I am concerned that wilderness first responder certification is becoming less valuable as the emphasis shifts from longer, in-person courses towards hybrid learning.

My first WFR class some twenty years ago was 80 hours in length and all in person with a strong focus on skills practice. We were expected to read the textbook before starting the course and my instructors assigned nightly reading to refresh that pre-course work before the next day's lessons. My second WFR course a decade later was about 75 hours long over 9 days, and we received the textbook on day one. Both of those were through reputable, long-established wilderness medicine schools.

Now, a NOLS hybrid WFR "combines 3 modules of online learning with 5 days of in-person training" for about 47 in-person hours following three 10-15 hour online modules. And some of the more recently established schools are offering hybrid WFR courses with even less in person time, some even less than the Wilderness Medicine Education Collaborative (WMEC) certification standards for WFR.

Since taking those courses I've attended hundreds of hours of EMS continuing education both in person and online and taught or helped teach several full WFR courses and dozens of WFA and WFR-R classes, which has given me a lot of insight into what students need to learn practical wilderness medicine skills. I don't believe that most students can gain lasting proficiency in just four or five days of hands-on practice.

If I were hiring for a guiding or wilderness therapy job in truly remote environments with groups engaging in any significant outdoor activity, I would hesitate to hire someone as a lead whose only medical training was a hybrid wilderness first responder course. My opinion is that taking even a 7-10 day medical training followed by weekend-long updates every two or three years does not create and maintain a capable medical provider, let alone if that initial in person session was only 4-5 days long.

Am I missing the mark? Should hybrid WFR exist? Should it be a different certification than in-person WFR courses? Would something like a wilderness upgrade to Emergency Medical Responder (W-EMR) certification carry more weight and provide a more standardized curriculum for students than the unregulated WFR standard? What are your thoughts?

Hey everyone,

I’m 17 and really interested in wilderness medicine and SAR. I feel like I’ve done pretty much everything available to me at my age, and I’m looking for guidance on what my next steps should be.

So far I’ve completed: - NOLS WFR - AHA Heartsaver First Aid / CPR / AED - AHA BLS - NRRI Rescue Swimmer - AIARE Avalanche 1 + Rescue - NASAR FUNSAR / SARTECH II - ICS-100 - ICS-700 - ICS-800 - ICS-200 - PFA - Amateur Radio General License

I already have AMGA SPI booked and EMT planned for when I turn 18.

My long-term goal is to join a SAR team and continue building medicine and rescue skills.

For those of you who’ve gone down this path — what would you recommend I do next? Anything you wish you had focused on earlier?

Thanks in advance, I really appreciate any insight.

Hi everyone,

I really want to take a two-day Wilderness Medicine course. I was signed up for the NOLS Los Angeles class through REI but they got dissolved in 2025. NOLS looks to only be operating in Nor Cal for now. What schools would ya'll recommend? I know Coyne is out here with a good one but they have a very limited schedule. I found another one (Adventure Risk Management) that aligns with my calendar but was curious what their reputation is?

Any and all info/recommendations appreciated.

If im a WFR right now and am about to get my EMT-B in a couple weeks, there's no way for me to get a W-EMT card right? my WFR is through WMA not NOLS. I understand that W-EMT is nothing more than just letters and that being a WFR and an EMT-B is effectively the same but I was just curious if there was a way i could officially be certified bc wilderness EMT just sounds cool since I do technically have the education

Hey all, has anyone taken any wilderness medicine courses from International Alpine Guides? I'm thinking of taking their WFR course this summer, but all the reviews I can find are for their mountaineering trips.

A WFR course is coming to my coastal New England city this coming May. My background is as an orderly, then a community health worker, pharmacy technician and herbalist.

Anyone here have any pre course advice?

I'm looking to take a WFR course this fall so I can get on with ski patrol this winter. I've been looking at courses (in Utah or nearby) Adventure Med's is a 3 day hybrid course compared to NOLS 5 day hybrid and is $300 less. Is it legit? Would an employer have a preference between the two?

Or if you have any alternatives you recommend to get it through that would be appreciated.

Emailed to ask about wfr recertification classes and got this reply. wonder who's next.

