Eligibility and Requirements 

Family Medicine or IM/Peds (Urgent Care)-Wilderness Medicine Fellowship Completion of an FM or IM/Peds residency with recommendation from your program director, board-eligible or board-certified, ability to obtain Virginia Medical License and be credentialed at Carilion Clinic Work approximately 1,200 clinical hours at a Carilion facility as an attending physician. Time will be split between Carilion Velocity Care (urgent care) locations. Salary of approximately $80,000 plus institutional benefits will be available. There will also be a fellowship stipend to cover portions of course tuition and travel. Expect to spend 80–100 hours on average each month on fellowship activities outside of clinical expectations.

Emergency Medicine-Wilderness Medicine Fellowship Completion of an EM residency with recommendation from your program director, ABEM or AOBEM board-eligible or board-certified, ability to obtain Virginia Medical License and be credentialed at Carilion Clinic. Work 1,200 clinical hours at a Carilion urgent care facility as an attending physician. Time will be split between Roanoke Memorial Hospital and Carilion outlying hospitals. Salary of approximately $80,000 plus institutional benefits will be available. There will also be a fellowship stipend to cover portions of course tuition and travel. Expect to spend 80 – 100 hours on average each month on fellowship activities outside of clinical expectations.

NP/PA-Wilderness Medicine Fellowship Completion of an NP or PA program, two years of postgraduate clinical experience, board-certified, ability to obtain Virginia Medical License and be credentialed at Carilion Clinic. Work 1,200 clinical hours at a Carilion facility as an NP or PA. Time will be split between Carilion Clinic emergency departments or urgent care based on experience. Salary of approximately $52,000 plus institutional benefits will be available. There will also be a fellowship stipend to cover portions of course tuition and travel. Expect to spend 80 – 100 hours on average each month on fellowship activities outside of clinical expectations. Applying Applications should include a personal statement, CV and two letters of recommendation. Applications will be accepted on a rolling basis, interviews will be conducted and offers will be presented on the national offer date. The MD/DO fellowships start on July 1 or August 1. NP/PA felllowships start on February 1. 

Send applications to salareau@carilionclinic.org.

Current Fellows

Alex Axtell, PA-C

Alex is a PA who graduated from Elon University in 2017. He worked with a hospitalist service in Grand Rapids, MI for several years prior to moving to Roanoke. His interest in the outdoors and first aid began in Boy Scouts on his journey to earning his Eagle Scout in 2005. He discovered the WMS while a member of the medical council for the Fortune Bay Expedition Team, an outdoor adventure group located in West Michigan. Alex became a FAWM candidate in 2017 and is currently awaiting confirmation of his FAWM completion. Skiing has been a lifelong passion of his and as a member of the National Ski Patrol, hopes to continue his ski patrol service while in Virginia. He has also earned his Rescue Diver certification as a Fellow and is a member of the Scruggs Public Safety Dive Team on Smith Mountain Lake. One of his favorite parts of the Fellowship is the opportunity for teaching, both with other medical providers as well as the general public.

Carver Haines, M.D.

During college in Oregon he became more involved in outdoor activities including mountaineering, canyoneering, caving, diving, backpacking and more. He obtained his EMT and Wilderness EMT certifications, as well as additional mountain and swift water rescue. He completed a disaster training and rescue course as well. Carver joined the Medical Reserve Corps and during the summer worked as a Wildland Firefighter and Wildland EMT, I was assisting at many large fires in the Northwestern United States. He continued being involved in equestrian sports, competing with Oregon State University, and eventually becoming the chair and coach of the equestrian teams. Carver went on to Medical School at AUC in St. Maarten, with clinical rotations in Long Island, NYC, and Ohio. He then attended residency in Family Medicine at the University of Arkansas Medical Sciences, where he worked on promoting telemedicine and rural care, was on the COVID-19 task force, and was Chief Resident during his last year. He continued being involved in wilderness medical care, volunteering with the local caving organization as the medical advisor. Carver is excited to be continuing his wilderness medical education in the fellowship program.

Ty Stannard, M.D.

Ty graduated medical school from East Tennessee State University in 2018 with a focus in rural medicine. He completed his emergency medicine residency in 2021 at the University of Texas Southwestern/Parkland Hospital where he served as a Chief Resident. Ty became a WMS member and started working on his FAWM in 2019. During residency, he participated in the WMS-VTC Appalachian trail hike, MedWAR, and led the UTSW Medicine in Extreme Environments elective. Ty’s hobbies include mountain biking, rock climbing, fly fishing, snowboarding, and aviation. He enjoys spending time with his wife, Shelby, his one year old daughter, Scout, and two dogs, Jazz and Luna. During Fellowship, Ty plans to complete his FAWM, earn his Swift Water Rescue certification, Rescue Diver SCUBA license, SWR instructor certification, and to complete his DIMM and AIARE.  He plans to become an instructor for AWLS, WFA, and WFR. Ty’s particular interests for fellowship include search and rescue, expedition medicine, and education.

Past Fellows

2020-2021 Emergency Medicine: Justin Gardner, D.O.

Justin completed an Emergency Medicine residency at Henry Ford Macomb hospital in Clinton Township, MI in 2020, followed by a Wilderness Medicine Fellowship with Carilion Clinic in 2021. He is now faculty with the Carilion Wilderness Medicine Fellowship and Clinical Preceptor with VTCSOM.

Justin is an AWLS, WFA, and ACA River Safety and Rescue instructor.

Justin has completed his FAWM and is working on his DIMM. He is a PADI Rescue Diver and is working towards his Master Diver certification. He is the current chair of the WMS Student/Resident Education Committee and runs a monthly wilderness medicine journal club series. He has completed his AIARE level 1 course and plans to take the AIARE Avalanche Rescue course next.

He hopes to increase cooperation amongst Wilderness Medicine interest groups and make it easier for students and residents to access wilderness medicine training. He also wants to become more active in Search and Rescue, Expedition medicine, and teaching Wilderness Medicine and Emergency Medicine. Justin enjoys mountain biking, hiking, kayaking, backpacking, camping, and snowboarding. He looks forward to upcoming adventures and incorporating wilderness medicine into his career.

2020-2021 N.P//P.A. Family Medicine: Sarah Eves, P.A.-C

Sarah grew up camping, hiking, and adventuring in the mountains of West Virginia and traveling the world. Her interest in medicine began as a young child while watching MASH with her father. Her interest grew when she took First Aid and CPR during a lifeguard course as a teenager. This evolved soon after when she took a Wilderness First Responder course while working at an adventure camp. She went on to work for Buckskin Scout Reservation, BSA, teaching swimming, lifeguarding, emergency preparedness, first aid, and was the director of the Adventure West Virginia program. She then applied these skills as a Hospital Corpsman in the US Navy serving active duty and reserve for 12 years. She served in both field and hospital settings, as well as a tactical field medicine instructor for Tactical Combat Casualty Care teaching military and civilians. In 2018, she graduated from Eastern Virginia Medical School with a Master of Science in Physician Assistant Studies. As a PA, she has worked in orthopaedic trauma, humanitarian medicine, and urgent care. She currently works for Carilion VelocityCare and U.S. Border Protection. Sarah’s most important priority is her family and most of all her seven year old daughter. She loves teaching her daughter about the outdoors and encouraging to live life as an adventure. Her hobbies include travel, water adventure sports, backpacking, hiking, snowboarding, and running. Her ultimate goals in medicine are international and domestic humanitarian and disaster relief.

2019-2020 Emergency Medicine: Christopher Waasdorp, DO, FAWM, FAAEM

CJ completed a combined Emergency Medicine and Family Medicine residency at Jefferson Health Northeast in Philadelphia, PA in 2019. He was very active in education within his residency and with medical students, having served as a resident director for the WMS elective for the past two years. He enjoys outdoor sports in a multitude of settings from mountains to marine, frontcountry to backcountry: splitboarding, mountain biking, rock climbing and sailing. In fellowship, he learned to scuba dive, completed his FAWM, his DiMM (Uniformed Services University), continued to pursing learning to be a better educator, and became more involved in wilderness medicine education for the public, EMS and other medical professionals as well as in the Wilderness Medical Society.  He enjoys teaching AWLS, WFA, WFR, SWR, ATLS and other wilderness and emergency education topics.  He now serves as a co-director for the WMS student/resident elective in Virginia, and continues to serve as Faculty for the Wilderness Medicine Fellowship at Carilion, Virginia Tech Carilion, and Radford University Carilion. While continuing to work in the Emergency Department, CJ also practices Family Medicine, serving patients out of Community Care. He has a particular interest in hypothermia and wilderness medicine applications for EMS and SAR personnel.  Current pursuits include additional scuba certifications working toward Master Diver, training in hyperbarics and dive medicine, experience caving and learning cave rescue, and completing the WMS DiMM while learning to be a better kayaker and rafter on top of the water.

