UTMB offers extreme medicine program for doctors in training
Gabe Pecha looked down at the ground as he quickly rappelled down from the highest point on the wall at Space City Rock Climbing Center in League City.
Pecha and his class partner for the day, Omar Abdelaziz, took turns racing up the walls and hitting the top as the other belayed from below. It was far from a typical day for the medical school students at University of Texas Medical Branch in Galveston.
“This is very ‘survival guide.’ We’re learning how to assess and perform medicine with limited resources,” said Abdelaziz, an aspiring emergency room doctor. “In most clinical settings, everything is right there at your disposal. But we need to learn how to take care of people in the middle of nowhere.”
The two second-year med students are part of an extreme medicine program offered at UTMB in the preventive medicine residency department. The class is aimed at getting new doctors trained in troubleshooting accidents outside of a hospital or clinic setting — able to provide the same level of care without the typical medical equipment onhand.
It’s being offered as a certification program for first- and second-year students, but professors Dr. Brian Pinkston and Dr. Cheryl Lowry are petitioning for a Master of Science in Extreme Medicine to be offered at the school. The class is broken down into mini-semesters (14 credit hours), and each class is at a different location.
“It’s an emerging field, and we have one of the only ones in the world,” said Lowry, director of the school’s Aerospace Medicine Residency and associate professor of Preventive Medicine and Community Health. “They’re learning to take care of patients in any environment.”
In addition to the rock gym, the students went scuba diving to experience weightlessness and lack of gravity; sailed to troubleshoot injuries or illnesses associated with being on the water; and experienced NASA’s buoyancy laboratory to learn about space medicine, another emerging field of study.
The students were also thrown into a mass-casualty scenario to learn how to better triage and stabilize patients before they’re taken to a hospital or emergency medical facility. Every class is a lesson on quick-thinking and use of imagination, Lowry said.
Both Lowry and Pinkston have extensive military medical backgrounds in the aerospace field, working with pilots and special forces. What the schools call “extreme medicine,” they call a typical day at work. What medical schools typically teach is hospital and clinical medicine, not what military doctors face in the field.
“It’s hard to find people with training and experience in these environments,” Lowry said. “They need to be able to think evacuation, best way to carry the patient, basic medical kit and baseline knowledge of the environment, whether it’s mountain, desert, jungle or a colder or hotter climate.”
The class is loosely based on courses offered by World Extreme Medicine, which provides remote, expedition and wilderness medicine training courses in the United Kingdom and other overseas locations. Those courses cover prehospital trauma care, conservation medicine, alpine, desert, mountain and polar medicine, as well as an Antarctic extreme medicine mini-conference.
Lowry and Pinkston plan to take their skills to Antarctica for a few months this winter. Some of the doctors who are hired for expedition or remote-based work go for the novelty, but there is always a big need for qualified professionals who have worked outside of a hospital.
“These classes will make people more qualified to make decisions,” she said.
The students learn rope knots and splints, but they also get experience communicating with patients in emergency situations. In one demonstration, Pinkston donned a pair of fake blood-splattered jeans and a helmet, and the students were tasked with figuring out what happened to him and getting him stabilized before they could take him to a facility.
“Sir, can you hear me? Can you move your arm? What hurts the most?” the students asked their professor, who ended up having a fictitious broken femur.
One group used tent poles as a makeshift splint while another group fashioned a rope litter, a type of do-it-yourself stretcher made from climbing ropes, before Pinkston was rolled gently onto the device and carried. The professor would live another day.