VENOMOUS snake bites, ice climbing, and desert survival are hardly the stuff of an average NHS shift, but a growing demand for travel and expedition medicine worldwide has spurred clinicians in Glasgow to create the UK's first degree courses.
The new two-year Master's qualifications - one in travel medicine and one in expedition & wilderness medicine - will be delivered jointly by the Royal College of Physicians and Surgeons Glasgow (RCPSG) and Glasgow Caledonian University.
Students - expected to include doctors, nurses and pharmacists - are enrolled initially on a postgraduate diploma but can opt to complete a six-month dissertation to gain the Master's.
The current intake has attracted participants from Australia, the Middle East, India, Singapore, Hong Kong, New Zealand, Canada, and America, as well as the UK and Ireland, with a second cohort due to start at the end of August.
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The initiative is the brainchild of Dr Sam Allen, a specialist in infectious diseases and tropical medicine, who said the College was "continuing a 400-year-old tradition".
The RCPSG, founded in 1599, is home to the world's first faculty of travel medicine which boasts among its archives the medical kit used on African expeditions by the Blantyre-born missionary physician, David Livingstone, and a large collection of papers belonging to Sir Ronald Ross, who discovered the malaria parasite.
"Many names in tropical medicine actually derived from Scottish physicians," said Dr Allen.
"Leishmaniasis [a parasitic disease spread by sandflies] is named after William Boog Leishman, a pathologist.
"And there was Thomas Cochrane, a Glasgow medical school graduate, who went off to China and developed treatments for leprosy.
"The spread of western medicine came about through these people."
It is something Dr Allen - who is an advisor to the Scientific Exploration Society as well as Dean of the Faculty of Travel Medicine - has experienced first-hand as a frontline medic in Sierra Leone during the Ebola epidemic in 2015 and in Brazil as the outbreak of Zika virus took medics by surprise in 2016.
"It came out of nowhere," he said.
"The only reason it was reported was because mothers were delivering babies with small heads and often the cranium in the skull were collapsed - there were a lot of cases of that.
"Unfortunately many of them were in rural parts of north-east Brazil because they wouldn't have had ultrasound or screening."
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In 2001, Dr Allen also served as the medic on an expedition sailing from the source of the Amazon to the Atlantic ocean which saw him faced with a string of medical emergencies.
"Snake bites were very common," he said.
"Then there's things like dengue, and forest fires, bush fires, and lots of stinging insects.
"The Africanised honey bee can be quite serious, people can die from that.
"Also anaconda. None of [my team] got caught by an anaconda or boa constrictor, although in one of the villages we went to, about six months earlier, they'd had to cut out a missing fisherman who had been taken by an anaconda.
"We had to open up the belly of the dead anaconda and the decomposing body was there, so he was identified.
"That's pretty rare, but it does happen."
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Those signing up to the College's training courses are unlikely to encounter anything quite so grisly, but they will cover everything from treating broken bones and rapid blood loss outdoors, to snakebites, tropical fevers, frostbite, and how to use portable hyperbaric oxygen bags to relieve decompression at altitude.
There is a focus on hot and cold environments, with field trips to the Scottish Highlands and the Atlas mountains in Morocco.
Dr Allen said: "In Morocco, we do training with ropes, abseiling, trauma, search and rescue - map reading, using GPS, how to locate someone using an iPhone.
"We also camp out in the desert and look at how to spot venomous scorpions using ultraviolet light, how to look after camels on a trek, and how to find water in hot zones. Survival techniques, really.
"There's also a module in the Highlands for the cold experts, learning how to do avalanche rescue, use crampons, and ice climbing.
"How to rescue travellers that have got stuck in those sorts of environment, or medicine for people going on expeditions to Everest base camp and beyond, for example, who would wish to summit the peaks."
In October the Faculty will also host the anaesthetist who famously helped to rescue members of a Thai football team after they became trapped in underground caves in 2018.
The boys, aged 11 to 16, had to be sedated to prevent them panicking as they were pulled to safety through the tight, water-logged tunnels.
Dr Allen added: "It's a wonderful opportunity for students because these are the first courses of their kind in the UK, and travel medicine is a really burgeoning speciality around the world."
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