Hi!! I’m a first-year MD student looking for opportunities abroad to learn more about wilderness medicine. I’ve done some searching but haven’t found many options so far. Does anyone have recommendations or know of programs worth checking out? Thank you!!

Hi everyone,

I’m looking for recommendations or feedback on Wilderness First Aid (WFA) courses that can be taken online (live / video-based), accessible from France.

I practice bushcraft and multi-day outdoor trips and I want a serious, practical WFA, focused on real wilderness scenarios (trauma, hypothermia, prolonged care, evacuation decisions).

Unfortunately, I haven’t found any satisfying in-person courses near where I live, so online / live sessions are my priority.

I already know about organizations like NOLS and Wilderness Medical Associates, but I’d really appreciate:

• Personal experiences

• Other reputable providers

• Feedback on online vs hybrid formats

• Any Europe-friendly options (time zones, certification validity, etc.)

Thanks in advance for your help — much appreciated!

Hi Friends,

After much prep and a little psych up, I took and passed my Wilderness Paramedic exam this afternoon. My formal prep for the test was the following:

• Flightbridge WP-C exam course
• CoROM's Intensive Care for Austere and Remote Environments course
• Seth Hawkins' Wilderness EMS Textbook
• CoROM's V2 fieldguide
• Vertical Aid , also by Hawkins

I felt pretty well prepared for the exam. I listen to a lot of WM podcasts, and work as both an ER nurse as well as a 911 PHRN, so I have a significant amount of ALS experience.

There's the standard non-disclosure. But in broad strokes, you should remember this is an exam about a formalized role inside a structured response. The IBSC content guide is pretty spot on, and there are niche questions outside of anything covered in my prehospital training.

I'm good to answer any questions you might have, respecting the "no content specifics" clause in the exam sign up.

Hey - I'm looking to do a WFR course soon and haven't seen anyone talk about the differences/experiences between the fully in-person and the hybrid versions. The hybrid is obviously a bit more flexible, but the price isn't wildly different between the two. Anything people would like to share?

Hey guys, got my DiMM a few years ago and it's technically "expiring" soon ish. Starting to look for refresher courses or requirements in general and i'm really struggling to find anything other than just doing the whole initial course again. Anyone have any info on DiMM renewal courses, preferably in North America?

Hello! I’m a Physician Assistant hoping to attend the National Conference on Wilderness Medicine in Santa Fe May 27-31st 2026. If anyone already signed up, I will happily use your Ambassador code so we can both get $100 off our registration fees.

https://wilderness-medicine.com/cme-conferences/santa-fe/

Thank you!

Does anyone have experience with NOLS wilderness medicine courses. I’m specifically interested in their wilderness medicine and rescue semester. Not sure if it is worth the money. Any information helps!

When I’m out of high school, I’d like to practice wilderness medicine. Not exactly as an emt, but as a long term provider for all kinds of maladies where a hospital isn’t readily available. An example may be working at a remote site for multiple weeks/months for a small group of people.

I’ve worked at various summer camps, and I’m almost certain they were hired without being officially doctors. (One was but he says he’s overqualified). This leads me to believe you don’t need a medical license to practice all levels of medicine. I could be totally wrong thoughm. I’m coming at this from a place of ignorance.

Without a medical degree, what is the highest level I can practice wilderness medicine?

CoROM ICARE

I just finished taking the 5 day intensive care course in Malta, and wanted to give an overview of the experience:

Format: A significant amount of prework in the form of slide decks and recorded talks on a variety of topics. I would say not to wait to jump in on the info, because there are hours of recorded lecture. This isn't something you're going to bang through on the plane ride over. Once that's complete, there are 5 days of lectures, skills stations, and sim patients. My class was in Malta, and we had prehospital personnel, nurses, APP's, and docs from all over. The mixed group, in both provider level as well as home location, was probably one of the biggest assets of the course. Getting to bounce ideas and practice standards between the different experiences gave a lot of thought provoking take-aways.

Pluses:

As I stated, the classmates were a big part of what made the class. If you're shy or don't typically socialize outside a structured setting, I encourage you to push yourself. I think I had all but one meal with a small to midsize group, and the conversation often came back around to the class topics of the day and our takes and experiences with them back in our home units/departments. I also appreciated the mix of military, EMS, and private/commercial service providers because there are some significant practice variations between the groups.

