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Wilderness medical adventure races (MedWAR, for example) have become a staple of the wilderness medicine community’s calendar with over a dozen highly anticipated regional and national events in a typical year. Advertised as a Tough Mudder meets Bear Grylls and Auerbach’s Wilderness Medicine, these events are known to throw daunting physical, survival and medical challenges at teams of racers. These races can be quite the logistical feat to accomplish both for racers and race organizers. As we begin to optimistically look forward to in-person wilderness medicine events in the coming year, we have put together a list of top tips (in no particular order) for racers and organizers from seven former race directors with over a dozen different races between them. Good luck and have fun!

2019 EMRA MedWar, Credit: EMRA

Tips for Racers

1. Be physically fit.

Getting to the stations first and finishing all of them the fastest is the number one way your team can vie for the top prize. Be ready for a variety of physical challenges including trail running in various conditions, swimming, paddling, crawling, biking, climbing, snowshoeing, and carrying gear (or mock victims) long distances!

2. Balance the talent of the team.

Put together a team with knowledge and skills in various aspects of wilderness medicine and survival skills. Races organizers will often provide a list of topic areas that may be included in the race - make sure to have all bases covered. 

3. Practice like you play.


Meet with your team early and often to discuss scenarios and practice together on similar terrain (or at least outside) to get your team gelling and figure out strengths and weakness. Consider setting up a mini-race or practice scenarios for your residency, medical school, or outdoor club.

4. Plan for any weather.

Wear appropriate layers so you can quickly add or shed clothing during the race with weather changes. Plan on having long stretches of both exerting yourselves and standing in the same place. Keep extra clothes in a waterproof bag so they don't get wet and bring extra clothes in sizes that would fit all of your team members in case you need to lend them to a teammate or victim in a scenario.

5. Know your essentials.

Studying ahead of time is difficult because anything can be fair game! Concentrate on the basics: patient assessment, stabilization, evacuation. Knowing multiple treatment modalities for common injuries and presentations will help your team stay flexible in various scenarios. A successful team doesn't just fake it on the fly.  

WMS 2019 Masters of Wilderness Medicine Conference MedWAR

6. Think teamwork. 

Your team will only be successful if you work well together, support one another and be attentive to each other’s needs on the course. Ask each other: Who needs to eat? Who isn’t drinking water? Who’s ignoring those blisters that will make the last two miles take an hour? Clear communication while completing various tasks and scenarios is paramount. 

7. Bring the gear.  

Pay attention to packing lists when they are provided. Remember you will have to carry everything with you for the entire course so sharing the weight is a must. Don’t wait until the night before to go over everyone’s gear. Avoid duplication when possible, however, having multiple methods of starting a fire (and knowing how to use them) is never a bad idea. 

8. Read the fine print. 

Read and re-read pre-race documents carefully: there may be important information on essential gear, topics to cover, and other preparation work prior to the race. Make sure to have a good understanding of how the race will work, (ie, route, scenarios, point system, penalties, etc.) This can often mean the difference between a podium finish and last place!

9. Read the map. 

Race courses may take various forms: circuit, wheel-and-spoke, free-for-all, or a combination of those. Take the time to plot out your team’s race plan. A missed scenario or inefficient route can cost teams significant time or penalties later in the race. Make sure to familiarize yourself with map and compass skills before race day. 

10. Make it fun.

Consider team uniforms, costumes, team cheer, secret handshake, mascot, cheering with the spectators, etc. Keeping morale up will be key in the later stages of the race!

2019 EMRA MedWar, Credit: EMRA

Tips for Directors

1. Build a balanced team.

Get a team with a good mix of experience in wilderness medicine, race planning, managing a budget, marketing, and writing scenarios. Don’t be afraid to delegate and follow-up. Encourage less experienced members to get involved; they may be future race directors!

2. Seek outside perspective.

Ask an outside expert to review the race plan, scenarios, and questions for feasibility and accuracy. A fresh set of eyes can make a big difference. Review the race plans and expectations with the venue managers and staff to make sure you are all on the same page. 

3. Scout the location in advance.

If going to a new location, talk to locals and venue managers for their perspectives. Make sure to take into account how and when you will get volunteers and scenario materials to various points on the course. Walk the course after the scenarios are written with your co-directors to make sure the race logistics make sense and to make sure the race is doable in the timeframe you have set. Take into account non-participants that may be enjoying the location that day as well.  

4. Make it educational. 

Make sure racers are learning along the way. Beyond an awesome adventure, racers should be leaving the race with a better understanding of wilderness medicine topics and skills. Build in time for the proctors to be able to give brief explanations at the end of a scenario when teams make a mistake. 

5. Make it fun. 

Striking the right balance between challenging, educational and fun is key to putting together an event that racers will enjoy and want to return to. Consider comical penalties if a team doesn’t execute a task correctly such as making racers come up with an interpretive dance to earn an educational pearl that will allow them to be successful in a medical scenario. Be creative and make sure there is a good balance of Type 1 and Type 2 fun while avoiding Type 3. 

6. Communicate clearly with partners. 

Venue managers, park rangers, caterers, sponsors, and your race medical director are key players for the big day. Make sure to communicate your plans and share expectations early to avoid last minute hurtles. Maintaining good relationships with race partners will pave the way for successful future events as well. 

7. Plan Ahead. 

Establish and maintain a timeline for when you want preparation tasks to get done and make sure to follow-up with your co-directors along the way. Finishing tasks like gathering supplies, printing race maps, and calling caterers early is key; the week before the race should be kept free for last minute troubleshooting. Off-load as many tasks from race day as possible; this is usually a long day for race directors and one you should enjoy! 

8. Volunteers are essential. 

Recruit volunteers early and often. Many hands make for a lighter load (this includes for race preparation and breakdown as well). Treat your volunteers well and make sure to give clear instructions and pre-race briefings. Consider recruiting local medical students, scout troops, or teams from the waitlist. Try and optimize their experience as well. No one wants to be sitting outside in the cold for hours if they don't need to be there. Provide education and teaching during downtime if possible.

9. Hope for the best, plan for the worst. 

Expect to adapt your plans to the whims of weather, venue rules, medical emergencies, and unforeseen dangers on the course. If you stay flexible and open-minded, racers may not even realize your plan wasn’t executed as initially planned! Have backup plans such as an extra scenario that doesn’t require a lot of resources in case one of your main scenarios falls through. 

10. Stay on budget. 

Calculate costs early and leave plenty of buffer room for last-minute unforeseen expenditures. When deciding the number of teams to enroll make sure to balance recruiting enough to pay for the event and still provide a fun experience for racers (ie: not too much bottlenecking at scenarios). Engage your local community to find sponsors or champions. These are fairly unique events and if you talk to local park managers, outdoor retailers, rescue squads, and local news, you may find all sorts of interested participants. 

WMS 2019 Masters of Wilderness Medicine Conference MedWAR

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