Wilderness Medicine Fellowship

How to Submit

All applications and evaluations must be submitted through the online portal by 5pm Central Time on the deadline. If the deadline falls on a holiday or weekend, applications will be accepted on the next business day.

New Application Deadline: March 31st

Renewal Application Deadline: September 30th

• Renewal applications are due the third year after initial application is approved.
• Subsequent renewals are due every five years.

Application Fees

• Application fee is $400 at the time of submission.
• Annual fee of $150 for years 1 and 2.
• Annual fee of $200 for year 3 and beyond.
• Please make check payable to "SAEM" and reference "[Type of fellowship] Fellowship Application."
• Checks can be mailed to: SAEM, 1111 East Touhy Ave, Suite 540, Des Plaines, IL 60018 or faxed using the credit card form [pdf] to (847) 813-5450.
  

You can download a copy of the Application Form questions.

Please note, you must submit applications through the online portal. Emailed copies of an application will not be accepted.

Annual Reports

(Non-research fellowships only)

Annual Fellowship Evaluations are required of approved programs on March 31st each year. The annual evaluation will ask you to list graduating fellows. Please make sure to complete this form in order for your fellows to receive their certificate.

Institution Application

Introduction

Wilderness Medicine (WM) is the practice of resource-limited medicine in austere environments. The skills taught by WM fellowships have broad and unique application in wilderness areas, prehospital care, disaster medicine, international and developing-world projects, climate change and human health, and advancing environmental/medical policy. WM fellowships exist as an academic sub-specialty of Emergency Medicine (EM). WM fellowships are widely dispersed across the county. The first WM Fellowship program was established in 2003. There are now 16 established WM Fellowships. There are thriving WM Sections and Interest Groups contributing to the academic missions of multiple national medical organizations including the Society for Academic Emergency Medicine (SAEM), American College of Emergency Medicine (ACEP), Emergency Medicine Resident’s Association (EMRA), and the Wilderness Medical Society (WMS).

Purpose

WM is an increasingly mature area of academic and clinical expertise. Just as EM encouraged peer-review of its new training programs to earn its rightful place as a ABMS-recognized medical specialty, WM fellowship training is sufficiently widespread and mature that peerreview of our WM fellowships is an important next step to advance our sub-specialty. External review of WM fellowships will help ensure that fellows have a voice and that all fellowships have access to best WM teaching, curriculum, research, and other resources. It will provide EM Chairs and administration evidence of our excellence which will be useful to individual programs.

More than five years ago, SAEM recognized there are many valuable non-ACGME-approved post-graduate training opportunities for EM residency graduates (e.g., admin, global health, geriatrics, etc.). As sub-specialties of Emergency Medicine, SAEM is uniquely suited (by expertise and authority) to review these EM academic programs. To meet this need, SAEM created an active and efficient Fellowship Review Committee to provide peer-review of EM fellowships and help ensure best practices are available to all. The goal of this review is aspirational – the chance for programs to demonstrate a level of excellence as defined by our peers (in our case WM Fellowship Directors) and to earn endorsement as an SAEM-approved fellowship.

Since all WM Fellowships are based in EM programs, as a national EM body already charged with external fellowship review, SAEM seems best positioned to succeed in WM Fellowship Review. The review process is transparent and with limited administrative burden.

In 2014, a group of experts in WM education developed a consensus statement published in Academic Emergency Medicine which outlined the core content of WM fellowship training (see below). This consensus document created by WM Fellowship leaders is the basis of SAEM’s fellowship review.

Essential Elements for an SAEM-Approved Fellowship in Wilderness Medicine

SAEM endorsement of a WM fellowship is contingent upon a review of the following (consistent with other areas of current EM sub-specialty fellowship training reviewed by SAEM and with the previously mentioned WM expert consensus document published in AEM):

1. Institutional environment
2. Success of prior program graduates (if applicable)
3. Current members of the faculty fellowship team
4. The proposed curriculum for future fellows

All approved institutions must have an ACGME-approved emergency medicine residency and support for WM programs in place. They must demonstrate strong collaboration with WM clinicians, educators, and researchers as well as with other clinical and expert services that supervise relevant clinical, technical outdoor/ rescue skills, and research experience.

Wilderness Medicine Fellowship Criteria

Fellowship Eligibility

• Fellow must have graduated from an EM residency; American Board of Emergency Medicine (ABEM) or American Osteopathic Board of Emergency Medicine (AOBEM) eligibility or certification; or other specific arrangement with the fellowship program.

Duration of WM Fellowship Training

• 12 to 24 months

Site Requirements

• Sponsored by an Accreditation Council for Graduate Medical Education (ACGME)‐accredited EM residency program with expertise in wilderness medicine clinical practice, education, and research.
• Dedicated wilderness medicine fellowship faculty.
• Financial support for the fellowship and fellow.
• Resources sufficient to enable the fellow to achieve the fellowship's stated educational and other goals.
• Active involvement in providing online and offline medical direction for at least one wilderness medicine system whose patient population meets the fellowship's educational goals.
• Active participation in supervised care delivery in a wilderness setting.
• Active involvement in wilderness medicine scholarly activity, defined as original research and /or writing project for the peer-reviewed literature or other formal publication.