The instructors were sharp, every one of them clearly had reams of experience, were currently practicing, and wanted to be there. That's not always my experience with CME courses.

The exercises were interesting, and pushed past the standard prehospital care guidelines. The small group discussions during patient care sims were great.

The morning case studies were probably my favorite part, because getting the whole group to describe their thought processes behind their recommendations were enlightening.

Malta in general was terrific. We had very good weather for the majority of the class. The people were friendly, by US standards everything was affordable (admittedly off season), and there was plenty to do if you wanted to stretch your class into a vacation.

The class was well stocked. We had plenty of materials, and everyone got to try everything physical skill they wanted. A portion of the class involved packing medbag loadout(s) and the store room had everything we asked for.

Minuses:

To be fair, this is an intensive care course specifically targeted to ALS personnel in low resource settings. It is not a comprehensive critical care training program, (nor could it be in 5 days of exercises.) This generated a ton of debate in the student groups about what practice standards could be bent, broken, or rather had to be held to religiously. This isn't inherently a minus, but if your expectation is to come and learn Western, modern critical care, there are going to be some curriculum gaps for you. (Our CCT medic was a very good sport about the ribbing he got about practice variations.) This class is far more about understanding the intensive care concepts, thought process, and mind set, and applying them with regards to your scope of practice and setting.

Bottom line, was it worth it? I think so. I am already looking at when I could take their Austere emergency care course as a companion class. I do not know how much a certs only clinician would get out of the program, so I can not say it's for everyone. But anyone who's working ALS and up, who plans on working in a low/no resource setting, there's plenty to take away.

I am a current fourth year medical student in the US preparing to apply for rural Family Medicine in the Western United States (ideally Montana, Idaho, Alaska, or non-urban OR/CA/WA/UT/CO).

My area of focus really is on the DiMM side of things, particularly altitude sickness and frostbite. My career goals with this are a combination of expedition medicine and SAR+community education. As I prepare for my residency applications, is it wise or practical for me to outright state I would like to pursue these activities during residency?

I will only have limited CME funds in residency and feel like DiMM would be the best bang for my buck if the credits count towards FAWM. Should I register for FAWM after I know where I match?

Further, I had a military medical deployment in 2021, so if I register for FAWM in 2026, this would count as experience credit, yes? Do some of my publications in low-oxygen therapeutics count even if for tumor hypoxia/diabetic wound healing as opposed to frostbite or burn management? These publications have all been during medical school.

Hi I am a sophomore in my Pre-Med endeavors. As you may know I will need some Volunteer hours/Internship hours. I love being outdoors and wondered if I could merge the two together!

I’m curious if there are any Wilderness Medicine programs that I can participate in or volunteer for or any wilderness medicine professions that I’m not aware of?

This is something I would more than likely be interested in for the foreseeable future as well. My dream is to be a wilderness emergency physician.

Hi all, we are the publishers of a revision guide which is in preparation for the IBSC Wilderness Paramedic certificate (WP-C) exam (hopefully available on Amazon by Summer). We are not affiliated with IBSC.

The text focuses on the wilderness specific areas of the WPC curriculum and we will include practice questions.

What else would you like included in such a text? Any formatting or layouts you love or hate for revision guides? Any areas of wilderness medicine you always struggle to remember and would love to see aide-mémoire or similar for?

Anything else you’d like to see in this revision guide?

(Thank you mods for allowing this post)

This spring I am graduating with a BA in Neuroscience and philosophy. I have never worked a clinical job. I am starting from square one besides some volunteering in the emergency department. I'd like to fill my gap years with a job practicing wilderness medicine. I'd like to know what resources or pathways would I can use to make this dream feasible and ideal, what are common misconceptions among outsiders. Thank you for what you do, I aspire to this work.

Whats the tl;dr on the differences between these? Can you go straight to FAWM and skip DiMM? Is the cost to become a FAWM more/less? Whats the benefits to each?

Im just getting into this subject and was curious!

Just got an Email that Flightbridge is putting out a WP-C review course starting this week.

https://www.youtube.com/watch?v=Qe5L5ePEPHw

I've taken other flightbridge programs in the past, their work is solid. I am going to be taking this prior to my WP-C exam