University of Exeter launches 'extreme medicine' master's

University’s new MSc teaches doctors how to overcome the psychological and logistical challenges of working in remote regions

May 28, 2016
Mountain rescue team
Source: Alamy

A medical school has launched what it claims to be the world’s first master's programme in extreme medicine.

The MSc at the University of Exeter Medical School aims to support medics providing healthcare "in remote and extreme environments”, said programme leader and acute sub dean Malcolm Hilton, who believes that the new course could eventually lead to the subject becoming a wider specialism in its own right.

He expects most applicants to be qualified doctors, although some may be nurses or advanced paramedics who already have experience responding to humanitarian crises or working in polar, tropical or high-altitude regions.

All will attend a part-time three-year programme, on offer from this September, incorporating a series of residential courses lasting three to five days.

To put on this new master's programme, which has been endorsed by celebrated explorer Sir Ranulph Fiennes, Exeter has joined forces with an organisation called World Extreme Medicine, which has been organising courses and conferences for the past 12 years. Mr Hilton, who works as a consultant ear, nose and throat surgeon as well as on charitable assignments in Nepal, recently attended one of the courses.

“On a wet, windy day in October on the top of Dartmoor,” he recalled, “when you’re working with the local actors’ union who are mocked up to have broken legs and major head wounds, and are covered in artificial blood and lying in gorse bushes, it feels very, very authentic.

“You’ve had to conduct a search and come across these people lying in a remote area and have to figure out evacuation strategy – could we land a helicopter here or what’s the alternative in terms of roads to get people out? It’s actually surprisingly easy to create what feels like a very real and authentic challenge.”  

Elements of these World Extreme Medicine courses are now being built into a formal academic programme for the first time.

Although they may go on to specialise in high-altitude or jungle medicine in subsequent years, explained Mr Hilton, first-year students will learn the generic skills required “when delivering healthcare outside the confines of a Western hospital environment” and generally lacking basic diagnostic equipment such as facilities for blood tests and X-rays.

They will explore issues such as pre-trip planning, situational awareness, the psychological challenges of working when one is dehydrated, hungry or tired.

All students will be required to write a dissertation as part of their MSc and, in the longer term, Mr Hilton hopes to build up a proper research framework and establish extreme medicine as a genuine subdiscipline.

He said that he remembered a time when doctors who happened to like sport offered to help at their local rugby team. Now they would need a degree in sports medicine. In time, he said extreme medicine may also become a similar niche field.

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