Program Requirements

• Wilderness medicine fellowship director who has appropriate authority for conduct of the program, including involvement and demonstrated experience in wilderness medicine clinical practice and education.
• Following July 1, 2021, NEW wilderness medicine fellowship directors must have graduated from an established WM Fellowship.
• Goals and objectives that are designed for the educational outcome for each fellow.
• The establishment and implementation of an educational curriculum.
• Specific criteria for assessment of successful completion of fellowship requirements.
• Faculty and fellow evaluations with appropriate documentation and communication.

Wilderness Medicine Core Content

Academic Skills

Goals. To become familiar with the knowledge and skill sets necessary to pursue a successful academic career in wilderness medicine, to develop knowledge of how to teach wilderness medicine learners, and to contribute to the academic wilderness medicine literature.

1.0. Teaching techniques directed to adult learners

1.1. Residents and medical student

1. Didactic

2. Bedside

3. Applied skills

1.2. Wilderness medicine prehospital personnel

1.2.1. Didactic

1.2.2. Applied skills

2.0. Quality management

2.1. Wilderness and out‐of‐hospital treatment protocols

2.2. Data collection, management, and analysis

2.3. Quality improvement programs

2.4. Evidenced‐based practice

3.0. Research

3.1. How to design a research project

3.2. Fundamental epidemiology and biostatistics

3.3. Completion of a scholarly project

4.0. Leadership skills

Wilderness Medicine Knowledge and Skills

Goals. To demonstrate understanding of the physiology, pathophysiology, recognition (diagnosis), treatment, and prevention of each core subject, including related improvisation and application of all knowledge in a wilderness medicine setting. This includes special populations, such as children and individuals with chronic illnesses. All graduates will complete a minimum of 2 weeks in which they are dedicated to taking care of patients in a wilderness environment.

1.0. High‐altitude illness

1.1. Physiologic response to high altitude and hypobaric hypoxia

1.2. Acclimatization

1.3. Risk factors for developing high‐altitude illness

1.4. Types of high‐altitude illness

1.4.1. Acute mountain sickness

1.4.2. High‐altitude cerebral edema

1.4.3. High‐altitude pulmonary edema

1.5. Risk assessment and advising patients traveling to high altitude

2.0 Environmental exposure

2.1. Heat illness

2.1.1. Muscle cramps

2.1.2. Heat syncope

2.1.3. Heat exhaustion

2.1.4. Heat stroke

2.1.5. Dehydration

2.2. Hypothermia

2.3. Cold injuries

2.3.1. Nonfreezing cold injury

2.3.2. Freezing cold injury

2.3.2.1. Frostnip

2.3.2.2. Frostbite

3.0. Wilderness trauma

3.1. Basic principles

3.1.1. Situational awareness

3.1.2. Stabilization

3.1.3. Packaging

3.1.4. Long‐term patient management

3.2. Head trauma

3.3. Spinal trauma

3.4. Chest trauma

3.5. Pelvis trauma

3.6. Penetrating trauma

3.7. Extremity trauma

3.7.1. Fracture and dislocation reduction techniques and splinting

3.8. Sprains and strains

3.9. Wound management

3.10. Foreign body management

4.0. Expedition medicine

4.1. Pre-travel considerations

4.2. Evacuation criteria

4.3. Medical kit

4.4. Acute and chronic medical conditions

4.5. Infectious disease

4.6. Infectious diarrhea

4.7. Field water disinfection

4.8. Nutrition

4.9. Medical–legal considerations

5.0. Drowning

6.0. Dive medicine

6.1. Physics and physiology

6.2. Barotrauma

6.3. Decompression illness

6.4. Risk assessment

7.0. Aquatic medicine

7.1. Injuries from marine animals

7.2. Poisonings

7.3. Infections

8.0. Bites, stings, and zoonoses

8.1. Animal attacks

8.2. North American snakes

8.3. Spider bites

8.4. Tick‐borne diseases

8.5. Hymenoptera stings

8.6. Scorpion stings

8.7. Mosquito‐borne diseases

8.8. Rabies

9.0. Wildland fires and fire management

9.1. Predictable injury and illness patterns

9.2. Medical complications

10.0. Wilderness medicine emergency medical services (EMS)

10.1. Interface with EMS

10.2. Air medical transport

11.0. Search and rescue

11.1. Theory and application

11.2. High‐angle rescue

11.3. Swift‐water rescue

11.4. Alpine rescue

12.0 Wilderness survival

12.1. Shelter

12.2. Water procurement and disinfection

12.3. Fire building

12.4. Navigation and signaling

13.0 Lightning injuries

13.1. Risk assessment

13.2. Physiology

14.0. Avalanche

14.1. Terrain and snowpack assessment

14.2. Avalanche victim physiology

14.3. Patterns of injury

14.4. Rescue equipment

15.0. Wilderness toxicology and toxinology

15.1. Poisonous plants

15.2. Poisonous mushrooms