SummaryA medical school elective designed for medical students interested in learning about the management of patients in remote and low resource areas. This elective offers medical students an opportunity to expand their practical and academic knowledge through an educational experience that stresses problem-based learning and education among their peers. Our core pedagogical components instill the best practices of medical school education by including didactic sessions, case study discussions, a variety of simulated patient encounters, practical skills labs, and evidenced-based medicine reviews. Particular emphasis is given to assessing patients, formulating problem lists, and carrying out student-planned treatments (including evacuations) in relatively low-tech environments. Our goal is to help our students actively investigate and articulate these best practices via a curriculum that is engaging, practical, and hands-on.
The first elective was held in 2005 by WMA International for medical students at McMaster University in Hamilton, Ontario. The motivation was to offer an alternative elective that stressed the practical elements of medicine in a wilderness setting. Since then, the elective has grown with an expanded scope to include any low-resource setting such as rural practice, remote clinics, and disasters. Over 200 students have attended courses in Alberta, British Columbia, Maine, Nova Scotia, and Saskatchewan. In recent years, residents have been included on the elective as faculty-in-training. Some of the students have been granted permission to use this time to help satisfy their residency’s educator development requirements.
The curriculum in this elective is integrated into three phases: (1) introduction to the basic science of body systems, pathophysiology, pharmacology, plus environmental and rescue topics; (2) practical workshops; and (3) integrative exercises. Each day has a balance of student-led presentations, case study discussions, evidence-based medicine (EBM) reviews, practical skill labs and simulated patient encounters. One day serves as a building block for the material covered on subsequent days. Topic discussions and simulations become more complex and challenging as the course progresses.
Some the highlights of the course include:
- Student-led discussions and case study reviews.
- One-on-one viva (oral examination) with a faculty member, focused on a wilderness case study.
- Application of practical medical knowledge and training to simulated patients.
- Preparation for work as a resident and physician in untraditional settings.
- Critical analysis of conventional and unconventional approaches to diagnosis, treatment, and ongoing management—including evacuations.
- Exploration of current literature and use of practical EBM metrics for analysis.
- A great opportunity to share and learn with other medical students and an interdisciplinary health team that includes advanced-level, prehospital practitioners.
This elective is typically held in a rustic area, comfortable wilderness camp, or outdoor center. Electives can be hosted on-site at your university, given access to a suitable classroom and extensive outdoor space. WMA International will work with interested groups to find a rustic rental location or outdoor facility within a price range that is suitable for the students.
Students must be enrolled in an MD or DO program.
Recognition and Medical School Credit
This two-week elective has been run successfully for over 200 students from across North America, the UK, and Europe. Some medical schools have formally identified this as a for-credit elective. Please check with your academic office to see if this experience will count towards an elective block.
At the end of the elective, each student is formally evaluated and receives a completed evaluation form from one of the physician instructors. Some schools add this to the student files. Even when not counting as credit, the information contained has been added to residency letters as evidence of extracurricular involvement.
Contact WMA International if you require assistance or have questions. We are eager to speak to interested institutions about course content and the evaluation process.