Both attending faculty and resident instructors provide teaching.  Residents provide continuity between evolutions as they stay for the entire elective.  Faculty rotate between evolutions and bring specific expertise to each environment.  There are a few core faculty with long histories of teaching and practicing wilderness medicine as well as with specific experience with this elective. 

History & Curriculum

History & Ethos

The MMC Wilderness and Environmental Medicine elective is probably the oldest wilderness medicine elective in the country. It was started at University of Massachusetts Medical School in the 1980s by William Houghton, MD as part of the department of Family Medicine. He ran this course solely until 2001 when Matt Sholl, MD, from Maine Medical Center, first became involved.  In 2006, the elective took a new home in the Department of Emergency Medicine still at UMass but run almost entirely by faculty from MMC.   After more than 30 illustrious years with UMass the course took a new direction.  In 2014 the faculty moved the course to their home institution of MMC, this means the course is now registered through Tufts University School of Medicine.  We are proud to take this course with a rich and storied history into new grounds with continued improvements and growth.

Our elective is unique because, to our knowledge, it remains the only wilderness medicine course in the country that is taught primarily by physicians and takes place 100% in the outdoors. The majority of wilderness medicine courses are taught mostly in a classroom with occasional ventures into the actual (omigosh) wilderness. This means that our course is far heavier on actual experience than most others.

A Strong Learning Experience in an Adventurous Environment

The elective is not simply a chance to go on a great trip; it involves a significant learning experience. Past participants have said that it helped them to prepare for their intern year more than any other fourth-year elective. We attribute this to a new system for organizing patient evaluations (our patient assessment diamond) and the well-run scenarios that force you to make decisions and act based on your knowledge without being able to rely on the support of residents and attendings. Such a rigorous and thorough learning opportunity holds full credit as a fourth year elective. In an adventurous environment… Of course this is also a great chance to go play in the mountains, rivers, and deserts of Utah. Expect to have a lot of fun, even if you’ve never camped before.

One specific goal of this course is to enable all participants to succeed and excel regardless of experience or ability level. In the past participants have ranged from well traveled mountaineers with guiding experience to first time campers who have never worn a hiking pack before. Our intention is for all participants to learn from and enjoy their time with us. With a focus on wilderness medicine taught to the fourth year student level the medical aspect of the course should challenge all students.


The course is organized into three different parts called “evolutions”: alpine, swift water, and desert. In each environment we teach how to travel and live in that setting while maintaining safety and comfort. We believe that, in order to be able to care for patients in a wilderness setting, you must first understand how to care for yourself, to quote the pre-hospital provider maxim: “a dead rescuer saves no one.” We then learn about medicine that is specific to that environment via daily lectures by faculty and students (each student prepares and gives one lecture with faculty guidance) and scenarios designed to reinforce topics covered in the previous days.

Wilderness travel skills that are covered include (but are not be limited to):

* Intro to mountaineering including Ice axe/crampon use and climbing techniques

* Avalanche awareness/avoidance

* Knots and low angle rescue

* Swift water rescue land and boat based

* Drinking water management.

* Land navigation, map, compass & GPS use

* Basics of search and rescue

Medical topics to be covered will include but are not limited to:

Environmental topics such as:

* Altitude illness

* Hypothermia and cold injuries such as frostbite

* Heat Exposure such as heat syncope, stroke and hyponatremia

* Lightning injuries

* Submersion/Immersion injuries and hyperbarics

* Bites and Stings

* Ingestions & other wilderness toxicology

Trauma topics such as:

* Orthopedics of the upper and lower extremities: fractures, dislocations & splinting

* Wound care

* Eye injuries

* Heat injuries or burns

Medical topics such as:

* Wilderness infectious disease

* Traveler’s diarrhea and water treatment

* Acute medical complaints such as chest pain or abdominal pani

* Managing chronic medical problems in the wilderness

Also specific skills such as:

* Scene safety and patient assessment

* Lifts and rolls

* Improvised splints

* Hypothermia wraps

* Patient packaging as well as litter building and carries

There is significant one on one teaching as well as realistic mock scenarios that utilize students, faculty, and river-guides as patients which incorporate moulage and other tools.

Fellowship Academy of Wilderness Medicine

FAWM Credits are usually available if requested by students far enough in advance.

Garreth Debiegun, MD, FAWM, FACEP

First year on elective: 2006

Sara Nelson, MD, FACEP

First year on elective: 2010

Matt Sholl, MD, MPH, FACEP

First year on elective: 2001

Lead Faculty