The Diploma in Mountain Medicine (DiMM) is an exciting program designed to train the participant in the essentials of caring for patients in the technical mountain environment.  The DiMM has set the standard over the past 10 years in Europe and other parts of the world for education of doctors, mid-level providers, nurses, and medics in mountain medicine and rescue.  The Wilderness Medical Society is partnering with the University of Utah and University of Colorado to introduce this exciting program in the USA.  The DiMM is an internationally recognized course certifying that the participant has undergone rigorous training and testing. The medical commissions of the International Mountaineering and Climbing Federation (UIAA) and International Commission for Alpine Rescue (ICAR), together with the International Society for Mountain Medicine (ISMM), established minimal requirements for these courses in 1997.

The WMS/University of Utah/University of Colorado program meets requirements of and is fully approved by UIAA, ICAR, and ISMM.

The DiMM

• Is intended as continuing education for doctors, mid-level providers, nurses, and medics who work in or aspire to work in austere environments. 
• The required coursework is an ideal blend of didactic and practical education in wilderness medicine, technical rescue, and self-sufficiency in the backcountry. 
• This skill set crosses a multitude of disciplines including expedition medicine, search and rescue operations, mountain guiding, ski patrol, and mountain recreationalists.

The program is divided into four week-long sessions that should be completed within a two or three-year time period.

February: WMS Winter Conference
February 13-19, 2014

June: Alpine Skills and Rescue Session
June 15-22, 2014 
June 22-29, 2014

July: WMS Summer Conference & Pre-Conference
August 1-6, 2014

September: Rock Skills and Rescue Session
September 7-14, 2014
September 21-28, 2014

• Two of these week-long sessions will be primarily didactic and offered in conjunction with the WMS Winter and Summer Conferences. 
• Attendance at pre-conference workshops and selected conference lectures will be required. 
• The definitive mountain medicine authorities will serve as faculty at both the Park City, Utah Winter Conference occurring each February, and at the Snowmass, Colorado Summer Conference each July (or the World Congress in select years).
• The other two week-long sessions will be aimed at acquisition of practical mountain rescue skills. The experts at Remote Rescue Training will teach these dynamic technical courses.  The June session will take place on the glaciated slopes of Washington’s Mount Rainier and focus on rescue techniques in typical alpine mountaineering terrain.  The August/September session will be located in Colorado’s Rocky Mountain National Park or Utah’s Wasatch Range. In both of these phenomenal classrooms, participants will focus learning on high angle rescue technical skills necessary for rescue on vertical terrain.
• Following attendance in each session, DiMM candidates are required to complete and pass an open-book online exam within 90 days.

Due to the demanding physical nature of the DiMM field sessions, some basic prerequisites are required to ensure a safe learning environment for all participants.  Doctors, nurses, or medics enrolling in this program of study must have experience with backcountry hiking, beginner/intermediate-level rock climbing safety systems, snow travel, and cold weather camping.

The academic nature of the Diploma requires participants to pass both written and skills examinations in order to complete the program. During skill sessions, instructors will perform reasonable remediation for any participant that does not meet the minimum skill standards set by ICAR/UIAA/ISMM and the WMS DiMM. If the participant still has not passed these skills by the end of the session, as determined by the instructors, he/she will be required to re-take that session at their own cost. The participant will be given a maximum of two attempts to successfully complete any certain skill session and three attempts to pass a specific written exam.  If the participant does not pass a certain written exam or skill session after these attempts, the Diploma cannot be awarded.

ENROLLMENT COST

• $200 non-refundable deposit.
• $1,975 per session* (x 4 sessions). Goal is to complete sessions in 2 years.

(Maximum enrollment: Alpine section = 10, Rock section = 12)

* A surcharge may be required to cover costs if full enrollment numbers are not met for skills sessions. Enrolled students will have option to reevaluate.

