Expedition Medicine

The practice of medicine with limited supplies, caring for a group. Large amounts of improvisation are often needed, and the speciality is as much about planning for a successful expedition as it is the provision of care once you are on the expedition. Doctors are often required to have skills outside of the standard medical syllabus, such as mountaineering experience, off-road driving skills, and the ability to hike long distances. Notable examples of Expedition Medicine doctors include Dr. Mike Stroud (expedition partner of Ranulph Fiennes), and job opportunities can be found through organisations like Raleigh International, and the Expedition Advisory Centre of the Royal Geographical Society.

Pre-hospital Care

An up-and-coming speciality, pre-hospital care now has its own faculty under the Royal College of Surgeons of Edinburgh. Essentially, this speciality is emergency medicine outside of the hospital setting; doctors, particularly from the organisation BASICS, working alongside paramedics and other emergency services at serious incidents – with rapid medical intervention having been shown to save lives. One of the leading groups of pre-hospital care practitioners in the UK are London HEMS.

Emergency Medicine

Although a hospital based speciality, the skills and knowledge required for working in an emergency department are very similar to the those required in the field.

Military Medicine

The founding environment for the practice of pre-hospital care, military medicine calls on a unique skill set, dealing with injuries on a daily basis that most of us only see in films. Blast injuries and gunshot wounds are common, and skills such as triage and major haemorrhage control come into play very often. The military offer scholarships to medical students who meet their entry requirements.

Extreme Environment Medicine (sub-aquatic/high altitude/space)

These specialities deal with the physiology of the human body being pushed to its limits. As a result, each adopts its own ways of dealing with injuries specific to the environment, and those doctors practising in the specialities tend to have been introduced prior to beginning medical practice.

Tropical Medicine

Things you’ll never usually see in the UK are the remit of Tropical Medicine – think parasites and poisons. The speciality covers a huge amount of fascinating illnesses, and leads to work in hospitals in far-flung reaches of the globe, as well as international centres of excellence here in the UK. Tropical Medicine is extremely useful in for those involved in humanitarian aid work.

Disaster Relief Medicine

This speciality really consists of two parts – dealing with the immediate effects of a disaster, and then aiding the long-term recovery of the area’s health. The first day on site you could be looking for a clean water supply, the second day could be spent dealing with a cholera outbreak, and a month later you could be dealing with starvation. Organisations such as MSF are fantastic places to start looking into this area, but large disaster relief organisations tend to want more experienced doctors.

Humanitarian Aid Medicine

This speciality is often alike to General Practice, providing health care for a given area. The ratio of doctors to population is always vastly less than in the UK, and the problems seen can be far more varied. If you can’t fix the problem, the nearest help is usually too far away, or non-existent. Medical education usually plays a large part too, as you can’t be there forever, and people need to begin caring for themselves. The time spent abroad can be considerable – the shortest trips are usually 3 months long.

Search and Rescue

Less well established, Search and Rescue Medicine tends to be practised by doctors in Mountain Rescue teams, or those RAF doctors based with squadrons with a Search and Rescue remit in the UK. Issues such as exposure rapidly come into play, and knowledge of how to safely package a patient for extraction is vital. These doctors are more ‘one of the team’ than doctors, as issues such as pain relief are usually secondary to actually finding the injured party. There are also organisations involved in delivering Search and Rescue aid on an international scale, after large natural disasters, such as SARAID.