The subspecialty of Undersea and Hyperbaric Medicine deals with the therapeutic use of high environmental oxygen pressure and the prevention of injury and illness due to exposure to environments with elevated ambient pressure. The scope of the subspecialty emphasizes hyperbaric chamber operations and hyperbaric oxygen (HBO2) therapy; as well as occupational, environmental, safety, and clinical aspects of deep sea diving. One-year Diving and Hyperbaric Medicine Fellowships should provide education and training in the theory and practice of diving and hyperbaric medicine. Those interested in the field should look for programs accredited by the ACGME. Graduates from non-accredited programs will be eligible only until 2008 to sit for the American Board of Medical Specialists’ certification examination for special competency in Undersea and Hyperbaric Medicine.
Individuals should obtain sufficient didactic and practical knowledge to work in a hyperbaric clinical and research environment, and to act in a supervisory capacity of a hyperbaric chamber. A fellowship should facilitate development of a knowledge base and the clinical skills necessary to evaluate and prescribe appropriate HBO2 therapy for all the accepted conditions, and to manage patients during hyperbaric treatment. It should also provide training to evaluate individuals for scuba diving activities, and treat diving-related illnesses. Ideally, it should provide an opportunity to carry out some investigational activities and discussions on directions for future research.
The curriculum should heavily emphasize clinical activities including participation in hyperbaric chamber operations that expose trainees to virtually all the accepted indications for HBO2 therapy. This should include experience with emergency evaluations and management, critical care, and an elective consultation service to physicians referring patients. The curriculum should include participation in one or more clinics to learn aspects of wound care. One should also look carefully that there is an organized didactic curriculum with lectures, clinical rounds, and discussion sessions.