After nearing completion of the long journey to becoming a physician, considering completing a fellowship post-residency can seem like a continuum of the never-ending training cycle. However, it is important to consider, given academic programs are increasingly seeking fellowship-trained faculty to bring specific skills, research, and diversity to the training of future clinicians. This article is one of a two-part series to help inform potential applicants interested in pursuing a wilderness medicine fellowship.
What are wilderness medicine fellowships?
Wilderness medicine fellowships are non-accredited ACGME fellowships that offer physicians the opportunity to join a growing body of experts adding to the evolution and expansion of wilderness medicine. Since 2003, the number of these fellowships has expanded to over 20 unique programs that share core knowledge and offer expertise training and experience in different areas of wilderness medicine. Most fellowships follow a core curriculum of foundational knowledge laid out by the Fellowship Subcommittee and Taskforce of the American College of Emergency Physicians Wilderness Medicine Section, ranging from high-altitude mountain medicine, to diving and marine medicine, environmental toxicology, and beyond. Fellowship training provides not only a deeper understanding of the injuries and illnesses that can occur in austere settings but also provides the skills to adequately respond to and treat patients in these locations. While core wilderness medicine content serves as the foundation for the fellowship curriculum, each program has the freedom to mold these topics into unique experiences and focus on specific areas of expertise. Programs may offer the opportunity to perform mountain rescue at a ski resort, travel to remote locations for research, or work as an expedition doctor; these experiential and hands-on training opportunities unique to each fellowship location work in tandem with a generalized curriculum to provide specialized education for fellows.
What does non-ACGME accredited mean?
Fellowship programs that are not approved by the Accreditation Council for Graduate Medical Education (ACGME) are deemed non-ACGME accredited and are not required to have an examination for certification of special qualification by the specialty board. Given there is no specialized certification, potential employers, particularly in academic settings, may not find there is value to be added by an applicant who completed one of these fellowships. However, multiple fellowships exist that are non-ACGME accredited, including those for medical education, ultrasound, and research. Many of these fellowships, including wilderness medicine, are highly sought out and make for highly desired job applicants. Being a non-ACGME accredited fellow does not hinder your ability to be a strong job applicant compared to ACGME-accredited fellows; however, the lack of accreditation can result in a difference in pay. Finally, being non-ACGME accredited can lead to variability in training across wilderness medicine fellowships; however, this allows fellowships the freedom to generate learning opportunities tailored to the individual fellow. If seeking an academic career, fellows can mold their experience toward education and research. Likewise, fellows can gear their training toward other areas of expertise that would better serve specific regions and communities.
How many wilderness medicine fellowships are there?
On the Wilderness Medical Society (WMS) website, you can find a working list of the various fellowships offered by different institutions. Whether a program hosts a wilderness medicine fellow every year can vary. Unfortunately, the only way to discover this is by contacting each program directly. The majority of programs are one year long and accept one fellow per year although some fellowship programs offer the opportunity to obtain further educational training, such as a Master of Public Health.
Of the listed wilderness medicine fellowships, there is a distinction categorizing fellowships as WMS certified, meaning their curriculum is approved by the WMS, allowing their fellows to obtain Fellowship in the Academy of Wilderness Medicine (FAWM) certification upon fellowship completion. The difference in program curriculum and experiences between those that are WMS certified and those that are not is negligible. Furthermore, any MD, DO or other recognized medical discipline can independently apply to be a FAWM candidate.
Which program is right for me?
While the core content of wilderness medicine fellowships do not vary significantly from program to program, areas of expertise can. One key consideration when applying is to find which program best aligns with your interests. Some programs specialize in high altitude and mountain medicine, while others offer expertise in dive and marine medicine. A few focus on climate change and its impact on health, and others have greater involvement in wilderness emergency medical services and search and rescue. The process of selecting where to apply can be further aided by looking at what prior fellows from various programs have done post-fellowship. For some, this has led to careers in expedition medicine, serving as on-site physicians for experiences ranging from touring groups to remote research teams, while for others, they have continued to pursue careers in developing new fellowships and expanding wilderness medicine education for varying medical providers. Others have focused on performing wilderness medicine research, working for the Divers Alert Network (DAN), pursuing careers in hyperbaric medicine, or further developing search and rescue programs and wilderness emergency medical services. Finding a niche of interest and seeking a fellowship that not only tailors to that niche but has aided prior fellows in building careers like the one you envision, will help determine which program might be the right fit for you.
Who applies?
While most programs require that applicants be emergency medicine-trained, there are a few that accept family medicine physicians, internal medicine physicians, or mid-level providers. When applying for individual sites, it is important to make this distinction in order to determine your eligibility as well as possible clinical duties outside of fellowship, such as whether clinical time is guaranteed as a part of the contract or if you need to find work outside of fellowship.
When and how do I apply?
While there is no common application to submit for wilderness medicine fellowships, most programs request similar application materials including a curriculum vitae, personal statement, and 2 to 3 letters of recommendation, all to be emailed to each program separately.
Each fellowship has their own application deadlines as outlined on their individual websites. Typically, the final due dates are in mid-September. Many programs welcome applicants to submit information to programs as early as July of their final year of residency. Once the application deadline has passed, applicants are extended individual offers from fellowship directors for interviews occurring from September to early October. Given that wilderness medicine fellowship opportunities have expanded, a match system was introduced during the 2022 application cycle in order to formalize the acceptance process, occurring at the beginning of November. Further details regarding the application process can be found here.