The Importance of Academic Training in Operational Medicine

Last year’s dramatic rescue of the Thai boys’ soccer team from a flooded cave in Thailand once again brings home undersea and hyperbaric medicine’s firm link to what I call “operational medicine.” One of the things I have always loved about hyperbaric medicine is that it is firmly linked to military, exploration, scientific and commercial operations, and we are frequently asked to offer opinions and provide management of people working in unusual or extreme environments.

Any graduate of a hyperbaric medicine fellowship could look at the recent Thai boys’ soccer team news coverage and immediately determine the necessity for monitoring of carbon dioxide (CO2) levels, oxygen levels, thermal conditions, infectious disease exposure, and a host of other factors, as well. We all knew that CO2 would likely become an issue and, eventually, hypoxia would even affect their ability to absorb nutrition and, ultimately, their ability to comply with instructions during the course of the rescue. While any hyperbaric physician has immediate and greater insight into the entire international ordeal than the average physician, I think it is also appropriate to take a moment and make this plug to advocate for undersea and hyperbaric medicine fellowship training.

For those aspiring new residency graduates, trying to determine if another year of graduate medical training is worth the financial, emotional, and time commitment … I would offer that fellowship is the absolute best way to take your interest in undersea and hyperbaric medicine to the next level and truly establish a sense of global expertise in a very cutting-edge field. The hyperbaric medicine fellowship programs spend considerable time ensuring that you understand the specialty, literally down to the molecular level, so that you can be called upon to make critical decisions that affect men and women involved in real-time operations in all types of environments: undersea, on land, at high altitude and even in space, as well as in the hospital. If you found yourself interested in events as they unfolded and want to be on a team guiding future exploration of new frontiers and helping with future emergencies, a fellowship in hyperbaric medicine opens doors you can hardly imagine. As for my colleagues who are UHM fellowship directors and faculty, they know that the training provided for extreme environments is inherent in and critical to our specialty, and they are dedicated to mentoring the next generation. As the human race continues to expand and explore, our expertise will be needed more and more in the future, and it is incredibly rewarding to be a part of those expanding frontiers. I know I personally would never have had those opportunities without the knowledge, skills and expertise developed during my fellowship.

Richard Walker, MD, MS