This Diploma is basedon UIAA/ICAR/ISMM

Diploma in Mountain Medicine(DiMM) 2010 JapanDIPLOMA in MOUNTAIN MEDCINE

Applied on November 30, 2009 by Dr. S. Masuyama
andAccepted on February 21, 2010 by Dr. John Ellerton

UIAA-Med in Are Sweden, Oct.20 2011
Shigeru Masuyama, MD
Chairman of DiMM committee“The organization(JSMM) is entitled to use
the UIAA, ICAR and ISMM logos for theircourses for two years from May 2010,
and award the title UIAA/ICAR/ISMM
Diploma/Certificate in Mountain
Medicine to successful candidates as set
out in the Diploma.”Japanese Society of Mountain Medicine

Whole image of our courses

Application guidebook in Japanese
http://www.jsmmed.org/_userdata/2010DiMM_yokou_20100616.pdf
*International Diploma : (110h)
The candidates for International Diploma in Mountain Medicine
are requested to finish all of the common courses based on
European standard.

The DiMM program in Japanis operated by
the Japanese Society of Mountain Medicine(JSMM)

in cooperation with

Common Course (111 hours)
divided into six clusters
1. Spring cluster (2 days) consecutively held after the (30th )Annual Scientific Meeting of JSMM, Tanigawa in May 2010.
2. Tokyo cluster (2days): Basic theory in June 2010
3. Tateyama cluster (3days): Mountaineering techniques insummer, in July 2010
4. Utsunomiya cluster (1day): Various medical problems inJapanese mountains in October 2010
5. Yatsugatake cluster (3days): Mountaineering techniques in
winter, in January 2011
6. Experiences of mountain and sports activity in Japan(4days), Tateyama, Utsunomiya, Yatsugatake and Nasu.

Special course: 40 hours.

*Expedition and Wilderness Medicine .(40h)The candidates for International Diploma in Mountain Medicine
can apply this course.

the Japan Mountaineering Association (JMA)andthe National Mountaineering Training
Center Japan(NMTCJ)

Common course: 111 hours.

Expedition and Wilderness Medicine course(40 hours) divided into 3 clusters
7. Altitude, cold, travel medicine, traumatology, improvised rescue
techniques in Tokyo, September 11and 12 2010




8. Survival techniques in high altitude in Nasu, February 19 2011

9. Expedition medical kit, team building, common expedition
problems and personal equipment for high altitude mountaineeringin Tokyo, March 5 and 6 2011
1

Venues

1-1 Tanigawa cluster following the 30th Annual Scientific Meetingof JSMM May 9, 10, 2010

Nasu

Responsible Officials: S, Saito, N. Kamikomaki,

Tanigawa

We launched DiMM program
Japan at Tanigawa, which has oneof the most difficult granite walland has experienced the mostaccidents(751 fall victims from
1931 to 2005) in Japan.

Utsunomiya

Tokyo

Yatsugadake

Tateyama

1-2 Tanigawa cluster following the 30th Annual Scientific Meetingof JSMM May 9, 10, 2010

Media

Responsible Officials: S, Saito, N. Kamikomaki,

May 9 and 10 2010

Common course

Rescue technique(introduction)

theoryRescue technique(practical)

practical

Travel Medicine-Malaria and wilderness theory
medicine

Entry

34

Accepted

32

(hrs)

Place

1ｈ

Tanigawa-dake

Gunma
Prefectural
Department,

2ｈTanigawa-dakeGunma Prefectural Government
Air Rescue, GMA Rescue Team1ｈ

Scientific Meeting

Professor
Sigeyuki(National Center for
Health and Medicine)

1h

Scientific Meeting

Professor Takashi Matsukawa(Yamanashi University)

theoryHypothermia

Flying Mountain
Medicne Doctor

PoliceKano
GlobalAll lectures/practice are given by experienced professional guides/climbers/doctors.

2-1. Tokyo cluster: Theory Basics June 19, 2010
Responsible Officials: S. Masuyama, N. Kamikomaki

at Miura Base Camp Tokyo

2-2. Tokyo cluster: Theory Basics June 19, 2010
Responsible Officials: S. Masuyama, N. Kamikomaki

July 19, 2010 Tokyo
Hypothermia and Frostbite
Sunburn and heat illness
water hazzard
nutrition
stressmedical equipments
Altitude related neuroligy
Altitude related endocrinology
Altitude related chest diseases
Health care network Japan
Internationnal organization

theorytheorytheorytheorytheorytheorytheorytheorytheorytheorytheory

2h
1h
0.5h
1h
1h
1h
0.5h
0.5h
0.5h
0.5h
0.5h

Dr. M. Kaneda
Dr. S. Kamio
Dr. H. Natsui
Dr. H. Ohno
Dr. S. Hashimoto
Dr. N. Shiga/ Mr.H. Isao
Dr. S. Hashimoto
Dr. N. Kamikomaki
Dr. T. Kobayashi
Dr. M. Horii
Dr. M. Nakashima

All lectures are given by experienced professional guides/climbers/doctors.

