DIPLOMA IN MOUNTAIN MEDICINEMany countries offer regular courses in mountain medicine. The medical commissions(Medcom) of UIAA and ICAR, together with the International Society for Mountain Medicine(ISMM) established minimal requirements for these courses in August 1997 (Interlaken,Switzerland). Many course organisers adopted these standards and the Diploma in MountainMedicine (DiMM) has become a widely respected qualification. The regulations have been
updated to reflect developments in mountain medicine, internet communications and to ensurethat the high standard of the DiMM is maintained. The member organisations approved thechanges in the regulations on the 3rd of October 2007 at a joint meeting in Aviemore, Scotland.
Organisers of mountain medicine courses can apply to endorse their courses with the labels ofUIAA Medcom, ICAR Medcom and ISMM by sending their course curriculum to Dr David
Hillebrandt (dh@hillebrandt.org.uk) or John Ellerton (ellerton@enterprise.net). Applications
must be made in English. New course organisers are encouraged to discuss with, and/or invite,
members of the UIAA Medcom, ICAR Medcom and ISMM to observe their courses. Afterapproval, the course organisers can award the UIAA/ICAR/ISMM International Diploma/Certificate in Mountain Medicine to appropriate participants that successfully complete thecourse and assessment. For new courses, approval is for two years; when the course is reapproved, approval is for four years
Courses can be organised for medical doctors (including medical students near graduation)
and/or registered nurses or paramedics. Participants should be interested and/or experienced
in mountaineering, and have current (< 5 years) training in basic life support. The course canbe divided into different parts appropriate for the organising country (e.g. summer, winter;basic, specialty etc.) but must include the common course syllabus. This must have a minimal
study time (lectures, workshops and practical work) of 100 hours. Course organisers candetermine who can attend the course and the speciality offered. In addition, course organisers
may seek University status for the course. All courses should have some form of valid theory
assessment and demonstration of practical skill with a fail potential. On successful completion,
the course organiser can award the following qualifications:Type of student

CourseQualification

Medically qualified doctor

Common course

UIAA/ICAR/ISMM Diploma in
Mountain Medicine

Medically qualified doctor registered in their Common course & rescue U I A A / I C A R / I S M M D i p l o m a i nc o u n t r y o f o r i g i n t o p r a c t i s e e m e r g e n c y speciality course
Mountain Medicine and title
medicine'Mountain Emergency Doctor'
Nurse or paramedic

Common course

UIAA/ICAR/ISMM Certificate in
Mountain Medicine

Nurse or paramedic registered in their country Common course & rescue U I A A / I C A R / I S M M C e r t i f i c a t e i nof origin to practise emergency medicine
speciality course
Mountain Medicine and title'Mountain Emergency nurse orparamedic'

Curricula
COMMON COURSE:

Basics of:

Minimal time Instructors:(hrs)

Training:

Altitude

3 high altitude experienced doctor

theoryHypothermia

4 experienced doctor

theoryAvalanche

4 experienced doctor + mountain guide theory + practicalor avalanche/ski patroller

Frostbite

2 experienced doctor

theorySubmersion and immersion in water

1 experienced doctor

theoryHeat and solar radiation

1 experienced doctor

theorySurvival in the mountains/ exhaustion

4 experienced doctor

theory + workshop

Children and mountains

1 experienced doctor (paediatrician)theoryPractical traumatology

4 experienced doctor

workshop

Weather

1 mountain guide or meteorologist

theoryRescue techniques (introduction)

1 experienced mountain rescue doctor, theory
team member and/or mountain guideRescue techniques (practical)

2 experienced mountain rescue doctor, practicalteam member and/or mountain guide

Mountaineering techniques in summer andwinter, and personal mountaineering equipment

