Intended for healthcare professionals


The coldest job on earth

BMJ 2009; 338 doi: (Published 25 June 2009) Cite this as: BMJ 2009;338:b2453
  1. Alex Salam, research MD in human biology and medicine
  1. 1European Space Agency, Concordia Station, Antarctica
  1. alex.salam{at}


Alex Salam describes life as a doctor on Antarctica’s only international base

Concordia Station ( is a permanent French-Italian research facility located at an altitude of 3233 metres on the high Antarctic plateau at Dome Charlie (Dome C). The station is jointly run by the Institut Paul Emile Victor ( and the Programma Nazionale di Ricerche in Antartide ( and is the only international Antarctic base currently in operation. Construction of the “winter over” base was completed in 2005 and crew members have stayed throughout winter each year since. The station does research in the fields of astronomy and astrophysics, glaciology, atmospheric sciences, geophysics, and human biology and medicine. It supports an average of 50 people during the summer and 12 crew members during the winter. The winter crew consists of a mix of Italian and French nationals as well as the European Space Agency ( research MD (from any European Space Agency member state), who is responsible for carrying out all of the European Space Agency’s biomedical research projects in Antarctica.

Extremely hostile environment

The station is one of only three permanent stations located on the Antarctic plateau; the American Amundsen-Scott South Pole base and the Russian Vostok base are the other two. Dome C is one of the coldest, driest, and most inhospitable regions on the planet. There is no vegetation or wildlife and the landscape is completely flat and white for as far as the eye can see. The weather conditions at Concordia Station are very stable. Dome C receives 2-10 cm of snow precipitation a year and the average wind speed is 2.8 m/s. The mean temperature is -30°C during the summer and -60°C during the winter. Temperatures often plummet to -80°C during the winter (not including wind chill), however, and the lowest recorded temperature was -84.6°C in 1982 (the lowest temperature ever recorded on earth was -89.2°C at Vostok Station in 1983). Because of its location at the South Pole, the atmospheric pressure at Concordia Station is approximately equivalent to an altitude of 4000 metres at the Equator.

Concordia Station and Vostok Station are the two most isolated bases on the planet. Vostok Station is 560 km from Concordia Station, and the closest coastal post to Concordia Station is the French Dumont d’Urville base, 1100 km away. Transport to the base is either by a four hour flight from one of the coastal stations or by overland crossing from Dumont d’Urville, which takes about 12 days. The summer season lasts three months, and the winter season lasts nine months, from mid-February to mid-November. In the summer the crew experiences three months of constant sunlight, and in the winter three months of unrelenting and total darkness. During the nine month winter season there is no possibility whatsoever of evacuation or deliveries. Communications are restricted to satellite telephone, limited email connections (which can be sporadic during the winter), and unsurprisingly there is no internet access. As a result, the crew has to be totally self-reliant during the winter period.

Research MD

The challenges for a winter over crew are many and include prolonged isolation and confinement, an extremely hostile natural environment, self-reliance and crew autonomy, limited resources, life in a small multicultural setting, constant sunlight or darkness, and limited mobility outside the station. As a consequence, Concordia Station is an ideal research analogue for a lunar base, a mission to Mars, or a space station. This is why, since 2007, the European Space Agency has sponsored and recruited a medical doctor specifically to perform biomedical research during the summer and winter seasons. Each year, the European Space Agency puts out a call to universities and research institutions for suitable projects to be carried out at Concordia Station. Fields of research interest include immunology, psychology, microbiology, sleep medicine, biomedical technology and telemedicine, crew medical training, nutrition, and exercise and hypoxia among others.

During the 2008-9 season, four projects are being implemented at Concordia Station:

  • Consequences of long-term confinement and hypobaric hypoxia on immunity in the Antarctic Concordia environment (CHOICE)

  • Concordia microbial dynamics (COMICS)

  • Effect of blue-enhanced light on alertness and sleep-wake behaviour (BLUELIGHT)

  • Countermeasures to sleep disorders induced by a monotonous cold environment (NIGHTSOCKS)

CHOICE is a large multinational project investigating the effects of stress and hypoxia on the immune system, headed by the Ludwig-Maximilians University of Munich in collaboration with the National Aeronautics and Space Administration (NASA). The study involves regular blood, urine, saliva, and breath sampling and processing to measure numerous immunological and stress parameters, as well as on-site flow cytometry including cell volume and morphology, immunophenotyping, functional cell assays, intracellular protein staining, and enzymatic activity.

