Intended for healthcare professionals

Career Focus

Returning to high altitude

BMJ 2007; 334 doi: (Published 20 January 2007) Cite this as: BMJ 2007;334:s27
  1. Alison Evans, F2 in general practice
  1. Derbyshire Royal Infirmary evansalison{at}


Alison Evans faces up to a mountain and re-experiences altitude sickness

This experience helped us put into practice theories and skills we'd learnt and also to realise some of the unpredictable problems that arise


  • Morocco Mountain Medicine Expedition:

  • Next trip: Autumn 2007, dates to be confirmed

  • Price: £725 including accommodation, food, course book, and tuition but excluding flights.

I had always wanted to combine my love for the mountains with a career in medicine until I became ill with altitude sickness in my teens. A few years later I decided to pursue my interest and see if I could make it to high altitude and not end up in hospital again. A search on the internet came up with a trip to Morocco to study expedition medicine. Although it was a pilot trip the company runs other successful and longstanding courses in Chamonix, so I thought it would be worth a try. I am delighted I went. It was a fantastic week in which I learnt useful skills and techniques which I hope to use in future as well as being an exciting and challenging adventure that I would recommend to anyone.

What did the course entail?

The course, spread over five days, is based at the Kasbah, Ilmil, an hour's drive from the hustle and bustle of Marrakech. The first two days comprise lectures and small group sessions in the surroundings of the beautiful Atlas Mountains.

During this time we learnt what it meant to be an expedition medic—the role and expectations. We discussed what you'd take in your medical kit, taking into consideration the different surroundings you might be going to as well as the limitations of being perhaps two days from civilisation. We were trained how to navigate, discussed the role of the global positioning system and radios on expeditions, and talked about altitude sickness, hypothermia, and tropical diseases. Evenings were free, with optional talks from the qualified leaders.

Three day expedition

Then it was time to prepare for the trek up the highest mountain in northern Africa, Jebel Toubkal. We divided into small groups, within which we would each take the role of leader for one part of the three day expedition. This experience helped us put into practice theories and skills we'd learnt and also to realise some of the unpredictable problems that arise. We mingled with the locals on the way up, taking our time given the excessive heat and huge altitudes we were ascending. We reached base camp in good time on the first day, which gave us a chance to practise some medicine on other hikers who'd been unprepared for the altitude and were suffering with crippling headaches and nausea.

With good teamwork and luck with the weather we reached the summit on the second day, enjoying the stunning views just before the cloud came in. The descent was steep and a few people fell, but everyone made it back to base camp safely, exhausted after the 4 am start but in high spirits having achieved our goal. After a basic Moroccan meal and an early night we headed down the valley the next day, learning a few more skills. These included how to make a pulley on the mountainside for rescue and then to make a rope stretcher to get the victim down safely.

After a hot, and pungent, journey back to Marrakech we settled back into civilisation with a shower before meeting on the terrace to debrief on the week's achievements. We then headed to the souk for some culture and shopping and found a few souvenirs among the snake charmers.

What did I learn?

The course rekindled my love for the mountains and helped me highlight my competencies and weaknesses. Having done the course I now feel that I would be able to offer a small expedition enough experience to cope with most mild to moderate problems. The course also prepared me for situations that could arise out of my control. For these I would now feel prepared enough to know what to do and how to get appropriate help. Further mountain training would be needed for more risky and potentially dangerous trips.

Accommodation and food

The accommodation and food at the Kasbah were excellent. The rooms were shared but we had plenty of space and scope for privacy. The food was plentiful and tasty, with a chance to experience real Moroccan culture; however, as a result the vegetarian menu was limited.

In the mountain refuge the rooms were adequate but the food less so. The course organisers provided good mountain food. When you've climbed higher than 2000 m you don't really mind what you eat.

Organisation and additional travel plans

The information given before the course was appropriate, and cheap flights were recommended on the website. Group emails were sent out before the trip, giving the chance to contact other members of the group to plan a weekend by the coast afterwards. If you asked the organisers to find you accommodation after the trip this was easily arranged.


I had an amazing week away, learning about expedition medicine and developing skills. Depending on how much experience you have before the trip you may need a little more before leading a trek yourself. I am planning a trip abroad after completing my foundation year 2 and I would never have felt confident or competent enough to do that without going on this course.

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