2019-2020 Family Medicine: Jeremy Kessler, M.D., FAAFP, FAWM

Originally from Queens, New York, Jeremy Kessler studied medicine at the Universidad Autónoma de Guadalajara, in Mexico and then completed a one-year internship at New York Medical College.  Jeremy initiated residency in General Surgery at the University of Florida - Gainesville, and subsequently transferred into and completed a Rural Family Medicine residency at the University of Wyoming - Cheyenne.  Jeremy has worked with the Himalayan Rescue Association in Nepal, assisting with setting up Everest ER at Everest Base camp. He also is certified as a Diver Medic Technician and has worked in Roatan, Honduras in the Cornerstone clinic at Anthony's Key resort focusing on scuba dive and hyperbaric medicine while treating the local Meskito Indians, who suffer from frequent dive related injuries.  Jeremy set up a Pediatric/Adolescent medicine practice at the sleep away camp he attended as a youth, located in the Berkshire Mountains of New York State.  He spent 5 years as medical director of this not-for-profit practice.  Jeremy is a board-certified Family Medicine physician and has practiced both rural family medicine and in the urgent care settings of Cheyenne, WY and Roanoke, VA.  Jeremy completed his Wilderness Medicine fellowship at Virginia Tech Carilion Clinic School of Medicine in July of 2020 and since has transitioned to faculty with an academic appointment as assistant professor with VTCSOM.  Currently Jeremy is doing a fellowship in Undersea and Hyperbaric Medicine at Aurora Health in Milwaukee, Wisconsin.  He is passionate about teaching in both the austere and clinical settings.  Presently, he has completed his SWR, AWLS, AIARE, Mountain Medicine, FAWM, Wilderness Lifeguard, Open water and Advanced Open water scuba dive certifications. He plans to complete the last remaining portion of the DiMM requirements shortly. He has co-authored a chapter on the emergency treatment of submersion injuries which was published in the Corependium online textbook by Emergency Medicine Reviews and Perspectives. He has become an instructor for courses such as WFA, WFR and AWLS. In his free time, Jeremy has been a medical and surgical brigade volunteer across Latin America, giving back to the underserved Spanish speaking population.  He is enthusiastic and enjoys working as an instructor with the Blue Ridge Adventure Medicine group and looks forward to upcoming adventures, incorporating wilderness medicine into his future career path, while satisfying his passion for travel by exploring the globe.

2019-2020 N.P./P.A. Emergency Medicine: Claire Wilsey, PA-C, CAQ-EM

Claire Wilsey is an Emergency Medicine PA at Carilion Clinic.

She has completed an Emergency Medicine Fellowship at Upstate Medical Center in Syracuse, NY, and a Wilderness Medicine Fellowship at Carilion Clinic in Roanoke, VA. Claire has earned the Fellowship in Wilderness Medicine and Diploma in Mountain Medicine. She has lectured at the Wilderness Medicine Conference and Southeastern Student Wilderness Medicine Conference. Outside of work, she is a volunteer instructor for wilderness first aid (WFA) and advanced wilderness life support courses (AWLS). As an avid outdoor enthusiast, Claire enjoys downhill skiing, paddle boarding, hiking, photography, backpacking, yoga, mountain biking, and international travel.

2018-2019 Family Medicine: Theophile Lyotard, M.D. 

Theo finished his residency in family medicine at Creighton University in Omaha, Nebraska in 2017. He then went on to complete a fellowship in emergency medicine at the Monroe Clinic in Wisconsin. He is currently working towards his Di.M.M. and F.A.W.M. through the Wilderness Medical Society and teaches wilderness medicine to medical providers and the public whenever the occasion arises. Theo is certified in AWLS and as a Diving Medical Physician through NOAA and the UHMS. Whenever he is not working or teaching, Theo enjoys rock climbing, mountain biking, running, skiing and scuba diving.

2018-2019 Emergency Medicine: Matt Robichaud, M.D. 

Matt is a graduate of the University Of Vermont College of Medicine, 2015, and a graduate of the Virginia Tech Carilion Emergency Medicine Residency, 2018. He initially stayed on in Roanoke after fellowship before relocating to Lake Tahoe where one can sail and ski in the same day. Matt’s areas of interest in wilderness medicine are numerous, but he has maintained a focus on maritime medicine and sailing safety. During fellowship he completed his American Sailing Association degrees 101, 103 and 104, enabling him to captain his own sailing vessels anywhere in the world. He is also taking a three-part class currently to become certified as the Medical Care Person in Charge (MCPIC), enabling him to provide medical support for sailing races, yachts, cruise ships, etc. with the hopes of eventually being involved in the America’s Cup in the future.

Matt is currently working on his Diploma in Mountain Medicine (Di.M.M.) degree, a four-week intensive series including avalanche training, crevasse rescue, mountain medicine and high angle rescue. During fellowship Matt taught wilderness first aid in Peru, as well as to the larger Roanoke community. He completed his AWLS certification (Advanced Wilderness Life Support) and went on to teach the course later in fellowship in Utah. His area of research lies in snake envenomations and currently has an ongoing research project reviewing management of snake envenomations within the Carilion hospital system in Virginia. Before medical school, Matt was a semi-professional mogul skier, competing for Breckenridge, Vail and Killington teams in 2003-2006. In 2006, he skied in the North American Tour (NorAm Tour), which is comprised of the top 30 mogul skiers from the U.S. and Canada on a four-competition tour. For fun, Matt still skies during the winter as much as possible and spends as much time as he can sailing on Smith Mountain Lake, as well as at the Outer Banks and the British Virgin Islands. He enjoys cooking, all outdoor sports including rock climbing, hiking, camping, fly fishing, hunting, mountain biking, scuba diving, skiing, surfing, yoga, trail running and adventure traveling. Matt has a passion and enthusiasm for life and medicine and enjoys the fast pace of the Emergency Department.