22-3. Tokyo cluster: Theory Basics June 20, 2010

2-4. Tokyo cluster: Theory Basics June 19, 2010
Responsible Officials: S. Masuyama, N. Kamikomaki

at Miura Base Camp Tokyo

Responsible Officials: S. Masuyama, N. Kamikomaki

July 20, 2010 Tokyo
High altitude Medicine/Physiology
History
theoryAdaptaion to Hypoxia
theory
HAPE update
theoryExercise at altitude
theoryExercise experience in normobaric
hypoxic room
theory and practice
Altitude related circulatory diseases theory
Risk management in the field
theoryPain control in the field
Children at altitudelegai problems
weather in Japanese mountains

theory and practicetheorytheorytheoryHypoxia room
0.5h
0.5h
0.5h
0.5h
2h
0.5h
1h

Dr. K. Matsubayashi
Dr. S. Masuyama
Dr. T. Kobayashi
Dr. M. Yamamoto
Mr. H. Ando, Mr. T. Maegawa
and Dr. M. Yokoi
Dr. M. Takayama
Dr. C. Aoyama

0.5h
1h
0.5h
0.5h

Dr. S. Saitoh
Dr. T. Seto
Mr. S. Kurokawa/Mr. M. Nukita
Mr. T. Inokuma

Registered

46

Entry

28

Accepted26

All lectures/practice are given by experienced professional guides/climbers/doctors.

3. Tateyama cluster: Mountaineering techniques in summer

3-1. Tateyama cluster: Mountaineering techniques in summer
July 17, 2010 Responsible Officials: H. Isao, Y. Chishima

July 17- 19, 2010at the National Mountaineering Training Center Japan
Responsible Officials: H. Isao, Y. Chishima
http://www.jsmmed.org/pg79.html
Chief guide (IFMGA qualified guide)
Mr Yasushi Tanahashi
Guides(JMGA climbing guide)
Mr Hitokazu Okuda

http://www.jsmmed.org/pg79.html
June 17, 2010
9:30～18:00
Orientation
Navigation
theory and practice 4hSurvival techniquetheory and practice 2hPersonal mountaineering
equipments
practice
1h
At NMTCJ

Prof. M Murakoshi(Shizuoka Univ.)
Mr. Tanahashi and mountain guides
Mr. Tanahashi and mountain guides

Mr Makoto Kuroda
Mr Tomoji Kato
Mr Hiroki Hongo

3-2. Tateyama cluster: Mountaineering techniques in summer

3-3. Tateyama cluster: Mountaineering techniques in summer

July 17- 19, 2010 Responsible Officials: H. Isao, Y. Chishima

July 17- 19, 2010 Responsible Officials: H. Isao, Y. Chishima

http://www.jsmmed.org/pg79.html

http://www.jsmmed.org/pg79.html
June 19, 2010
4:00～16:00
canyaon waterfall climbingpractice
12h Mr. Tanahashi and mountain guides
At Shiraiwasawa

June 18, 2010
6:00～16:00
mountaineering techniquein summer
practice
8h
Mr. Tanahashi and mountain guides
survival techniquepractice
2h
Mr. Tanahashi and mountain guides
Climbing, personal reschue and survival techinique training at NMTCJ and Zakkokudani

All practices and techniques are taught by IFMGA qualified international mountain guides.

Registered

50

Entry

26

Accepted183

4-1. Utsunomiya cluster: Medical problems in Japanese mountains

4-2. Utsunomiya cluster: Free climbing & Trail run

Oct. 03, 2010 Responsible Officials: H. Kajitani, N. Kamikomaki

Oct. 03, 2010 Responsible Officials: H. Kajitani, N. Kamikomaki

Date

(hrs)
1/3

theoryUtsunomiya

Prof. Sjiori Hashimoto

Elderly people and mountain

1/3

theoryUtsunomiya(Tokyo womens medical college)

Alternative person and mountain

1/3

theoryUtsunomiya

Harmful organisms in mountains(vertebrate)

1/4

theoryUtsunomiya

Dr. N. Kamikomaki

Harmful organism in mountain(invertebrata, parasite,
microorganism)

1/4

theoryUtsunomiya

Dr. Hiroshi Kajitani

Harmful plants in mountains

1/4

theoryUtsunomiya

Dr. Hiroshi Kajitani

Poisonous gas, lightning stroke

1/4

theoryUtsunomiya

Dr. Hiroshi Kajitani

Dental problems

1/4

theoryUtsunomiya

Prof. Izumi Nguchi(Tsurumo Dental Col.)

