ExpedMed's CME Polar Bear Adventure: Why You Should Go

Hopefully, you've seen the advertisement here on Freelance MD about our 2011 ExpedMed CME Polar Bear Adventure (during October 20-25, 2011). However, I wanted to take a moment and explain why I think this is such an incredible opportunity for our Freelance MD readers.

In a recent Freelance MD post, Dr. Barry Silbaugh, president of the Americal College of Physician Executives, mentioned that it sometimes takes getting away from it all to have one of those "epiphany" moments that end up being life-changing.  

Here at Freelance MD we're committed to providing opportunities for our readers. We provide these opportunities in multiple ways-- by recruiting excellent authors for our site, by recommending products and services that we believe can be beneficial to today's modern physician, and by creating events in which our readers can participate that can lead to significiant life-change. The ExpedMed CME Polar Bear Adventure is one of those potentially life-changing events.

In late October I will be leading a team of adventurous medical professionals to Churchill, Canada to see the famed polar bears of this region. Churchill is located right on the Hudson Bay, one of the first portions of the Arctic ocean that freezes every winter. In September and October, polar bears come from miles around to await the freeze so they can move onto the ice to hunt seals.  During these months, there is no better place to see polar bears in the wild than Churchill, Canada.

You can read more about the specifics of the trip on our here.  I'll summarize the page simply by saying that the trip will be a lot of fun, you'll earn 25 hours of CME credits for your participation, and you'll get two nights in the famous Tundra Buggy Lodge during your five day adventure. 

However, this trip is more than polar bears and earning a chunk of CME credit.

When I speak with physicians around the US-- and I speak to a lot of them each year-- many seem overwhelmed, despondent, trapped. They're not sure what their next step should be and they're afraid of making a mistake. They're in need of more than simply a job tweak, they're really in need of some life inspiration.

Yes, there are those who have been inspired in their daily work environments, but there's just something about leaving the comforts of your home, going some place truly wild, and taking your mind off your practice and your daily woes that helps refocus your energies and plant the seeds of something new and exciting in your life. It's difficult to be distracted by the problems with your medical billing company when a 1,500 lb creature is staring at you from a few feet away. It's much easier to dream big dreams when your cell phone and pager aren't constantly buzzing and the only "static" you're taking in is the snowfall on the Canadian tundra.

Life is busy. Medical life is especially busy.  This CME adventure is designed to slow everything down and take you away...far, far away.

Ultimately, our hope with this CME adventure is to take you out of your comfort zone, expose you to a magnificent wilderness and some incredibly majestic wild creatures, and help you get your priorities in order (and give your problems a little perspective). You can't do this at home and you can't do this online.  You have to untether yourself from your busy world and make a break for it.  

If you've been looking for an excuse to take a break, this is your opportunity.  This trip will enable you to create memories with other like-minded individuals in a remote wilderness setting that you'll never forget.  

Come with us to Churchill in October and meet other members of the ExpedMed and Freelance MD communities. Earn some CME credits and return home recharged and refocused. Stop making excuses and quit the whining. Take charge of your career and remember this quote from Helen Keller: "Life is either a daring adventure, or nothing."  

The ExpedMed Textbook: Expedition & Wilderness Medicine

For those of you who are interested in learning more about Expedition Medicine or Wilderness Medicine, I'd like to mention our textbook, Expedition & Wilderness Medicine, that was recently published by Cambridge University Press.

This textbook is used as the syllabus for our Expedition Medicine National Conference and also as a teaching tool for many other courses and organizations around the globe.

The textbook is a hardcover text over 700 pages in length, with full-color photos and diagrams.  We recruited more than sixty experts from around the world who contributed content for this project.  Contributors include many notable individuals such as 

Richard Carmona, MD, MPH, FACS: 17th Surgeon General of the United States

Luanne Freer, MD, FACEP, FAWM: past president of the Wilderness Medical Society and founder and director of Everest ER

Ken Kamler, MD: Vice President of The Explorers Club and author of Doctor on Everest

Richard Williams, MD, FACS: Chief Health and Medical Officer for NASA

Peter Hackett, MD: Director, Institute of Altitude Medicine

We have been pleased to read many favorable reviews of our book in multiple journals including the New England Journal of Medicine and JAMA. Here's an excerpt from the JAMA review:

Expedition&Wilderness Medicine, edited by Bledsoe, Manyak, and Townes, is a comprehensive guide to the multitude of issues facing the expedition physician. The book is organized into 3 sections covering expedition planning, specific and unique environments, and specific wilderness illnesses and injuries. The comprehensive and often humorous chapters have been edited in a style that allows for easy reading, and they include numerous excellent illustrations.