2018-2019 Mary Carroll Lee, M.D. 

Mary grew up in Atlanta, GA and became interested in the outdoors through trips to the north Georgia mountains with her dad. After college she became interested in camping, hiking, climbing, water sports and international medicine. She still enjoys combining both her interest in medicine and the outdoors. During her fellowship she completed the NOAA/ UHMS Dive Physician Course, traveled to Peru to teach WFA skills, became an AWLS instructor, and she will earn the Diploma in Mountain Medicine. After fellowship graduation she relocated to Salem, OR and plans to remain active in wilderness medicine there.

2018-2019 N.P./P.A. Emergency Medicine: Keri Baker, N.P. 

Keri was the first Nurse Practitioner Wilderness Medicine Fellow at Carilion Clinic in Roanoke, VA. In 2015, she completed a one-year fellowship in emergency medicine at Carilion Clinic and now works in the Emergency Department. She is the executive director and co-founder of Sacred Valley Health, a nonprofit organization based in Peru that trains and supports women in remote areas who are becoming health care workers in their communities. She is enthusiastic about teaching others about medicine in remote and limited resource environments. She was a co-author and grant recipient from the Carilion Clinic Foundation and developed a community wilderness medicine education program in Roanoke. Her project reached over 500 community members. She is an AWLS and WFA instructor. Her outdoor interests include running, cycling, paddling and international travel. Keri has stayed on at Carilion as an Emergency Department N.P. and is an assistant fellowship director for the N.P./P.A. wilderness medicine fellowship.

2017-2018 Emergency Medicine: Joshua Nichols, M.D. 

Josh completed his emergency medicine training at VT-Carilion in Roanoke, VA. He is an avid whitewater kayaker and distance trail runner. His research interests include medical simulation and education. During his fellowship, he continued his research in medical simulation as well as expanded his experience in the areas of maritime and dive medicine. Josh also completed the Di.M.M., taught WFA in Peru, provided endurance race support and worked on wilderness medicine protocols for the Roanoke County EMS. After graduation, Josh stayed on as clinical faculty at VT-C as an emergency physician and serves as one of the assistant wilderness medicine fellowship directors.

2016-2017  Emergency Medicine: Jessie Gehner, M.D.,

Jessie completed her emergency medicine training at VT-Carilion in Roanoke, VA. Prior to medical school, she through-hiked the Appalachian Trail, with a short hiatus including a visit to Carilion Roanoke Memorial Hospital. She later went on to through-hike the John Muir Trail. Her interests include altitude medicine and Appalachian Trail hiker health and safety. During her residency she researched acute mountain sickness at Everest Base Camp. As a fellow she worked on Appalachian Trail hiker health and safety projects and on a Nepali exchange program to give Nepali doctors exposure to our emergency medicine systems. Jessie accepted a clinical faculty position at VT-C and continues to remain active as an assistant wilderness medicine fellowship director. She continues education projects leading annual trips to Nepal with students and leading an Appalachian Trail CME trip through the WMS.

Keri Baker, N.P.-C.

Keri is the first NP to complete a wilderness medicine fellowship.  In 2015, she completed a one-year fellowship in emergency medicine at Carilion Clinic and now works in the emergency department. She is the former executive director and co-founder of Sacred Valley Health, a nonprofit organization based in Peru that trains and supports women in remote areas who are becoming health care workers in their communities. She is enthusiastic about teaching medicine in remote and limited resource environments. She was a co-author and grant recipient from the Carilion Clinic Foundation and developed a community wilderness medicine education program in Roanoke. Her project reached over 500 community members. She is an AWLS and WFA instructor. Her outdoor interests include cycling, running, hiking, swimming and international travel. Keri continues to work at Carilion as an emergency department NP and is an assistant fellowship director for the NP/PA WM fellowship. In fall of 2020, Keri started her PhD in Nursing at Virginia Commonwealth University.

Joshua Nichols, M.D.

Josh completed his emergency medicine training at VT-Carilion in Roanoke, VA. He is an avid whitewater kayaker and distance trail runner. His research interests include medical simulation and education. During his fellowship, he continued his research in medical simulation as well as expanded his experience in the areas of maritime and dive medicine. Josh also completed the Di.M.M., taught WFA in Peru, provided endurance race support and worked on wilderness medicine protocols for the Roanoke County EMS. After graduation, Josh stayed on as clinical faculty at VT-C as an emergency physician and serves as one of the assistant wilderness medicine fellowship directors.

Claire Wilsey, PA-C, CAQ-EM

Claire Wilsey is an Emergency Medicine PA at Carilion Clinic.