18 mountain guides

practical

Nutrition

1 experienced doctor or nutritionist

theoryExercise physiology

1 physiologist or experienced doctor

theoryTravel Medicine

1 experienced doctor

theoryNavigation in the mountains

4 mountain guide

workshop + practical

Personal first aid kit

1 experienced doctor

theoryLegal aspects

0.5 experienced lawyer or doctor withmedico-legal experience

theoryStress management

1 experienced doctor

theoryPre-existing clinical conditions

3 experienced doctor

theoryAnalgesia in the field

1 experienced doctor

theoryInternational mountaineering organisations

0.5

theoryAdditional subjects selected by the courseorganiser40

theory, workshop +practical

Information about:Total:

100 hrs

SPECIALTY COURSE: EXPEDITION AND WILDERNESS MEDICINEThis course is designed for persons going on treks and expeditions with the anticipation thatthey will be providing medical support.
Basics of:

Minimal time Instructors:(hrs)

Training:

Altitude

4 experienced expedition doctor

theory and workshop

Cold

3 experienced expedition doctor

theory + workshop

Travel Medicine

4 doctor specialized in tropical or travel theory
medicine, or experienced doctor

Traumatology

4 experienced expedition doctor

workshop

Improvised rescue techniques

4 experienced expedition doctor or
IFMGA guide

workshopSurvival techniques in high altitude andpersonal equipment for high altitude
mountaineering

10 mountain guide experienced in highaltitude climbing

workshop andpracticalExpedition medical kit

1 experienced expedition doctor

workshop

Team building

2 experienced team leader

workshopCommon expedition problems

8 experienced expedition doctor orleaderworkshop

Total :40 hrs

SPECIALTY COURSE: RESCUEThis course is designed for doctors (and if the course organiser wishes, registered nurses andparamedics) who are (or becoming) members of an organised rescue system. They shouldhave been trained in Advanced Life Support and be experienced in mountaineering to an
appropriate standard. Curriculum A focuses on medical aspects of terrestrial mountain rescue
and is the prerequisite for the attainment of the Diploma. The Add-on Module ‘Air Rescue’(Curriculum B) is recommended for air rescue operations in mountainous terrain and shouldat least attain the minimum standards and regulations of the region or nation.
Curriculum A(Terrestrial Mountain Rescue)

Minimal time Instructors:(hrs)

Training:

Rescue techniques in organised rescues

19 qualified, experienced mountainguides and rescue doctors

theory + workshop +practical

Helicopter rescue techniques

6 experienced helicopter persons

theoryMountain rescue in airborne sports

2 experienced mountain rescue doctor

theory + workshop

Canyoning rescue

2 experienced doctor and canyon guide theory + workshop +practical

Hypothermia, avalanches and frostbite

8 experienced doctor and mountainguide or experienced ski patroller

theory + workshop +practical

Cave rescues

2 experienced caving doctor

theory + workshop

Risk management

1 experienced doctor

theoryTeam building

2 experienced team leader

workshopCommon expedition problems

8 experienced expedition doctor orleader

workshop

40 hrsCurriculum B(Air Rescue)
Helicopter rescue
Total:

16 experienced helicopter persons andair rescue doctors

theory + practical

16 hrsAdministrative team
The administrative team is made up of representatives elected by the member organisations.
The minimum number of persons is three. It will conduct its work by email and be accountable
to the member organisations. A representative with a conflict of interest must inform othermembers of the team of the conflict. Decisions are made by consensus. The administrative
team does not have the authority to alter the regulations. Its role is to approve courses byassessing the curriculum and assessment methods, and to keep a record of courses (so thatenquiries can be directed to course organisers). The current (2007) team are: David Hillebrandt,Urs Hefti (urshefti@bluewin.ch) and Patrick Peters (patrickpeters@dokter.lu) for the UIAA
Medcom; Hermann Brugger (brugger.med@pass.dnet.it), John Ellerton and Bruce Brink(avadog@telus.net)/David Watson (heliotrupe3@shaw.ca) for ICAR Medcom; and JimMilledge (jim@medex.org.uk) for ISMM.

This document was originally produced by Urs Wiget and Bruno Durrer (January1998); it subsequently revised
by David Hillebrandt (DH) (April 2004) and DH and John Ellerton (September 2007)