of activities (Box 4) and allows candidates to gain credits for relevant qualifications, voluntary work or practice in a wilderness or extreme environment.

Gaining credits

There are many ways to gain credits for the core and elective topics. The WMS website provides two different ways to gain credits online. The first of these is the free facility to read selected articles from the society's journal, Wilderness and Environmental Medicine, and then answer a number of questions regarding its contents. Recent topics for these review activities have included rattlesnake envenomation and physiological changes during hypoxia.

The second provision on the website is the ability to download video lectures on a number of topics, as mentioned earlier. These are didactic lectures that have been given at previous WMS conferences by experts in their field. The video lectures are played through the WMS website and give you the option to view the speaker, their slides, or both side by side and are a great way to view previously given presentations if you were unable to attend the WMS conference in question.

Credits for many of the topics can also be gained through attendance at wilderness medicine courses both within the UK and abroad. There are various courses available which are accredited by the WMS FAWM programme and these cover aspects of wilderness medicine ranging from polar survival to tropical diseases to search and rescue techniques. Most of these courses also contain a high proportion of practical sessions and many of the skills covered are ones which will be familiar to UK paramedics, such as spinal immobilization or limb splinting. Attendance at these courses gain you credits for the various aspects of wilderness medicine taught on that specific course, and on average a course will provide you with around 20-30 credits towards the 100 required to become a Fellow of the Academy of Wilderness Medicine.

Other Wilderness Medical Society awards

In addition to the FAWM programme, based on the accumulation of credits, the Academy of Wilderness Medicine offers a number of other awards for practitioners showing a high level of dedication to the field of wilderness medicine through attendance at conferences, seminars and the like. These are awarded as part of the education achievement recognition programme (EARP) and consist of The Matterhorn Award, The Denali Award and The Everest Award. The last of which has not been awarded to date, but perhaps this in an opportunity for a UK paramedic.

There are no additional costs involved in gaining EARP awards and the Academy staff will automatically be alerted when you have attained the required criteria. The WMS is also currently developing a masters level programme and details of this will soon be released on their website.

Conclusion

The Wilderness Medical Society is an established and continuously growing organization with over 2000 members. The society continues to enhance the knowledge and understanding of wilderness medicine at an international level and provide world class education in this field.

The fellowship programme is an internationally recognized qualification in wilderness medicine which offers recognition to those practitioners who have met the demanding requirements of the fellowship curriculum. The fellowship programme also offers a means to identify yourself as having achieved a high standard of knowledge and experience in wilderness medicine to current or future employers, clients and patients.

The programme is designed with full time professionals in mind and it is easy to fit courses, and online activities around a busy schedule.

The FAWM programme is an excellent opportunity for UK paramedics looking to add something special to their CV or to develop their skills and knowledge to gain employment as a wilderness or expedition medic. The programme also has the benefit of respecting paramedics as experts in prehospital care and accepting them as fellows of the society, something that many other institutions are yet to do.

In short, the fellowship programme from the Academy of Wilderness Medicine is a world class qualification allowing paramedics to gain the knowledge and recognition to enable them to practice safely and effectively in hostile and remote environments. To be a fellow of the Academy is certainly an honour and one which demonstrates a very high level of academic achievement.

The author would like to thank Teri Howell and all the staff of the Wilderness Medical Society for providing valuable information about the society and fellowship qualification and to Expedition Medicine for providing the images to accompany this article.


Figure 3. Figure 3. There are more and more opportunities for medics to work with expeditions or with research teams in remote areas.

Box 4.Experience report

  • Higher degrees
  • Other training courses
  • Conference attendance
  • Voluntary teaching
  • Public service
  • Practical experience
  • Services provided to the Wilderness Medical Society.

Box 5.Additional informationWilderness Medical SocietyThe Academy of Wilderness Medicine2150 South 1300 East,Suite 500Salt Lake City, UT 84106(801) 990-2988http://www.wms.orgUK Provider of FAWM Accredited Training — Expedition Medicine: http://www.expeditionmedicine.co.uk.