She has completed an Emergency Medicine Fellowship at Upstate Medical Center in Syracuse, NY, and a Wilderness Medicine Fellowship at Carilion Clinic in Roanoke, VA. Claire has earned the Fellowship in Wilderness Medicine and Diploma in Mountain Medicine. She has lectured at the Wilderness Medicine Conference and Southeastern Student Wilderness Medicine Conference. Outside of work, she is a volunteer instructor for wilderness first aid (WFA) and advanced wilderness life support courses (AWLS). As an avid outdoor enthusiast, Claire enjoys downhill skiing, paddle boarding, hiking, photography, backpacking, yoga, mountain biking, and international travel.

Jeremy Kessler, M.D., FAAFP, FAWM

Originally from Queens, New York, Jeremy Kessler studied medicine at the Universidad Autónoma de Guadalajara, in Mexico and then completed a one-year internship at New York Medical College.  Jeremy initiated residency in General Surgery at the University of Florida - Gainesville, and subsequently transferred into and completed a Rural Family Medicine residency at the University of Wyoming - Cheyenne.  Jeremy has worked with the Himalayan Rescue Association in Nepal, assisting with setting up Everest ER at Everest Base camp. He also is certified as a Diver Medic Technician and has worked in Roatan, Honduras in the Cornerstone clinic at Anthony's Key resort focusing on scuba dive and hyperbaric medicine while treating the local Meskito Indians, who suffer from frequent dive related injuries.  Jeremy set up a Pediatric/Adolescent medicine practice at the sleep away camp he attended as a youth, located in the Berkshire Mountains of New York State.  He spent 5 years as medical director of this not-for-profit practice.  Jeremy is a board-certified Family Medicine physician and has practiced both rural family medicine and in the urgent care settings of Cheyenne, WY and Roanoke, VA.  Jeremy completed his Wilderness Medicine fellowship at Virginia Tech Carilion Clinic School of Medicine in July of 2020 and since has transitioned to faculty with an academic appointment as assistant professor with VTCSOM.  Currently Jeremy is doing a fellowship in Undersea and Hyperbaric Medicine at Aurora Health in Milwaukee, Wisconsin.  He is passionate about teaching in both the austere and clinical settings.  Presently, he has completed his SWR, AWLS, AIARE, Mountain Medicine, FAWM, Wilderness Lifeguard, Open water and Advanced Open water scuba dive certifications. He plans to complete the last remaining portion of the DiMM requirements shortly. He has co-authored a chapter on the emergency treatment of submersion injuries which was published in the Corependium online textbook by Emergency Medicine Reviews and Perspectives. He has become an instructor for courses such as WFA, WFR and AWLS. In his free time, Jeremy has been a medical and surgical brigade volunteer across Latin America, giving back to the underserved Spanish speaking population.  He is enthusiastic and enjoys working as an instructor with the Blue Ridge Adventure Medicine group and looks forward to upcoming adventures, incorporating wilderness medicine into his future career path, while satisfying his passion for travel by exploring the globe.

Justin Gardner, D.O.

Justin completed an Emergency Medicine residency at Henry Ford Macomb hospital in Clinton Township, MI in 2020, followed by a Wilderness Medicine Fellowship with Carilion Clinic in 2021. He is now faculty with the Carilion Wilderness Medicine Fellowship and Clinical Preceptor with VTCSOM.

Justin is an AWLS, WFA, and ACA River Safety and Rescue instructor.

Justin has completed his FAWM and is working on his DIMM. He is a PADI Rescue Diver and is working towards his Master Diver certification. He is the current chair of the WMS Student/Resident Education Committee and runs a monthly wilderness medicine journal club series. He has completed his AIARE level 1 course and plans to take the AIARE Avalanche Rescue course next.

He hopes to increase cooperation amongst Wilderness Medicine interest groups and make it easier for students and residents to access wilderness medicine training. He also wants to become more active in Search and Rescue, Expedition medicine, and teaching Wilderness Medicine and Emergency Medicine. Justin enjoys mountain biking, hiking, kayaking, backpacking, camping, and snowboarding. He looks forward to upcoming adventures and incorporating wilderness medicine into his career.

Blue Ridge Adventure Medicine Blue Ridge Adventure Medicine is a regional non-profit organization dedicated to wilderness medicine education for the community and health care providers. Many fellowship activities are done in partnership with this organization.

• Teach at the Southeastern Student Wilderness Medicine Conference 
• Teach at the Resident Wilderness Medicine Weekend 
• Teach WFA in Peru in partnership with Sacred Valley Health 
• Participate in the Nepal Exchange Program  

Appalachian Center for Wilderness Medicine The Appalachian Center for Wilderness Medicine is a regional non-profit organization dedicated to promoting quality medical care in limited resource ("wilderness") environments. The center serves as a regional resource to southern Appalachian states -- North and South Carolina, West Virginia, Virginia, Georgia, Tennessee, Kentucky, Maryland and Alabama.