Ophthalmic problems

1/4

theoryUtsunomiya

Dr. N. Kamikomaki

aurinasal problems

1/4

theoryUtsunomiya

Dr. N. Kamikomaki

Cutaneous problems

1/4

theoryUtsunomiya

Dr. Y. Chisima

Utsunomiya

theory2010/10/3

Free climbing & trail run trials

Place

Ladies and mountain

1/2

Registered

52

Entry

30

Accepted

30

Free climbing instructed by
Mr Yasushi Tanahashi(IFMGA qualified guide)
Mr M. Nagaoka(IFMGA qualified guide)

All lectures are given by experienced professional guides/climbers/doctors.

All lectures/practice are given by experienced professional guides/climbers/doctors.

5-1. Yatsugatake cluster: Mountaineering techniques in winter,
Training Mountain
Medicne Doctors

On Jan. 8- 10, 2011 Responsible Officials: Y. Chishima and H. Kajitani
Date

hrs

Place

Training

Jan 8/2011

Hypothermia

4

theory practical

K. Oshiro

Jan 8/2011

Avalanche4

theory practical

M. Kuroda

Chief guide (IFMGA qualified guide)
Mr Yasushi Tanahashi
Guides(JMGA climbing guide)
Mr Wataru Kobayashi
Mr Makoto Kuroda
Mr Kenro Nakashima
Mr Takeshi Tani

All lectures/practice are given by experienced professional guides/climbers/doctors.

5-2. Yatsugatake cluster : Mountaineering techniques in winter5-3. Yatsugatake cluster : Mountaineering techniques in winter,
On Jan. 8- 10, 2011 Responsible Officials: Y. Chishima and H. Kajitani

On Jan. 8- 10, 2011 Responsible Officials: Y. Chishima and H. Kajitani
Date

Common course
Mountaineering
Jan 9/2011 winterJan 10/2011 Ice climbing

techniques

hrs

Place

Training

9

Ioudakepractical

8

Jyogosawapractical

inRegistered

60

Entry

12

Accepted

7

Cultivating
Mountain Medicne
Doctors

All lectures/practice are given by experienced professional guides/climbers/doctors.

4

6. Experience of mountain sports activities in Japan

6-4. Back country skiing, snow boarding, snowshoeing
in Nasu Feb. 19-20, 2011 Responsible Officials: Y. Kamikomaki and H. Kajitani
Chief guide
Mr Kenji Kondo (IFMGA qualified guide)

Date

Common course

Time (hrs) Place

Training

2010/10/3 Free climbing, trail running

4.5 Kogashi-yamapractical

2010/7/19 Valley climbing

12 Tateyama

practical

2011/1/10 Ice climbing

12 Yatsugatake

practical

Back country skiing, snow
2011/2/20 boarding, snowshoeing

11 Nasupractical

GuidesMr Makoto Kuroda (JMGA climbing guide)

Registered

60

Entry

26

Accepted25

Mr Toshiyuki Kitamura (IFMGA qualified guide)

All lectures/practice are given by experienced professional guides/climbers/doctors.

7-1. Expedition and Wilderness Medicine

Expedition and Wilderness Medicine (40 hrs)

Responsible Officials: N. Shiga, M. Nukita

Responsible Officials: Naoko Shiga, Muneo Nukita

Altitude and Cold

September 11, 2010 Miura Base camp, Tokyo

Theory and workshop

7. Theory and workshop on altitude and cold at
Miura BC on September 11-12, 2010
8. Survival techniques in high altitude, etc. at Nasu
on February 19, 2011


9. Eexpedition problems at Miura BC on March 4-5,2011

Cold and Frostbite chaired by Dr. Y. Chishima 9:00-10:30*Lessons from Shivling 2005 and Piolet d'Or awarded the first ascent of
the South-West face of Kamet 2008 by Kazuya Hiraide and Kei Taniguchi

Cold and Hypothermia/Frostbite chaired by Dr. S. Hashimoto
10:45-12:15*The reason of lost fingers at Kangchenjunga by H. Okuda (JMGA climbing
guide)*A case of hypothermia in a guided winter climbing inYatsugadake byAtsushi Yamamoto(JMGA climbing guide)
All lectures/practice are given by experienced professional guides/climbers/doctors.