Several of the chapters are written by some of the world’s authorities on the topic. Not only have many of the authors published widely on their areas of expertise, they have spent considerable time in the field. The authors have diverse experience ranging from serving as the expedition physician on a climb of an 8000-m peak in the Himalayas to providing medical care to a patient injured thousands of feet underground in a Mexican cave. This experience—and the willingness of many of the authors to illustrate ways to avoid future problems by describing their own misadventures in the field—contribute to the strength of this text.

Expedition & Wilderness Medicine is a must-read before any expedition. It carefully details what an expedition medical kit should contain, along with details on what to consider taking along for toxicological and dental emergencies. Although this book is aimed at the expedition and wilderness medicine physician, many of the chapters are superb summaries of core emergency medicine knowledge that are better distilled and presented than chapters in some more traditional textbooks of emergency medicine. We recommend this text to all who practice acute care medicine and all physicians who hike, climb, or vacation outside the city or who might encounter anyone else who does.

Jones ID, and CM Slovis. JAMA. 2009;302(4):442-44

We'll be writing more about opportunities in Wilderness Medicine and Expedition Medicine here on Freelance MD, but for those of you who need something to begin your journey, pick up a copy of our textbook online or attend our Expedition Medicine National Conference and receive the book for free.

Epiphany

Have you had yours yet?

When did you think you might be capable of trying something different from your training as a physician?  Did it happen suddenly, or was it a gradual pull to a new area of interest?  Have you made the transition yet, or just thinking about it? 

Whatever your answer, it's good. One experience for me got me started in directions that I never dreamed possible. If I hadn't followed my instincts, my world would be very different today.

1985. Working way too hard in my medical practice, organizing an IPA, getting burned out. I wanted a complete break from practice for awhile to get my priorities straight. I wanted to see the highest mountain on the planet.  Not climb it—just see it. Imagine asking your partners in practice—and your wife—to take a month off to do that! I was blessed to have the support of both.

I agreed to be an expedition doctor for a well known trekking company. That way their clients could feel more secure, and I could just tag along with a well organized group. Eat "American style" food, and have my own private tent each night. Nothing too difficult or challenging.

To make a long story short, the group was small. Because the clients and their physician weren't honest on their medical forms (heart issues), they got scared at 13,000 feet in the village of Namche Bazaar. They wanted to go home to the US.

The group leader was frustrated. He wanted to visit his friend the rimpoche at the monastery a half days walk up the trail. He asked me what I wanted to do. He could see I was impressed with the Himalayan experience. We bargained with our clients to give us one more day to make a decision. They agreed, and asked us to take lots of pictures for them.

I decided to stay the remaining three weeks—but without a group to take care of me. Just me and a nineteen year old Sherpa who spoke as much English as I spoke Sherpa. It was a turning point in my life. Every day was a new adventure. Stay in the Sherpa lodges and homes. Eat the native cuisine.  Explore at my own pace. Learn to deal with altitude sickness, and maybe a bit of HACE. 

I asked my young Sherpa guide to take me to HIS favorite place—not the usual tourist destinations. His choice? The chorten memorial to Sir Edmund Hillary's wife and daughter, who were killed in a plane crash at Lukla several years earlier. The Sherpas built the chorten out of respect and love. It was in a beautiful spot. Sir Edmund never did visit the site because of his emotions, but I was privileged to see it with my Sherpa friend.

As a result of having everything fall apart, and having to face a new challenge every day, I realized I could handle new career challenges that I never imagined. I returned home with a new appreciation for my wife and kids—and a promise to bring them to Nepal someday. (They've been there twice now, and my boys have spent far more time there than my wife or me.) One of my partners told me I was "different now". How, I asked. "You aren't as serious". My attitude about serious issues had changed. I saw the struggles differently. 

Six years later, when a new career challenge popped up unexpectedly, I was prepared for it. The inner confidence and desire to take on something new and different helped me move in that direction. Follow your instincts, even if you aren't quite sure why. You might find, as several other physicians who have journeyed to China and Tibet, or Rwanda, with my wife and I, that these adventures help develop your leadership, flexibility, and creativity. You don't have to travel half-way across the world to find your inspiration. Just be aware that what's drawing you to a new interest is happening for a reason—even though you may not understand that reason just yet. 

Or, as the rimpoche tells climbers wanting to know the secret to getting to the top of Everest—no secret. He says there are many ways to get to the top—fast, slow, different routes, etc.  Or you can decide the top isn't your goal anymore.  He laughs and says, "it's all OK".

Begin a Career in Wilderness Medicine: Dr. Eric Johnson

I sat down with Dr. Eric Johnson at our Expedition Medicine National Conference to ask him about his career in Wilderness Medicine.  