• Participate in the Advanced Wilderness Life Support Course (AWLS)
• Contribute to the quarterly newsletter

WMS Student Elective An international four-week medical student elective in New Castle, Viriginia which includes: Small group discussions of wilderness scenarios, formal lectures of Wilderness Medicine principles and specific topics by leaders in the field, field and hands-on instruction in survival and pre-hospital patient assessment and evacuation, supervised five-day field-practicum incorporating medical assessment, treatment, evacuation, survival and improvisational techniques and a Wilderness First Responder Course.

• Function as an assistant course director
• Act as a backpacking mentor
• Present lectures/ workshops
• Act as onsite director
• Meet and network with elective faculty

Virgnia Tech-Carilon Wilderness Medicine Elective A two-week elective for fourth-year medical students and second-year PA students which includes an AWLS course, swift water rescue course, backpacking trip, caving experience and numerous outdoor scenarios.

• Function as assistant course director
• Earn SWR certification
• Earn AWLS/instructor
• Present lectures/workshops

Southeastern Student Wilderness Medicine Conference An annual wilderness medicine conference aimed at medical and health care students. The conference is in its ninth year and typically attracts between 200-300 attendees per year. The conference includes lectures, workshops and team-based realistic scenarios. 

• Act as mentor to student planners
• Develop and facilitate conference scenarios
• Lecture at regional event

Disrupting Natural Selection Lecture Series In conjunction with Roanoke Parks and Recreation and Carilion Trauma Outreach Services, a monthly free lecture series was created for the community. This project was recently funded by a grant from Carilion Foundation. With Roanoke having so many fantastic opportunities for outdoor recreation, and with more people participating in these activities, we have selected topics that focus on outdoor safety and first aid. We have offered everything from basic trailside first aid, to speaking to local skiing and mountain biking clubs. The lectures occur on a monthly basis and topics are tailored to the season and needs of the community. Below is a link to local news coverage of our trailside first-aid workshop: virginiafirst.com

Roanoke County EMS Roanoke County EMS reports that they receive multiple calls every week for patients lost, injured or ill in the backcountry. This fall Drs. Lareau and Gehner met with Roanoke County EMS to arrange an agreement in which members of the Wilderness Medicine Fellowship can be contacted when crews receive a call involving a trail/backcountry rescue. This is a wonderful opportunity for physicians involved in the fellowship to practice wilderness medicine in the greater Roanoke area. Not only will fellowship members better understand the challenges of prolonged extrication over difficult terrain, but they will also be involved in the continued education of EMS personnel on wilderness medicine-related topics so that they not only may better care for patients in the backcountry, but care for themselves and prevent their own injuries and illnesses in remote/limited resource settings. 

MedWAR MedWAR (Medical Wilderness Adventure Race) combines wilderness medicine with adventure racing to create unique events designed to teach and test wilderness survival and medical skills. 

• Develop a regional event
• Assist with flagship event in Augusta, GA
• Field a team to participate

Snowshoe Ski Patrol Snowshoe is the premier destination for mid-Atlantic and southeast skiers, snowboarders and winter enthusiasts. It consists of 11,000 acres of unspoiled wilderness. Ski patrol is very active and many of the seriously injured find their way via helicopter to Carilion Roanoke Memorial Hospital. 

• Earn OEC
• Serve as volunteer patrol
• Work with local hospitals on education

GO FEST The Anthem Go Outside Festival in Roanoke, VA is an annual event to encourage healthy, active outdoor recreation. By combining the things outdoor enthusiasts love -- camping, music, gear, races, and demos and a beautiful outdoor setting – GO Fest is a celebration of everything outdoors.

• Present workshops for community on wilderness first aid
• Share information about local organizations with the community

Trail Days Celebration of the Appalachian Trail in Damascus, VA.

• Complete research on hiker medical needs
• Teach basic first aid to hikers
• Provide basic foot care

Aeromedical-Life Guard As Virginia's first air ambulatory service, Carilion Clinic Life-Guard provides 24-hour transport for the entire state of Virginia, as well as parts of West Virginia, North Carolina and Tennessee. Our specialized fleet of helicopters operates out of three bases throughout the state, providing fast emergency access to western Virginia's regional Level I Trauma Center at Carilion Roanoke Memorial Hospital.

• Work with crews on survival training
• Participate on ride-alongs

Carilion Resident Education Carilion Clinic has two emergency medicine residency programs, with a total of 12 residents per class. 

• Participate in resident didactics
• Present lectures to residents on wilderness topics
• Develop resident wilderness simulation cases

Carilion Clinic Faculty Development Combined series of lectures and workshop to assist new faculty with succeeding in academia. This innovative program is available to fellows. 

National Opportunities

Diploma in Mountain Medicine 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. 

• Complete Diploma in mountain medicine through Madigan (Tacoma, Washington) or WMS

WMS Annual Conferences Founded in 1983, the Wilderness Medical Society (WMS) is the world's leading organization devoted to wilderness medical challenges. Wilderness medicine topics include expedition and disaster medicine, dive medicine, search and rescue, altitude illness, cold- and heat-related illness, wilderness trauma, and wild animal attacks. WMS explores health risks and safety issues in extreme situations such as mountains, jungles, deserts, caves, marine environments, and space.

