Diploma in Mountain Medicine Programs: A Comprehensive Guide

The Diploma in Mountain Medicine (DiMM) is an internationally recognized certification designed to equip medical professionals with the essential skills and knowledge needed to provide high-quality care in challenging mountain environments. This article provides a comprehensive overview of DiMM programs, their structure, curriculum, target audience, and the benefits of obtaining this prestigious qualification.

What is the Diploma in Mountain Medicine (DiMM)?

The DiMM has established itself as a global benchmark for advanced mountain medicine training. It is an exciting program designed to train the participant in the essentials of caring for patients in the technical mountain environment. For over a decade, the DiMM has set the standard in Europe and other areas of the world for educating doctors, mid-level providers, nurses, and medics in mountain medicine and rescue.

The DiMM is an internationally recognized course certifying that the participant has undergone rigorous training and testing, adhering to accreditation standards established by the medical commissions of the International Mountaineering and Climbing Federation (UIAA), the International Commission for Alpine Rescue (ICAR), and the International Society for Mountain Medicine (ISMM) since 1997. The UIAA Medical Commission, together with its partners, the International Society of Mountain Medicine (ISMM) and the International Commission for Alpine Rescue (ICAR), has established and developed a joint Diploma in Mountain Medicine.

Many 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 a formal Diploma course in August 1997 (Interlaken, Switzerland). Many course organisers adopted these standards and the resulting Diploma in Mountain Medicine (DiMM) has become a widely respected qualification.

The regulations have been updated to reflect developments in mountain medicine, ideas presented at meeting of course organisers in November 2018 and to ensure that the high standard of the DiMM is maintained. The member organisations approved the administrative group to change the regulations at their individual meetings in Kathmandu, Nepal (November 2018). The regulations become effective for new and re-approval applications from January 2019. They were further updated in 2023.

Curriculum and Structure

DiMM programs typically encompass over 200 hours of didactic and hands-on instruction in mountain rescue. The course delves deep into wilderness pathologies and sharpens skills through simulated patient care scenarios in extreme terrains. The courses are divided up into three sections: foundation course, course for trekking / expeditions and a specialty course for Mountain Emergency Medicine. The specialty course is designed for the training of emergency physicians and paramedics working in mountain rescue organisations. The international syllabus covers altitude physiology and illness, expedition health, remote area trauma care, group psychology, travel medicine and also practical mountain skills.

A typical DiMM program includes:

Foundational Courses: These courses cover the core principles of mountain medicine, including altitude physiology, wilderness trauma management, environmental hazards, and expedition planning.
Expedition and Wilderness Modules: These modules focus on the specific medical challenges encountered during expeditions and in remote wilderness settings.
Rescue Specialties: These specialized courses provide training in terrestrial mountain rescue and alpine helicopter rescue techniques.

Specific Course Examples

Specialty Course: Terrestrial Mountain Rescue (60 hours) & Alpine Helicopter Rescue Specialty Course (53 hours): These courses are designed for Health Care Professionals who are (or are becoming) members of an organised rescue service. They should have been trained in Advanced Life Support (ALS) and be experienced in mountaineering to an appropriate standard. Curriculum A (Terrestrial Mountain Rescue Specialty Course Module) focuses on terrestrial mountain rescue. Curriculum B (Alpine Helicopter Rescue Specialty Course Module) focuses on air rescue operations in mountainous terrain and should at least attain the minimum standards and regulations of the region or nation.
WMS DiMM: The WMS DiMM aims to take the collective knowledge of the group and push and advance it further. “We are the Wilderness Medical Society, a community of medical professionals devoted to facilitating high-quality care in the outdoors. Our global membership and world-renowned experts affirm our collective authority to set clinical standards and disseminate the most comprehensive array of wilderness medicine knowledge. The WMS DiMM positions you directly in the center of this mission.
Northeast DiMM program: The Northeast DiMM program exceeds the requirements of the standard Foundational DiMM course and includes additional modules in Expedition / Wilderness and Rescue Specialties and Terrestrial Mountain Rescue. The Northeast DiMM program consists of four field courses and 36 hours of online wilderness medical and rescue education:DiMM Summer Rock Skills and Mountain Rescue Course (8 days) taught in beautiful Acadia National Park. Limit 12.DiMM Winter Mountain Skills and Rescue Course (7 days) instructed in the Presidential Range of New Hampshire. Limit 12. Level 1 Avalanche Course (3 days) or greater offered throughout the winter months. Does not require acceptance into the DiMM program. Limit 12.WMAI Wilderness Advanced Life Support Course (4 days) offered at least twice a year in Maine or New Hampshire. Does not require acceptance into the DiMM program. Limit 21. 36 hours of online wilderness medical and rescue education