Dr. Johnson is a past president of the Wilderness Medical Society and has twice served as a physician at the Everest Base Camp Clinic.  In this interview, Dr. Johnson discusses his involvement in Wilderness Medicine, how individuals can get involved in Wilderness Medicine, and then gives his thoughts on our Medical Fusion Conference.

TV News Report on the Expedition Medicine National Conference

The Expedition Medicine National Conference

For those who might be interested in seeing one of our CME conferences in action, I've posted this television news report that was done on our Expedition Medicine National Conference in 2007.  The news station is Fox 5 WNYW out of New York City.

Even though the report was a couple of years ago, most of the information is still current.

Tropical Medicine Education

Whether from the upsurge of "exotic" diseases popping up in the developed world, or a general curiosity in alternative medical careers, interest in Tropical Medicine appears to be growing. At our ExpedMed conferences on Expedition and Wilderness Medicine I am consistently approached by physicians who are interested in learning even more about Tropical Medicine and/or careers in tropical health.

There are a variety of ways a physician can obtain training in Tropical Medicine. For most, an intensive four or five day CME conference like our ExpedMed events will suffice. However, for those who want to go even deeper into the world of Tropical Medicine, the next step is earning the Diploma of Tropical Medicine & Hygiene (DTM&H).

The DTM&H is a certification program endorsed by the American Society of Tropical Medicine & Hygiene (ASTM&H). Diploma recipients must receive didactic training in Tropical Medicine from an ASTM&H approved course and then successfully pass a test of knowledge administered by the ASTM&H.  

Currently, there are 18 approved diploma courses around the world. A full list of the approved courses can be seen here. However, while all the courses are good, two continue to set themselves apart in terms of prestige and the endorsements I hear among those who practice Tropical Medicine as a career focus:  the annual course at the London School of Hygiene & Tropical Medicine and  The Gorgas Course in Clinical Tropical Medicine .

The Diploma in Tropical Medicine & Hygiene course at the London School of Hygiene and Tropical Medicine begins each January and runs until March and costs approximately $7,700 to attend. The course is limited to 70 students who rotate between lectures and clinical exposure in the Hospital for Tropical Diseases where tropical medicine cases are seen. The London School of Hygiene and Tropical Medicine has been been at the forefront of of integrated medical education for over 100 years and is recognized world-wide as a leader in Tropical Medicine education. Students can expect a broad exposure to tropical disease taught by experts from around the world.

The only drawbacks to the London program that I have heard relate to the city of London itself.  First, the expense of living in London can be prohibitive for some due to the cost of transportation and living expenses in the city. Also, since the course takes place in a developed city, I have heard some reports that the clinical exposure can be hit or miss since it is dependent on what cases are available.  However, participants still give the program overwhelmingly glowing reviews and everyone I spoke to said they would wholeheartedly recommend the course to interested peers.

The Gorgas course is directed by Dr. David O. Freedman of the University of Alabama-Birmingham. The Gorgas course is also run each spring and  is based in Lima, Peru. Participants live in Lima for the duration of the 3 month program.  While the Gorgas course does not have the long history of the London program, it is famous for the quality of its clinical exposure and past participants raved to me about the incredible breadth and depth of cases they examined and treated. Students rotate between classroom work and rounds in the  Instituto de Medicina Tropical (Institute of Tropical Medicine). Two field trips are included in the curriculum- a trip to high altitude in Cusco, and a trip into the Amazon jungle. 

From all accounts, the teaching at the Gorgas course is superb and the clinical exposure unparalleled. The only drawback to the Gorgas course is the limited number of positions offered each year. Only 30 positions are available and applicants come from all over the world. The application process takes place over a year before the course begins, so application in the fall of 2009 is for a position in the 2011 class.  The cost currently is $6,395 which includes flights within Peru and accommodations on both field trips.

One of the benefits of both courses is the network of peers a participant develops during the durations of their studies. Since both courses draw students from around the world, past participants tell me that one of their biggest enjoyments was learning from their peers and kindling friendships with individuals who live on the other side of the globe. The Gorgas course even has a Facebook group for its graduates, and both courses have distinguished faculty and supportive alumni networks.

Our ExpedMed faculty has ties to both programs. Dr. Michael Callahan and Dr. David Townes are both graduates of the London course, while Dr. David Warrell and Dr. Alan Magill teach at the Gorgas course.  

In sum, for those interested in further training in Tropical Medicine, there are numerous resources available. If you are not sure if Tropical Medicine is for you, try attending one of our ExpedMed events where you will get 3-5 days of Tropical Medicine from some of the premiere lecturers in the world.  After attending one of our events you will not only have a much better grasp of Tropical Medicine, but you will feel more confident deciding whether the investment of time and resources for one of the more intensive programs is right for you.