• Attend Annual Summer Conference (Colorado)
• Attend Annual Winter Meeting (Utah)
• Present oral presentation during fellow lecture series
• Work at committee level to develop educational materials
• Serve as mentor for students

WMS Fellowship of Academy of Wilderness Medicine Fellowship in the Academy of Wilderness Medicine (FAWM) is designed for individuals who want to be acknowledged for their professional achievement in wilderness medicine and wish to validate their training for their patients and clients. The Wilderness Medical Society will serve as a clearinghouse for agencies, employers, and the general public wishing to verify that Fellows have met educational criteria in the discipline. Individuals should realize that neither the Academy nor the Society vouch for the competency of any individual, only that he/she has met established educational criteria.

• Work toward FAWM

ACEP-Section for Wilderness Medicine Section on Wilderness Medicine is active in education, working with EMRA and enhancing wilderness medicine opportunities for ACEP members. 

• Work as mentor to medical students 
• Serve on subcommittee

Wilderness EMS Director Course As interest in outdoor sports grows, so do expectations for rescue services and the volume of EMS calls in wilderness (also known as austere or resource-deficient) areas. However, until now there has been no professional society-recognized training for physicians to provide this type of EMS oversight. Many physicians have extensive EMS training, but little wilderness medical experience. Similarly, many physicians have deep wilderness or wilderness medical training but little exposure to the EMS operational environment or EMS oversight. To address this issue, the Wilderness EMS Medical Director Course was developed to support physicians and other health care providers tasked with providing medical oversight to EMS systems operating in a variety of wilderness environments.

• Obtain certification in Wilderness EMS direction 
• Apply knowledge assisting with local EMS protocols and training

UHMS-NOAA Physicians Training in Diving Medicine The NOAA Diving Program and the Undersea and Hyperbaric Medical Society (link is external) (UHMS) team teach this two-week course at the NOAA Diving Center every year in the fall. This course is taught by a select group of diving experts, including experienced technical divers, current professionals practicing hyperbaric medicine and physicians conducting research and teaching at top universities and hospitals around the world. It is typically attended by university Fellows, physicians, nurse practitioners, physician assistants, and nurses from the U.S. and other countries who desire advanced training in diving medicine. Students participate in theoretical and practical sessions that include work in a pressurized environment.

• Participate in course
• Use information to develop Dive CME curriculum

National Park/Search and Rescue Numerous opportunities exist to work with the park medic program and work with local search and rescue in many of our national parks and forests.

• Work in national park clinic
• Shadow and work with national SAR organizations
• Develop educational programming

International Opportunities

Racing the Planet The 4 Deserts Race Series is widely recognized as the most prestigious outdoor foot race series in the world. The series consists of the Sahara Race (Egypt), Gobi March (China), Atacama Crossing (Chile) and The Last Desert (Antarctica). Competitors in the races traverse 250 kilometers in seven days over rough country terrain with only a place in a tent and water provided. They are supported by highly qualified staff, all with experience in hiking, marathons and ultramarathons, and medical teams specializing in wilderness medicine.

• Participate as medical support
• Learn about wilderness foot care
• Treat altitude illness, heat illness and potentially hyponatremia

MedicForce MedicForce is an independent, non-sectarian organization committed to improving access to rural health care throughout the world. Our mission is to establish sustainable healthcare systems through education, infrastructure and support.

• Participate as instructor/assistant medical director for Belize trip
• Teach medical students
• Teach local health care workers
• Assist in curriculum development
• Assist in conference planning

Nepali Exchange Program: During the fall of 2016 VTC piloted an exchange program in which we host Nepali doctors so that they may gain exposure to the U.S. health care system in preparation for residency interviews. During this time they shadow in the ED, teach at the wilderness medical elective and community workshops, and participate in SIM lab and U.S. workshops. In turn Fellows travel to the Khumbu region of Nepal to shadow, give lectures and continue ongoing research in altitude medicine. (email jrgehner@carilionclinic.org for more details).

• Help develop the field of emergency medicine in Nepal 
• Shadow in remote clinics and hospitals in Nepal
• ​Participate in educational activities/give lectures in Nepal 
• Participate in altitude medicine research

Sacred Valley Health, Wilderness First Aid in Rural Peru VTC Wilderness Medicine Fellowship has partnered with Sacred Valley Health to design a Wilderness First Aid course for volunteers and local health care workers (prometoras) in Ollyanta, Peru. The most recent trip was in November 2017. The trip focused on educating volunteers and prometoras that work in remote communities in skills such as trauma evaluation, splinting and patient extrication. The ultimate goal is to create a sustainable program where the prometoras may continue to educate new volunteers at Sacred Valley Health. In addition to the lectures and workshops there is free time to go on a day trip to Machu Picchu as well as other day hikes. For those that wish to participate, we also plan a multi-night backpacking trip in the Andean high country.

