What can you do to make yourself employable as an Expedition Medic?
When deciding on a route for self-study, ensure that you consider and weigh up the cost-benefit of any individual learning opportunity. Make sure to shop around, find and talk to people who have done the courses before, because ultimately these are businesses with income in mind.
While university courses are a year or longer commitment and a lot of hard graft, it may cost only slightly more than a two-week course in a chalet in the Alps and will give you infinitely more self-confidence and professional credential. That being said, you may not have a year to spare and therefore a short course may be what you are looking for.
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There really is no right or wrong answer, but a general word of advice is to ensure that the cost (financial and time) you put into any learning covers the outcome you wish to achieve. Because I can tell you for sure, the expedition world won’t make you any money. In fact, it will probably cost you thousands of pounds and it will also take up a lot of your time.
Just to put this into perspective, at one stage I was asked by a European operator to work on Aconcagua for 21 days in a row. When I asked them what they would offer me, they said that they wouldn’t be covering my indemnity, travel insurance or any kit contribution, and I would also be required to pay them as a business 66% of the cost that a fully paying client would pay. As you can imagine, I flat out refused, as did a long list of those who were subsequently asked.
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The Cost Benefit Analysis
To compound that and hammer home the point, of the five major expeditions I have done to date, only one of them has made me any money, and on average each one has cost me around £1000 for 2-4 weeks of work. I therefore cannot stress enough how important it is to treat yourself with respect and honour the skills you have spent time and money to acquire.
Do not accept every job, otherwise, as with the case above, this will erode not only your own future potential, but also the community as a whole, where companies will continue to undermine our value, make us pay to work and take the profit for themselves.
Because trust me, clients are shocked when they find out we are unpaid and often pay to work.
Check out this article from WEM on what you are worth as an expedition medic.
The Pay Conundrum
The unfortunate reason why this continues to happen is that opportunities in expedition and specifically high-altitude medicine are extremely hard to come by.
While there are various British and European providers that do trips to altitude (e.g. Elbrus, Aconcagua, Kilimanjaro, etc.), very few of these operators employ healthcare professionals to work ‘in country’ on their expeditions.
Coupled with that, when you think about where the high-altitude regions are in the world (Andes, Himalaya, Pamir, Hindu Kush), few of the mountains in these areas are yet deemed commercial enough to require on-site international medical professionals.
Whilst the high-altitude tourism world is growing and demand only rising, it is yet to be seen whether on-site medical cover will increase, or whether the demand will move towards further research into the altitude field. Thus, having a keen interest in the pathophysiology of altitude conditions and a desire to do research into high-altitude pathology may, in fact, stand you in better stead.
Either way, working on-site or doing a PhD, currently, both strands will still not make you any money.
Your expertise vs the expedition's demands
When an opportunity does come around, be very careful about what you say yes to.
Whilst the feeling may to be to grab anything and everything that you are offered, think carefully about the role.
Consider:
- What personal equipment you might need to buy
- How much it will cost you to get there and back
- If food and accommodation are provided or covered
- How much will your travel insurance be, indemnity cover
- How many clients will be present
- What operating procedures does the company have
- If there is there medical top cover accessible 24/7 to you
- What communication channels will you have in the country
- If there is an accompanying IFMGA guide, how much leave do you need off work?
Also, do you have the skills to cope with yourself on the expedition and then on top of that provide a medical service to countless other people at all times of day no matter how insignificant you may feel their issues to be?
The list of considerations is endless, and answers to all these questions determine if you have the necessary experience to cover the trip you have been asked to, the cost to you financially, the safety of others, and the risk of harm to you professionally or the client physically.
Another word of caution comes here and that is, above all, to protect yourself.
Currently, the expedition indemnity conundrum continues, and this is coupled with an absence of regulation in the expedition medical community generally.
For example, you could technically have graduated yesterday and go on an expedition and call yourself an expedition medical provider. Just as equally as I can with 5 years of ED experience across 4 countries, with most life support courses completed and having covered expeditions to the highest mountain in the world.
Thus, be very careful about what you are signing up for and be honest with yourself as to what skills you possess.