COMICS is investigating the ecology of microbial communities in Concordia Station as well as diversity and genetic fluxes among the microflora associated with the human crew and with the confined environment of the station. It involves monthly air, surface, and faecal sampling and processing.

BLUELIGHT is investigating the effect of “blue enhanced” light on sleep, concentration, mood, and performance during the winter period. It involves replacing the standard neon lights throughout the station with blue enhanced neon lights and performing actimetry, melatonin measurements, and psychological and psychometric testing on the crew members. The crew members will also wear a specially designed miniature sensor that measures light spectrum and intensity as well as atmospheric pressure, humidity, temperature, and acceleration.

NIGHTSOCKS is investigating the effect of decreasing core body temperature—by increasing heat loss from the extremities during sleep—on sleep quality and the autonomic system. CHOICE and COMICS will continue throughout the 2009-10 season and several new projects will commence.

The post includes several months of training at the respective research institutions before departure, as well as a pre-departure meeting and psychological training at the European Space Agency Paris headquarters. In total, the post lasts approximately 15 months: typically two months preparatory time throughout different European countries and 13 months in Antarctica.

In addition to human biology and medicine research, the European Space Agency research MD is also responsible for the long term psychological assessment and monitoring of the crew members during the winter period and chemical analysis of the recycled water produced by European Space Agency’s Grey Water Treatment Unit, which is a prototype water recycling system that recycles on average 85% of the water used at Concordia. Concordia Station is one of the rare stations, if not the only one, to have two medical doctors during the winter season. Although primarily a research post, the European Space Agency research MD is obviously expected to provide clinical support when needed and also to support the medical training of the lay crew members.

Challenges of working in Antarctica

Performing biomedical research at Concordia Station can be challenging and requires sound research methodologies and technical skills. The environmental conditions (altitude, lack of humidity, static electricity, cold) can often interfere with research equipment, and biological assays frequently don’t behave as they do at sea level. Resources and reagents are limited and communication with the principal investigators can at times be difficult owing to poor satellite connections. The European Space Agency research MD therefore needs to be self-reliant and able to troubleshoot effectively and formulate creative solutions to project problems without guidance. This can be a big responsibility for those not familiar with academic research, as many of the projects are multicentre, multinational collaborations involving high costs and a large workforce. One needs to remain professionally focused, determined, and motivated during the long winter months irrespective of personal issues.

A winter over at Concordia Station can also be physically and psychologically demanding. Time spent outside the base is minimal because of the extreme temperatures, and thus one remains mostly confined to the base with 11 other individuals during the nine winter months. There are very few forms of entertainment or pleasure on the base and daily life can be highly repetitive and monotonous. Communication with family and friends is limited and can sometimes be interrupted for several days at a time. There are very few colours, smells, or sounds both inside and outside the base and one’s senses become blunted with time. Living in a multicultural French-Italian environment could be challenging for those not accustomed to other cultures and one needs to be open minded, flexible, and diplomatic. Crew members often suffer psychological effects as a result of the isolation, confinement, and circadian rhythm disturbances, and as the European Space Agency research MD you are expected to provide psychological support for crew members when needed.

How to apply

The post is a unique opportunity to perform fascinating and challenging research in one of the world’s most pristine environments and to live an experience that only a handful of people will ever live, but one needs to be fully committed before making the decision to spend a year of one’s life in this demanding and daunting setting. The post is usually advertised around mid to late June on the European Space Agency website, with interviews in August, academic training beginning in October, and departure in early December. Requirements for the post include a medical degree from an accredited institution, nationality of a European Space Agency member state, previous laboratory research experience, several years as a practising doctor, an interest in space biology and extreme environment medicine, and excellent physical and mental health. Fluent English and French-Italian language skills are highly desirable.

View Abstract