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Comparing Wilderness Medicine Courses

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In my progress towards the Fellow of the Academy of Wilderness Medicine (FAWM), I've taken multiple instructor-led courses.  Each was valuable, yet each had its own unique strengths.  Here are my impressions comparing them, as a PA with an EMS background interested primarily in disaster and missionary (austere) medicine.

* Wilderness Upgrade for Medical Providers (WUMP)  http://www.nols.edu/wmi/courses/wildupgrademedpros.shtml

I took WUMP in 2012, while I was still in PA school.  I found it really valuable and accessible.  Of these three courses, this was the most accessible, as you can take it as an EMT.  I did my initial EMT certification through WMI in 2006, and so this was like a great big refresher (and did, in fact, reestablish my WEMT-B credential).  This was a very practical, hands-on, five-day course, and of the three courses probably gave the most time for individual students to repeat demonstrated skills enough times to obtain some level of mastery.  It was taught by two EMT instructors, and attended by everyone from EMTs to MDs.  It is a great intro-to-wilderness course for someone who already has a front country EMT-B.


* Advanced Wilderness Life Support (AWLS) http://www.awls.org/


I just finished AWLS today, and it was a very dense 2.5 day course, with both hands on and theoretical training.  One of the interesting characteristics about this course is that the course authors and instructors were themselves MDs, and so there was nothing dumbed down about the medicine.  I was especially pleased with the lecture on dive medicine was, in that it reviewed basic physics, and jumped right into the application, including pathophysiology.  Likewise, the high altitude disorders section really dealt with the pathophysiology of HAPE and HACE in a way I've not seen from similar courses.  It's a certification good or four years, but not sure how much that matters.  It's also got a four-letter A?LS acronym, so I'm sure some HR folks may look at it with feigned recognition.  The price and the time commitment are both reasonable, but of the three courses, this felt the most densely packed.


* Remote Medicine for the Advanced Provider (RMAP) http://www.remotemedical.com/RMI-Training/Remote-Medicine-for-the-Advanced-Provider-RMAP

I took RMAP in late 2013, and it had the best toys, the best scenarios, and was really about a 60 hour course over 5 days, with evening labs and actual homework assignments.  The lead instructor in my course was a PA, and we had everything from an ER attending to ICU RNs, but the real target audience seemed to be paramedics who wanted a crash course in remote, independent-duty medicine with telemedicine backup.  We had foleys, IVs, a portable ventilator, and did a basic suturing lab (so, it wasn't ALL new to everyone). We discussed what sat phones worked where on the globe, and how to serve as an expedition medical provider for weeks of backcountry adventure. The textbook, http://www.amazon.com/Expedition-Wilderness-Medicine-Gregory-Bledsoe/dp/0521868734/ is simply amazing.

I'm happy I took the classes in the order I did (WUMP, RMAP, AWLS), but doing AWLS second and saving RMAP for last would have allowed me to get even more out of it.  WUMP really focused on doing the right things at a BLS level if you got into a problem, and was an excellent foundational class.  AWLS and RMAP really assume provider-level familiarity, not just ALS, so I really recommend them for after PA school. Even if you're already a nurse or paramedic, the discussions of which antibiotics to bring on a back country trip won't have the same relevance or impact as they will once you have your own DEA number.

Each of these classes are separately valuable for wilderness medicine-oriented PAs; each has their own niche, and you will not do wrong by selecting whichever one best matches your experience level and budget. 

(Oh, and I don't have any financial interest in any of these companies or their courses, nor do I mean to imply that courses NOT included are in any way inferior.  I just haven't taken them (yet?), so I can't personally comment on them in relation to these courses which I have)

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I'm also a FAWM candidate.  Iv'e taken WUMP and AWLS as well.  I had not heard of RMAP prior to your post.  Looks like fun.  I start my PA program on Monday, so I'm looking at some time before I can commit to obtaining more FAWM credits.  Have you been to a wilderness medical conference, Rev?  I went to one in Jackson Hole last summer and had a blast!  I camped the whole time and met some really cool people.  

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I was going to try to go to the Jackson Hole one last summer, but by the time I was ready to commit, all the lodging was sold out. They don't seem to schedule wilderness medicine conferences in places with a lot of hotels, or anywhere close to sea level for that matter.  I've gotten several of the downloadable sessions for CME, and those were very worthwhile.  Maybe I will get to go someday...

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Just finished the RMAP class yestersay. great course. 11 participants from all over the world. a pair of medics from Denmark, flight nurses and medics from all over, a trauma surgeon, etc. Very hard core class for expedition med preparation. lots of great/realistic scenarios. for one of mine I was supposed to be a fallen climber so they harnessed me to a partner, hung us up in the woods at the base of a cliff, let us sit in the rain for a while until we actually got a bit hypothermic, then the rescue team had to find us, deal with our injuries and hypothermia, etc. I was moulaged to have a flail chest and femur fx. they had to traction splint my leg, decompress my chest (on a mannequin), I got an actual IV in my arm, we had simulated meds(all saline) that we administered, etc. great class, highly recommend it. I had it easy. another guy got thrown in the lake (northern cascades, very cold), allowed to get pretty cold, etc). he got stripped down and aggressively warmed. big dude too and we had to carry him out in a stokes.

we also had to plan several simulated expeditions with minimal info, do the research and give class presentations. things like " you have been asked to lead a group of 7 amputee climbers up xyz mtn on a 21 day trip starting from miami, florida. list and discuss all trip considerations. "

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