Includes:

• Registration for Winter and Summer WMS Conferences plus applicable workshops
• Membership in the Wilderness Medical Society for one year
• One to two day pre or post-conference to cover material not included in regular meeting
• Alpine Skills and Rescue session - Mt. Rainier National Park, Washington (includes Mt. Rainier summit attempt - conditions and situationally dependent - and all lodging during section, including 4 nights at Paradise Inn). Excludes travel and food.
• Rock Skills and Rescue session - Utah

Excludes travel, food and lodging (see above for Paradise Inn lodging inclusion).

GETTING STARTED

To begin your pursuit of the DiMM, enroll as a DiMM candidate by submitting the deposit in the Trading Post. Unless notified otherwise, you should then register as a DiMM candidate (instead of "Doctoral" or "Non-Doctoral", etc.) for the WMS Winter and/or Summer Conference(s). You should not register for either of the DiMM field sessions until you have completed at least one Winter or Summer session. If you have questions about this unique and special opportunity, please contact Loren at (801)913-2613.

FACULTY

Course Directors:
Scott McIntosh, MD, MPH
George Rodway, PhD, APRN
Christopher Davis, MD
Ryan Paterson, MD

Medical Advisory Board and Core Faculty:
Jennifer Dow, MD
Loren Greenway, PhD, FAWM
Colin Grissom, MD
Peter Hackett, MD
David Keitz, DO

Technical and Rescue Advisory Board:
Andrew Rich, WEMT-Basic, AMGA certified guide
David Weber, WEMT-Paramedic, Denali Mountaineering Ranger

DIDACTIC SESSIONS

Annual WMS Winter and Summer Conferences (February & July/August, respectively)

Topics covered:

• High altitude 
• Hypothermia  
• Cold injuries (frostbite and trench foot)
• Heat and solar radiation, hyperthermia
• Nutrition   
• Pre-existing medical conditions in the mountains   
• Medical problems in remote areas     
• Children in the mountains     
• Avalanche & weather
• Rescue organization
• Communications during rescue
• Patient assessment
• Search and rescue techniques
• Patient packaging
• Patient transport
• Helicopters
• Field treatment
• Field trauma treatment
• Analgesia
• Mountain navigation

FIELD (PRACTICAL SKILLS) SESSIONS

Alpine Skills and Rescue – Mount Rainier National Park, WA

Topics covered**:

• Expedition food planning
• Mountaineering gear review
• Climbing knots
• Snow travel considerations
• Personal safety systems
• Crampons and ice axe use
• Self arrest, self belay, safe glissading practices
• Patient transport on snow/rock/ice
• Snow anchors
• Ice anchors
• Raising/lowering systems
• Roped team travel
• Glacial camp craft
• Self/team crevasse rescue
• Avalanche awareness/rescue
• Glaciology and glacier navigation
• Belaying
• Ice climbing
• Rescue team organization
• Helicopter considerations
• Improvised raising/lowering techniques
• Terrain management strategies
• Short roping/short pitching
• Snow shelters
• Medical kits
• Advanced rescue techniques
• Scenarios (ongoing to reinforce practical skills)
• Medical treatment discussions
• Mount Rainier summit attempt (weather dependent)

Rock Skills and Rescue –  Rocky Mountain National Park, CO or Wasatch Range, UT

Topics Covered**:

• Personal safety systems
• Climbing knots
• Belaying
• Movement on rock
• Rappelling
• Lowering
• Ascending
• Rock Anchors (natural and artificial)
• Double rope rescue systems
• Pick-offs
• Mechanical advantage
• Low-angle litter lowers and raises
• High-angle litter lowers and raises
• Local SAR team cache tour
• Mountain Weather
• Navigation
• Patient transport
• Improvised rescue techniques
• Bivouac techniques
• Rock climbing
• Risk management in exposed terrain
• Short roping/short pitching
• Rescue team organization
• Helicopter considerations
• Medical treatment discussions
• Scenarios (ongoing to reinforce practical skills)
• Local technical summit attempt (weather dependent)

** Curriculum topics may change slightly depending on overall course organization

photos courtesy of David Weber