Fellow

Wilderness medicine fellowships integrate rigorous clinical and scholarly education that encompasses a greater scope of material than other wilderness educational opportunities. Other emergency medicine (EM) fellowship subspecialties may provide opportunities to be involved in academic wilderness medicine, but not to the same degree as the designated fellowship. While a fellowship is not needed to participate in some practical elements of wilderness medicine, such as search and rescue or expedition medicine, these additional training resources are excellent education opportunities that add to any practitioner's skillset and demonstrate commitment to the wilderness medicine community. Research during residency is not essential unless you are passionate about a given subject - developing your clinical skills should be your first priority.

Currently, wilderness medicine is not an ACGME-accredited fellowship, but this does not detract from its value for a physician considering a career in wilderness medicine. The lack of accreditation is helpful in this case as it allows for more flexibility in training emphasis that is unique to each program. Applicants will find that programs have different educational emphases in addition to the core curriculum such as mountain, marine, tropical, disaster, etc. Applicants will need to take into account the emphasis a program may place on a certain field of study when applying. Regardless, fellows are well prepared and qualified for job placement, education pursuits, and practicing wilderness medicine in a variety of settings.

Completing a fellowship in wilderness medicine is invaluable for the education it provides in understanding the academic and rigorous process of developing a testable hypothesis, designing a study, gathering data, interpreting, and generating publishable material. The dedication of one-three years to this academic rigor in the setting of wilderness medicine is invaluable for the development of a career path in this field. As previously mentioned, fellowship is seen as a formal introduction to the field of wilderness medicine and provides integration with colleagues and associates of the discipline. By comparison to other foci, wilderness medicine is a young, developing field. As a result, the society is closely integrated and participants are well known to each other. For this reason, establishing a network is vital for progression.

Fellowship Applications

Building a strong fellowship application is key. The consensus from content experts is that general, longitudinal involvement with outreach groups, organizations, volunteer experiences, and activities and hobbies that demonstrate an interest in wilderness medicine is recommended. A limited number of programs accept applicants from other specialties at this time, but this will potentially change with pending SAEM accreditation, which would limit it to only EM-certified applicants. 

Additional Accreditation and Alternatives

The Diploma in Mountain Medicine (DiMM) is a European-based standardized accreditation for the advanced care of patients in a mountain setting. This is an internationally recognized diploma and is advantageous for those who want to practice mountain medicine regionally or internationally. The DiMM is not an integrated part of the wilderness medicine fellowship, though some programs encourage their fellows to complete the training. Of note, training is an experiential/instructor-based educational experience. The cost of completing a DiMM is a consideration, and each clinician needs to decide for themselves if the degree will add significant value to their practice and will affect their education/research focus.

The Fellowship of the Academy of Wilderness Medicine (FAWM) is specific to the Wilderness Medical Society (WMS) and similar to the FACEP in the American College of Emergency Physicians (ACEP). It signifies that you have completed educational training and teaching activities within the WMS curriculum. This is meaningful for expanding understanding and practice of wilderness medicine as well as showing that you support and want to contribute to the field's academic society. Obtaining a FAWM may also be helpful in consideration for administrative positions within wilderness medicine academia and WMS. Of note, non-medical personnel can participate in FAWM, so it does not demonstrate medical pedigree. A wilderness fellowship is available only to physicians completing an accredited residency in EM and is an intensive one-three years of academic development and field training while providing greater networking and involvement.

There are other post-EM fellowships that can lead to a wilderness medicine lifestyle and can contribute to your abilities as a physician. Disaster, emergency medical services (EMS), ultrasound, and international fellowships can all be useful training elements that overlap with wilderness, and there are some opportunities to be involved.