7-1a. Expedition and Wilderness Medicine
by Piolet d’Or awarded climbers*Lessons from Shivling 2005 and Piolet d'Or awarded the first ascent of theSouth-West face of Kamet 2008 by Kazuya Hiraide and Kei Taniguchi

7-2. Expedition and Wilderness Medicine
Responsible Officials: N. Shiga, M. Nukita
Medical equipments and traumatology
September 11, 2010 Miura Base camp, Tokyo
Expedition medical equipments for Himalayan mountaineeringby Dr. Naoko Shiga 13:00-14:00
Traumatology and rescue technique I
chaired by Dr. Makoto Kobayashi 14:15-16:15*International evacuation from Gasherbrum to Japan-- A case of Hiro Takeuchi
Traumatology and rescue technique II
chaired by Dr. Naoko Shiga 16:30-18:30*Helicopter rescue of severe cervical spine injury patient in Yarigadakeby Dr. Naoko Yui and Dr. Takeshi Kamijyo
All lectures/practice are given by experienced professional guides/climbers/doctors.

57-3. Expedition and Wilderness Medicine
Responsible Officials: N. Shiga, M. Nukita
September 12, 2010 Miura Base camp, Tokyo
High Altitude I: workshop chaired by Dr. Shigeru Masuyama 8:00-10:00
1. HAPE/HACE case of Mr. Gota Miura at Mt. Everest

7-4. Expedition and Wilderness Medicine
Responsible Officials: N. Shiga, M. Nukita
Travel Medicine
September 12, 2010 Miura Base Camp, Tokyo
Travel Medicine I:Theory and workshop by Professor Kosuke Haruki
13:00-15:00

2. HAPE case at Annapurna by Mr. Kazuhiro Takahashi
3. HAPE case at K2 by Dr. Gen Sasao
4. HACE? at Chooyu by Dr. Shiori Hashimoto

Travel Medicine II :Theory and workshop by Professor Kosuke Haruki
15:15-17:15

5. Several cases of HAPE/HACE by Dr. Shigeru Masuyama
High Altitude II: workshop chaired by Dr. Norihiro Kamikomaki 10:15-12:15
1. Pre-exposure of normobaric hypoxic room; is it effective? By Mr. Hayato Ando
2. Simulation of team tactics of climbing Mt. Everest
All lectures/practice are given by experienced professional guides/climbers/doctors.

All lectures/practice are given by experienced professional guides/climbers/doctors.

8. Survival techniques at high altitude, etc.

8-a1. Rescue, Evacuation and Repatriation

Responsible Officials: N. Shiga, M. Nukita

International evacuation from Gasherbrum to Japan-- A case of Hiro Takeuchi

Survival techniques at altitude
Feb. 19, 2011 Nasudake, Tochigi

Huge avalanche at 6700m of Gasherburm II rushed down Hiro’s team 300m and they
were buried. Two found dead and Hiro was at death’s door.

Survival techniques; practical 9:00-12:00
by Kenji Kondo (IFMGA guide) and Makoto Kuroda (JMGA guide)

Survival techniques; workshop chaired by Dr. N. Shiga 13:00-18:00
1. Survival at extreme altitude climbing in the south face of Rotseby Toshiyuki Kitamura (IFMGA qualified guide)
2. Survival from GII avalanche by Mr.Hirotake Takeuchi
3. Survival techniques at Himalayan trekking by Mr. Muneo Nukita
All lectures/practice are given by experienced professional guides/climbers/doctors.

8-a3. Recovery

8-a 2 Rescue, Evacuation and Repatriation

International evacuation from Gasherbrum to Japan-- A case of Hiro Takeuchi

Left Haemo-pneumo thorax ＋left Rib 3,4,5,6,7 fractures ＋L3 burst fracture

SkardoSkardoIslamabad

BeijinTokyo6

9-2. Expedition Medicine

9-1. Expedition Medicine
Responsible Officials: N. Shiga, M. Nukita

March 5, 2011 at Miura Base Camp, Tokyo○ International patients evacuation:Theory 9:00-11:00
by Prof. Norifumi Ninomiya○ Special equipments for altitude climbing; theory +workshop 11:10-13:10
by Y. Sasakura (JMGA guide)○ Rescue technique: Theory+workshop 14:00-18:00
by Y. Sasakura and Toshiyuki Kitamura (IFMGA qualified guide)

All lectures/practice are given by experienced professional guides/climbers/doctors.

All lectures/practice are given by experienced professional guides/climbers/doctors.