Practical Skills

The other two week-long sessions will be aimed at acquisition of practical mountain rescue skills. The experts at Remote Rescue Training will teach these dynamic technical courses. The June session will take place on the glaciated slopes of Washington’s Mount Rainier and focus on rescue techniques in typical alpine mountaineering terrain. The August/September session will be located in Colorado’s Rocky Mountain National Park or Utah’s Wasatch Range.

In these phenomenal settings, participants learn technical rescue skills necessary to access and transport patients in rugged mountain terrain.

Target Audience

The DiMM is open to candidates that possess (or will possess in the near future) a nationally recognized professional medical certification appropriate to the level of the DiMM curriculum. These include Medical Doctor (MD), Doctor of Osteopathy (DO), Registered Nurse (RN), Physician Assistant (PA), Advanced Practice Registered Nurse (APRN), Paramedic (EMT-P), Advanced EMT (EMT-A).

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The DiMM is intended as continuing education for doctors, mid-level providers, nurses, and medics who work in or aspire to work in austere environments. More than 3,500 doctors, nurses and paramedics have been trained in these courses until now.

The specialty course is designed for the training of emergency physicians and paramedics working in mountain rescue organisations.

Active Duty and Reserve Navy Line Corpsmen or other Joint or Allied equivalent medical assets operating in support of Ground Combat Elements. Satisfies MAP requirements for field medical orientation. Scope: This course of instruction is designed to bring the student to a high standard of technical and medical proficiency particular to a mountainous environment. Prerequisite: Hospital Corpsmen is pay grades E3-E9, must have attended Field Medical Service School (FMSS) and possess NEC: 8404 and Tactical Combat Casualty Care (TCCC). Medical Officers attached to operational units are encouraged to attend. Any other applicants will be approved on a case-by-case basis by the Course OIC.

Locations of DiMM Programs

DiMM programs are offered in various locations around the world, each providing unique learning experiences and access to diverse mountain environments.

United States: The Wilderness Medical Society is partnering with the University of Utah and University of Colorado to introduce this exciting program in the USA. CU offers four weeklong sessions that include travel to Washington, Utah and Rocky Mountain National Park.
Northeast United States: This ground-breaking program is the first of its kind in the eastern United States and is a collaboration bringing together instructors and resources from the Dartmouth Hitchcock Medical Center Wilderness and Austere Medicine Fellowship program and the Acadia Mountain Guides Climbing School in Bar Harbor, Maine.
The Andes: The DiMM of the Andes is brought to you by Faculty of the Wilderness & Environmental Medicine section of the University of Colorado, USA. This expedition course will have a nomad spirit, rotating yearly on the different sub-ranges of the Andes (Cordillera Blanca, Patagonia, Central Andes, etc), we decided on this approach to positively impact the different countries of Latin America, offer a diversity of cultural and terrain experience and hopefully give you the chance to join us year after year in a variety of venues!

Admission and Progression

To begin your pursuit of the DiMM, enroll as a DiMM candidate by submitting the deposit in the Trading Post. Unless notified otherwise, you should then register as a DiMM candidate (instead of "Doctoral" or "Non-Doctoral", etc.) for the WMS Winter and/or Summer Conference(s). You should not register for either of the DiMM field sessions until you have completed at least one Winter or Summer session.

