Wilderness and Austere Medicine Fellowship (WAM)

This fellowship is a rigorous year-long educational experience in Emergency Medicine under austere conditions. While developing expertise can take years, this fellowship is uniquely designed to propel the fellow along in the process. We feel this particular skill-set, offered in this fellowship, is applicable to many career paths within wilderness and international Emergency Medicine-- whether the fellow goes on to develop a wilderness education program, becomes a rescue specialist, develops a community health program or helps Emergency Medicine development in the developing world; serve as a representative of a governmental or non-governmental organization; or lead a wilderness expedition in a medical capacity. The fellow will have access to our department’s national experts in Wilderness, Austere, Disaster and International Emergency Medicine, along with their unique and long-standing relationships with other countries and programs that have been cultivated over several decades.

In addition, the fellow will be eligible to earn the prestigious Diploma in Mountain Medicine, endorsed by the UIAA (International Mountaineering and Climbing Federation), IKAR (International Commission for Alpine Rescue), and ISMM (International Society for Mountain Medicine).

Through a combination of field work, study projects, conferences, clinical shifts in the ED and a series of fundamental didactics, the fellow should gain vastly expedited experience in austere emergency medicine.

While there is necessarily built-in flexibility to accommodate the fellow’s career interests, the basic architecture of the fellowship is as follows:

  • Field work, local and abroad (if desired)
  • Clinical shifts in the ED (0.5 FTE, 20 hrs per week average)
  • Weekly mentoring-didactics, journal article reviews, outdoor and austere medicine technical skills
  • Independent research project
  • Attendance at WAM specific conferences and meetings (1-2: WMS, ISMM, IKAR, ACEP, or other)
  • Co-directorship of Wilderness, Improvisational and International Medicine clerkship (March) and undergraduate Austere and Mountain Medicine course (2 semesters)
  • Other teaching duties as desired in the Department of Emergency Medicine

Proposed Field Work

Operational and medical team member, Albuquerque Mountain Rescue
Grand Canyon NP medical direction
Educational training, Yosemite and Joshua Tree NP
Badwater 135 Ultramarathon, Death Valley NP
Bataan Memorial Death March, White Sands, NM
Taos Ski Clinic
Hardrock 100, Silverton, CO
Institute for Altitude Medicine, Telluride
New Mexico Disaster Medical Assistance Team
Educational initiatives-online courses and podcast development
2-4 week training, Air Zermatt, Switzerland
Training with SAR Santiago, Chile
Medical work, Aconcagua NP, Argentina
Nepal Study Tour (November)
Latin America/PACEMD EM and WFR development (Mexico, Panama, Colombia, Peru, Argentina)
Kenya (fall and/or spring) – remote clinic and research experience
SAMU 93, Paris France
Mountain Medicine, University of Bern, Switzerland

Clinical Duties

The fellow will be expected to attend in the UNM Emergency Department at approximately 0.5 FTE.These shifts will be interspersed throughout the year to accommodate the fellow’s field work and international conference attendance. The fellow will be at the level of assistant professor.


Throughout the year, the fellow will enjoy a series of didactics delivered by our highly experienced attendings in topics pertaining to their interest while covering the fundamental principles of international EM, and EM in remote and austere environments. The fellow is encouraged to enhance his or her language skill commensurate with where fellow would later focus his or her future career goals.

Learning Objectives

Mountain Medicine
-high altitude physiology and illness
-temperature related illness
-solar illness

Marine Medicine
-dive medicine and dysbarisms
-marine envenomations and toxidromes
-hyperbaric medicine

Survival Medicine
-ability to care for self/others in survival or austere situations (procurement of heat, shelter, food, water)
-water purification
-tracking and land navigation
-arctic, desert, mountain, marine, tropical areas

Search and Rescue Medicine
-search and rescue techniques
-high angle rope rescue
-aeromedicine/helicopter rescue
-medical kits
-team leadership and decision making
-avalanche safety, weather prediction

Animal and Plant Hazards
-animal bites and injury
-envenomations and antivenins
-zoonotic infections
-medicinal and poisonous plants

Travel and Tropical Medicine
-infectious diseases/diarrhea
-laboratory medicine basics
-sanitation and public health issues
-travel methods/packing lightly and efficiently

Wilderness Trauma and Resuscitation
-correlation of ACLS, PHTLS, ATLS to austere environments
-assessment and stabilization
-orthopedic care and sports medicine
-improvising in austere environments
-use of ultrasound

Disaster and Tactical Medicine
-incident command and disaster mitigation
-how to deploy and lead a team
-disaster teams: national, IMSurt, NGO/self
-media relations
-firearm safety and usage
-tactical medicine/urban scene safety

International Medicine Development
-work with different development paradigms (short versus long term models, NGO versus government organizations, academic models, “medical tourism” and unsustainability)
-work with different development paradigms (short versus long term models, NGO versus government organizations, academic models, “medical tourism” and unsustainability)
-understanding of role of established EM programs initiating specialty elsewhere
-other EM systems overseas

Faculty Development
-expedition leadership
-successful speaking and presentations
-planning lectures, conferences
-research design and implementation
-grant application

2018 – 2019 Wilderness and Austere Medicine Fellowship

Nicole Mansfield, MD

Our Faculty

Our faculty have a combined 60 years experience in wilderness, austere, disaster and international EM and several are nationally recognized leaders in the field.

Darryl Macias, MD, DiMM, Fellowship Director
Jenna White MD, DiMM, Assistant Fellowship Director
Jason Williams EMT-P, DiMM, Director for Austere and Mountain Medicine
Trevor Mayschak, EMT-P, DiMM
Eric Gregory, EMT-I, Survival Unlimited
Megan Dell, MD
Phil Seidenberg, MD
Joe Alcock MD
UNM EMS Medical Consortium

We welcome the serious applicant interested in collaborating with our enthusiastic group.  Candidates must have completed an ACGME accredited emergency medicine residency. Your complete application will include:

  • Attached application form, completed
  • Letter of interest
  • Current CV and 3 letters of recommendation

Please email these items to:

Darryl Macias MD, Director: UNM Wilderness and Austere Medicine Fellowship
MSC11 6025  1 University of New Mexico
Albuquerque NM 87131