Nepal: Everest Base Camp Trek CME trip through WMS.

• Participate in CME trip

Diploma in Mountain Medicine: Nepal 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.

• Earn Diploma in Mountain Medicine internationally

DAN Hyperbaric and Dive Medicine Course Jointly sponsored by DAN and the Undersea and Hyperbaric Medical Society, the course is designed primarily for physicians. However, emergency medical personnel, paramedics, nurses and professionals, as well as instructors, divemasters and nonmedical, diving-related personnel with an interest in dive medicine may also find the course valuable. The program focuses on diving and hyperbaric medicine with emphasis on the latest scientific literature in the field. The course features lectures, case presentations and support materials as well as both formal and informal discussion sessions with faculty.

• Attend conference
• Obtain SCUBA certification

Curriculum

Obtain skills for teaching others and participating in academic wilderness medicine.  1.0 Teaching techniques directed to adult learner     1.1 Residents and medical student         1.1.1 Didactic         1.1.2 Bedside         1.1.3 Applied skills     1.2. Wilderness medicine prehospital personnel         1.2.1. Didactic         1.2.2. Applied skills 2.0. Quality management     2.1. Wilderness and out-of-hospital treatment protocols     2.2. Data collection, management and analysis     2.3. Quality improvement programs     2.4. Evidenced-based practice 3.0. Research     3.1. How to design a research project     3.2. Fundamental epidemiology and biostatistics     3.3. Completion of a scholarly project 4.0. Leadership skills Obtain wilderness-medicine-specific knowledge 1.0. High-altitude illness     1.1. Physiologic response to high altitude and hypobaric hypoxia     1.2. Acclimatization     1.3. Risk factors for developing high-altitude illness     1.4. Types of high-altitude illness         1.4.1. Acute mountain sickness         1.4.2. High-altitude cerebral edema         1.4.3. High-altitude pulmonary edema     1.5. Risk assessment and advising patients traveling to high altitude 2.0. Environmental exposure     2.1. Heat illness         2.1.1. Muscle cramps         2.1.2. Heat syncope         2.1.3. Heat exhaustion         2.1.4. Heat stroke         2.1.5. Dehydration     2.2. Hypothermia     2.3. Cold injuries         2.3.1. Nonfreezing cold injury         2.3.2. Freezing cold injury             2.3.2.1. Frostnip             2.3.2.2. Frostbite 3.0. Wilderness trauma     3.1. Basic principles         3.1.1. Situational awareness         3.1.2. Stabilization         3.1.3. Packaging         3.1.4. Long-term patient management     3.2. Head trauma     3.3. Spinal trauma     3.4. Chest trauma     3.5. Pelvis trauma     3.6. Penetrating trauma     3.7. Extremity trauma         3.7.1. Fracture and dislocation reduction techniques and splinting     3.8. Sprains and strains     3.9. Wound management     3.10. Foreign body management 4.0. Expedition medicine     4.1. Pretravel considerations     4.2. Evacuation criteria     4.3. Medical kit     4.4. Acute and chronic medical conditions     4.5. Infectious disease     4.6. Infectious diarrhea     4.7. Field water disinfection     4.8. Nutrition     4.9. Medical–legal considerations 5.0. Drowning 6.0. Dive medicine     6.1. Physics and physiology     6.2. Barotrauma     6.3. Decompression illness     6.4. Risk assessment 7.0. Aquatic medicine     7.1. Injuries from marine animals     7.2. Poisonings     7.3. Infections 8.0. Bites, stings and zoonoses     8.1. Animal attacks     8.2. North American snakes     8.3. Spider bites     8.4. Tick-borne diseases     8.5. Hymenoptera stings     8.6. Scorpion stings     8.7. Mosquito-borne diseases     8.8. Rabies 9.0. Wildland fires and fire management     9.1. Predictable injury and illness patterns     9.2. Medical complications 10.0. Wilderness medicine emergency medical services (EMS)     10.1. Interface with EMS     10.2. Air medical transport 11.0. Search and rescue     11.1. Theory and application     11.2. High-angle rescue     11.3. Swift-water rescue     11.4. Alpine rescue 12.0. Wilderness survival     12.1. Shelter     12.2. Water procurement and disinfection     12.3. Fire building     12.4. Navigation and signaling 13.0. Lightning injuries     13.1. Risk assessment     13.2. Physiology 14.0. Avalanche     14.1. Terrain and snowpack assessment     14.2. Avalanche victim physiology     14.3. Patterns of injury     14.4. Rescue equipment 15.0. Wilderness toxicology and toxinology     15.1. Poisonous plants     15.2. Poisonous mushrooms As described in Lipman, et al. “Core Content for Wilderness Medicine Fellowship Training of Emergency Medicine Graduates” Academic EM2014; 21:204-207. http://onlinelibrary.wiley.com/doi/10.1111/acem.12304/epdf