Intended for healthcare professionals

Career Focus

Polar medicine

BMJ 2005; 331 doi: (Published 24 December 2005) Cite this as: BMJ 2005;331:s273
  1. Laura Patterson, general practitioner
  1. The Park Surgery, Old Tetbury Road, Cirencester laurapatson{at}


Laura Patterson shares her experiences of a chilly but fascinating week spent in the frozen north, learning how to lead a cold weather expedition

Getting to grips with the dog-sledding


Earlier this year I set off on an unusual week's study leave to Alta in northern Norway, just inside the Arctic Circle. The course was designed to equip a medic with enough knowledge to safely lead an expedition in a polar environment. The course was based around outdoor activities and lectures, and culminated in a challenging rescue designed to use all the team skills. At the time I did wonder if the safety of the postgraduate centre would have been wiser, but I can recommend this fantastic week's study leave.

What did the course involve?

The course is based over five days. Outdoor activities are organised to make maximum use of daylight hours. Our team's first venture was skidoo travel. We set off on a 60 kilometre round trip, up onto the plateau with our local arctic adviser. We quickly mastered the skidoo, although I did manage to fall off several times. We also became experts on the workings under the bonnet, and I certainly now know more about the mechanics of a skidoo than my own car. I recall how quickly the weather changed as the sun disappeared when we travelled back down into the valley. My fingers became cold and painful and the biting wind, coupled with feeling tired, made concentration extremely difficult.

The second day for our team was spent dog sledding. This for me was the best day of the whole course. We were each given a team of dogs to harness up, and some instruction on how to operate the dogs and sled. Out onto the plateau the snowy desert was beautiful. The sound of the dogs was the only thing to be heard as they glided across the fresh snow. Lunch was taken on a frozen lake with flasks of hot chocolate and of course a few snowball fights. Our return journey was in the shadow of an amazing red fiery sunset. Descending again into the valley was a real test of skill, nerves, and upper body strength. The rollercoaster ride meant holding on very tight. The dogs raced downhill through the twisted forest path at high speed with little concern for their drivers, and consequently I had a few more encounters with deep snow.

The following day we tried our hand at cross country skiing—I am still sure that skis were never meant for going uphill. This day was probably the most exhausting. Snowshoeing was another challenging mode of transport we encountered. We had a lovely but exhausting walk through the picturesque local forest with the sun glinting on the snow.

As well as learning many new skills in negotiating the new terrain we also learnt a few survival techniques. We spent time learning to create emergency shelters, including digging snow holes. There was also an opportunity to immerse oneself into the waters of a frozen lake. Not for the fainthearted, but at least plenty of medics on hand if required. The course culminated in a rescue scenario. All the skills we had learnt were vital in rescuing our casualty. I was most fascinated to find that absolutely everyone found his or her role in the team and we managed to return our casualties to base, warm, and with no further injuries.

Of course this was study leave, and some lectures were included in the timetable after we returned from our outdoor activities. I congratulate the course organisers for such a good balance. We were informed about communication systems, clothing systems, hypothermia, public health, and frostbite. There were also lectures in pre-expedition and casevac planning, as well as aero medical evacuation and an opportunity to inspect and become familiar with all the kit that might be available or required.

Further information

Expedition Medicine—; 01460 30456

Next course 5-11 February 2006 Cost £1295 (excluding flights)


What are the requirements for the course?

No specific requirements are needed for the course except enthusiasm, willingness to participate, and a reasonable level of fitness. Some of the course members had previous expedition experience, but it is certainly not a prerequisite. Every effort was made to tailor all activities to suit the individual. Expedition Medicine (further information box) sends an impressive induction pack and clearly tells you what kit is required and what is provided for you. The temperature can go down to –30°C so plenty of layers are important.

Who would benefit most from the course?

Any doctor with an interest will be made welcome. Those with a background in expedition medicine or trauma experience will probably benefit most from the course, especially if you are considering accompanying a cold weather expedition in the future. There were doctors of all grades, from preregistration house officers to consultants. The course I attended also had two nurses participating, and paramedical staff are also made welcome.

What did I learn?

The course reminded me how important it is to work as a team, and how enjoyable it is to work as a team in an environment with which most of us were unfamiliar. Every day we faced new challenges and learnt some new skills.

How about accommodation and food?

Accommodation was in simple cosy wooden chalets shared between two. The meals were hearty, traditional, and enjoyed by all. There was plenty of tea, coffee, and cake in the afternoons, and a well stocked bar for the evening. After lectures there was plenty of time to relax, shower, jump into the hot tubs or enjoy a drink at the ice bar before dinner.

Organisation and additional holiday plans

The UK office staff were very helpful and very efficient. I was also able to use their local agent in Norway to book an additional night in the ice hotel and arrange transfers. Nothing was too much trouble for the agent and any additional arrangements were made via email direct to the agent, which seemed to work very well.

One of the many modes of transport on the course


Course strengths

Excellent pre-course information was sent before the course. Excellent course material was given on CD so that extensive note taking was not required. All the course leaders had wide experience, which they were keen to share.

Course weaknesses

There are no specific weaknesses of the course. Without a background of previous expeditions, or trauma and acute care medical experience, however, I am not sure that this course alone would give you enough knowledge to feel completely confident as the sole medic on a cold weather expedition.

Top tips

Hand warmers were really very useful, and I discovered some that were for once only use that would fit in my shoes. Bliss. The ice hotel is definitely worth a visit. For a small fee we were able to arrange to spend an evening at the ice bar in the hotel during our course.


I think this was an amazing week and a high quality course. It is great for networking for those interested in expedition medicine, as there is such a wealth of experience—not just from the course leaders but from those on the course who have already done expeditions. It's refreshing to learn some new skills in an extreme environment with a bunch of likeminded individuals. I definitely recommend you give it a go and I certainly came home very refreshed. ■


  • Competing interests: None declared.

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