Fellows Corner: Wilderness Medicine
By Dave Pomeranz, MD
Hello all, token bearded Reno mountain dude here, Dave Pomeranz.
I was asked to give some information on my fellowship in wilderness medicine. So here we go:
Why would I ever do something as ridiculous as a Wilderness Medicine fellowship?
First off, the reason to do a Wilderness fellowship is absolutely because you have an interest in the involved topics, such as high altitude, hypothermia, avalanche/lightning injuries, envenomations, endurance sports physiology, improvisational medicine, technical search and rescue, etc.
Why would you take such a significant pay cut to do such a ridiculous fellowship?
Well, there are accredited and non-accredited fellowships in EM. In non-accredited, you are treated as part-time faculty, and paid to be an attending on your ED shifts, teaching residents and working clinically. Most salaries are from $75-100k per year to work eight x 8 hour shifts, along with additional funds for research, conferences, and travel. You have 3-5 more days per month committed to meeting with your mentor, covering didactics, journal reviews, and teaching courses with undergrads and medical students. This leaves 18 days a month to moonlight, work on research projects, and travel for international projects. You can easily make over $200k being a Wilderness Fellow by moonlighting 4-5 shifts a month.
How many Wilderness Medicine Fellowships are there and what are the differences?
There are approximately 20 Wilderness Medicine fellowships in the country, and they all have different focuses based on their proximity to various national parks, search and rescue teams, departmental faculty, etc. Several different program focuses are:
- Educational: you cover didactics and teach residents, medical students, and undergrads wilderness medicine topics and techniques, both in classrooms and in the field. May involve a 1-4 week wilderness medicine field elective for residents or medical students.
- Park Management: (i.e. UCSF/Fresno) involvement in National Park Service medical management and rescue oversight through training rangers and staffing a base station for radio communication during rescues in the backcountry.
*** Search and Rescue**: collaboration with EMS and the local S&R teams, medical training of volunteers and staff, on-site involvement in efforts.
- Research/International: (ie Stanford/Utah/Denver) a few programs conduct funded research at domestic and international sites. You have a research mentor and learn the process of IRB approval, study design, statistics, methodology, and grant writing.
What is the application process?
Straightforward and simple. Application submission is non-match, and the deadline is usually the end of September. The application consists of your CV, three letters of recommendation, and a letter of intent. Interviews are conducted in September and October, and then offers are all sent November 1st.
How can I start to get involved now?
Besides growing a beard and driving a Subaru or Tacoma? Get involved with the Wilderness Medicine Society (www.wms.org), attend conferences and ACEP section meetings, and review past and current issues of the Wilderness and Environmental Medicine Journal and other related publications. Reach out to our USC resources such as Drs. Paquette and Mallon, as well as Dr. DeClerck, who teaches the USC undergraduate course on Wilderness & Survival Medicine. Additionally, our Toxicologists, Dr. Nordt and Levine, have conducted research in envenomations and other topics that overlap. You can get formal training through the Diploma in Mountain Medicine (DIMM) or Advanced Wilderness Life Support (AWLS) courses. You can also reach out to faculty at other institutions to get involved in international or domestic research projects.
Feel free to contact me with any other questions, anytime.
Dave Pomeranz MD
LAC+USC Emergency Medicine Graduate
Stanford Wilderness Fellow 2015-2016