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New course organisers are encouraged to discuss with, and invite, members of the UIAA Medcom, ICAR Medcom or ISMM to observe their courses. For new courses, approval is for two years. When a course reapplies for approval, the organiser must provide information on the number of successful and unsuccessful candidates during the previous period and provide an external assessor site visit report. Re-approval is for four years. The Diploma in Mountain Medicine cannot be awarded to basic life support personnel (EMT’s, First Responders, First Aid, etc.). Students in the final part of their course can start the course but must be registered prior to award of the full qualification. The course can be divided into different parts appropriate for the organizing country (e.g. This must have a minimal study time (lectures, workshops and practical work) of 120 hours. Course organisers can determine who can attend the course and the speciality offered. In addition, course organisers may seek University status for the course. Applications are to be English and a separate form is required for specialty modules. The administrative group will discuss the application and the course organiser will be notified of its decision. We will acknowledge receipt of the application within three weeks. We may ask for further details within one month. A definitive answer regarding registration of the course will be given within three months. If you are a doctor, paramedic or nurse who would like to take part in a mountain medicine course approved by the UIAA, please contact one of the institutions listed below for details.

ProgressionComponents may be taken in any order (although some components have required pre-course on-line work) and participants have up three years to complete the entire program to achieve their Diploma in Mountain Medicine.

Evaluation

The academic nature of the Diploma requires participants to pass both written and skills examinations in order to complete the program. During skill sessions, instructors perform reasonable remediation for any participant that does not meet the minimum skill standards set by ICAR/UIAA/ISMM and the WMS DiMM. If the participant still has not passed these skills by the end of the session, as determined by the instructors, he/she will be required to re-take that session at their own cost. The participant will be given a maximum of two attempts to successfully complete any certain skill session and two attempts to pass a specific written exam.

DiMM candidates must complete both practical and written assessments. The evaluation will be a combination of practical and on-line evaluations following several of the sessions. Each participant is allowed a maximum of two attempts for any specific skill session and two attempts for the written exams.

*Opt-Out from WALS Course. A candidate who, upon completion of other DiMM component courses, has a current WMAI Wilderness Advanced Life Support certification is exempt from taking repeating the course. The candidate will still be required to take the DiMM WALS exam. If the candidate does not pass the exam, they will need to retake the WALS course.

Opt-Out from Avalanche Level 1 course: A candidate who has taken a Level 1 avalanche course or higher (that meets AAA standards) within the last three years and has backcountry travelled in avalanche terrain at least eight days per season since attending the course does not need to take a Northeast DIMM avalanche course. Candidate is still required to take the DiMM avalanche course exam.

Faculty

Definitive mountain medicine authorities serve as faculty at both the WMS Winter Conference and Summer Conference portions.

Examples of faculty include:

Jonathan Glass, MD: A US Navy veteran and board-certified Dermatologist with a focus on developing access to high-quality Dermatology care and training to underserved communities and rural health / primary care providers.
Brian Irwin, MD: A primary care provider specializing in Travel Medicine and operates a travel medicine clinic. He was the expedition physician for National Geographic’s exploration of Guyana in 2022.
Evie Marcolini, MD: Vice Chair of Faculty Affairs for the Department of Emergency Medicine and practices Emergency Medicine and Neurocritical Care. She has led expeditions for the Outward Bound School in Maine for many years, and has led multiple climbing trips in the White Mountains, both Summer and Winter.
Richard Trierweiler, MD, MPH: An ultrasound fellowship-trained emergency medicine physician with significant experience in wilderness and austere medicine.

Benefits of Obtaining a DiMM

Graduates emerge equipped to adapt medical practices to mountain settings and assume leadership roles within rescue teams worldwide.

Enhanced Skills and Knowledge: The DiMM provides participants with a comprehensive understanding of mountain medicine principles and practical skills in wilderness rescue techniques.
International Recognition: The DiMM certification is internationally recognized, demonstrating a commitment to excellence in mountain medicine and adherence to the highest standards of training.
Career Advancement: A DiMM qualification can enhance career opportunities in various fields, including expedition medicine, search and rescue operations, mountain guiding, and wilderness medicine education.
Personal Development: The DiMM challenges participants both physically and mentally, fostering personal growth, resilience, and leadership skills.

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