9-3. Expedition Medicine
March 6, 2011 at Miura Base Camp, Tokyo

In order to complete the courses○ travel safety and insurance system:Theory 8:30-10:30
by Mr. Muneo Nukita(WEC)○ Selection of participants and medical check; theory +workshop 10:4012:10 by Dr. Masako Horii○ New devices of telecommunication: theory+practical 15:10-16:40
by Mr. Muneo Nukita(WEC)○ Team building: theory +workshop 15:10-16:40
by Dr. Shiori Hashimoto

Pre-exam paper before each cluster
Participation in each cluster
Terminal examination after each cluster
Completion all clusters needed (within 4 years)
Completion of BLS, ACLS and JPTEC/BTLS○ Media literacy: theory +workshop 16:50-17:50
by Mr. Yukio Kondo(Asahi Newspaper) and Mr. Muneo Nukita
All lectures/practice are given by experienced professional guides/climbers/doctors.

An example of pre-exam paper

An example of pre-exam paper

Tateyama cluster

Tanigawa clusteron theoretical and research side

on climbing techniques
Explain briefly
the difference between static and climbing rope
the difference between single and double ropehow to connect your main rope to your harnesshow to connect your main rope to a belay point
how to use clove hitchhow to use Munter hitchhow to connect two main ropeshow to connect tape slings
two representative friction knots
what belay devices are and how to use them
how to rappel downRead the following paper and discussappropriateness of the method
result its construe"Training in Normobaric Hypoxia and Its Effects on Acute
Mountain Sickness after Rapid Ascent to 4559m“ High
altitude Medicine & Biology Vol.11, No. 1, 19-25, 20107

An example of post-cluster examination

Examples of post-cluster examination
Tokyo clusteron theoretical problems

Tateyama cluster
on navigation skill
You are viewing from the south to the north. Plot the
points “a” and “b” of the photo(left) on the
topographical map(right).
Hypothermia: referring to p49-p63 of the accident report on
Tomuraushi disaster in the midsummer of last year 2009,
where 11 mountain climbers lost, exhibit a clinical lessons to
avoid accidental hypothermia in the Japanese mountains.
http://www.jfmga.com/pdf/tomuraushiyamareport.pdf
Nutrition: Exposit the mechanism of oxidative stressproduction during mountain climbing and explain how totreat the stress .
First aid kit at altitude: List up five drug groups which arebanned or need careful use at altitude higher than 4000m andgive medical explanation of the risk included.


photo

topographical map

An example of post-cluster examination

An example of post-cluster examination
Yatsugadake cluster; on meteorological task

Utsunomiya cluster: on trail runnung
You are the leader of the relief squad in a competition of trail run.
You are staying in the head office. A 38 year-old man took aseveral meters fall from the steep slope towards the flat terrain at
the point indicated by the red point . The discoverer radios toyou that he was lying on the ground and could not move hisextremities. He tells that the runner loses all sensation in his four
limbs though his pulse and respiration was stable. Write down
the way of dealing with him and his rescue in 600 to 800 words,
studying the more detailed topographical map. Note that only
you have a car in the relief squad.

You are climbing Ioudake（硫黄岳） from AkadakeKosen（赤岳鉱泉） via
Akaiwanokasira （赤岩ノ頭） in the morning of February 9, 2011 . You
encountered two climbers at the point of “X”with frostbite on theirright side of ala nasi, claiming violent wind on the ridge to Ioudake（硫黄岳） . Where and when do you presume they had their right side
injured? Choose one from A to E points and explain the reason byusing meteorological chart on the day and Yatsugadake topographicalmap.

DiMM Japan is growing

How many candidates completed the courses?
Pre-exam paper before each cluster : 90?
Participation in each cluster: 80?
Terminal examination after each cluster :40 to 7
Completion all clusters needed = DiMM holders
Registration numbers for DiMM Japan

85

35

46

51

58



93

66

*2010/05 *2010/07 *2010/09 *2010/12 *2011/03 *2011/06 *2011/10

Only three
No.001 Dr Hiroshi Kajitani awarded 11/June/2011
No.002 Dr Yasunori Chisima awarded 11/June/2011
No.003 Dr Takashi Sakamoto awarded 11/June/2011

35 registered doctors for JDMM at the opening Tanigawa cluster grew up to 93 (20 female and 73 male) now.
Their age distributed from 27 to 72 years old. They came from v arious specialties such as orthopedist, sports
medicine, cardiologist, chest physician, anesthesist, emergency physician, brain surgeon, neurologist, general
physician, surgeon, gynecologist, plastic surgeon, otolaryngologist, psychiatrist, and so on.
Greater than 40 people including mountain guides, climbers, skie rs, weather watchers, lawyers, government
officials, touring companies as well as physiological or medical researchers contributed to this program as alecturer or a field leader

8