Wilderness medicine opportunities in Canada do exist.

Wilderness medicine (WM) is a relatively unfamiliar area of medicine to most health care professionals in this country. However, most medical practitioners in Canada have at some point delivered care in less than ideal circumstances. These situations might include remote locations distant from definitive care or under exposure to severe weather or natural hazards. Any medical practitioner could face circumstances where resources are overwhelmed by major disasters, pandemics, or civil unrest. Given that this kind of care is delivered almost daily elsewhere in the world, there is a growing movement in Canada to recognize and formalize principles and practices unique to such demanding situations. Although several names have been given to this type of medicine, it is most often referred to as wilderness medicine within North America. WM can best be described as an encounter in which any or all of the following conspire to influence the practice of medicine: sparse resource availability, austere environmental conditions, and extended times to definitive medical care. It should be acknowledged that this definition of WM moves beyond what would traditionally be ascribed to the geography normally associated with this type of medicine, the ‘‘wilderness.’’ In fact, some examples of WM encounters would include patients found on a backcountry hiking trail, on a city street scarred by a disaster, on a fishing vessel many hours offshore, in a conflict or humanitarian zone, or in a remote community. As primary care physicians, emergency physicians are armed with the tools and expertise to tackle the spectrum of medical encounters that could be encountered in a WM context. The typical interventions that are reflexive in a conventional setting may no longer be the best management, however. For example, the gold standard of treatment may not be available; improvisation becomes necessary or the triage of patients may be altered because of the three elements listed above. Despite WM’s relatively unassuming status in Canada, there is a growing interest in obtaining exposure to this style of medicine. In November 2011, the Canadian Journal of Emergency Medicine published an article entitled ‘‘The Evolution of Emergency Medicine: The Pressing Need for ‘Made in Canada’ Subspecialty Training.’’ Of particular interest was the description of one emergency medicine resident and her journey to undertake wilderness medicine training, the majority of which required her to travel outside of Canada. Although it can be challenging to locate WM educational opportunities in Canada, over the last few years, I have discovered both didactic and clinical experiences that would be an asset to any health care professional seeking to develop his or her skills and training in WM. This overview provides a reference point for those interested as it includes the name of the opportunity and the name of the hosting organization. It should be noted that although each experience is not explicitly a WM opportunity in name, each contains learning objectives that are relevant to WM: