Courses — 5 May 2022 at 3:00 am

Endeavour Medical Altitude in Practice Course Review, European Alps

Dr Chris Grieco / FY2 / Somerset

Founded in 2021, Endeavour Medical is a new provider of wilderness and expedition medical training. Their large team of faculty boasts decades of experience in multiple extreme environments including mountain, jungle, polar, and desert with countless teaching and academic accolades to their name. Endeavour Medical delivers an array of courses, including global health and sports medicine courses as well as wilderness, expedition, and leadership offerings. The 2022 edition was the first iteration of Altitude in Practice for Endeavour Medical. Based in Morzine it provides the perfect location for easy access to the French, Swiss, and Italian Alps and is just 1hours drive from Geneva airport. The 2022 course was led by the founder, Dr Lucy Obolensky, Dr Nathan Hudson-Peacock, and Dr Shona Main, who combined, have an incredible passion and vast array of experience within expedition medicine. 

Key Facts

Duration: Five days of practical scenarios and ski touring to equip you with the knowledge and skills of an altitude medic

Dates: Late March 

Location: Morzine, France (Ski tour into Switzerland and Italy)

Cost: £1495 GBP (budget £400 additional for ski hire, flights, and food)

Qualification/ Accreditation: Course certificate worth 16 hours CPD

Delegates: 4-6 delegates (medics and non-medics welcome)

Prerequisites: Competent skier on black runs, ideally off-piste experience, and a physical fitness level able to hike for 4+ hours

Pre-course lectures: Total 5 hours of lectures pre-recorded by the faculty

The Course

On arriving in Morzine the faculty and course delegates with vehicles helped with transportation. Getting equipped with touring skis and boots was the first priority as well as being provided with an avalanche kit each by our mountain guide. The accommodation was a shared apartment at the foot of the ski slopes in the alpine village of St Jean D’Aulps, a 10-15 minute drive from Morzine allowing early arrivals to blow away the cobwebs with a few hours of downhill skiing. 

Example Course Contents

  • Pre-course lectures:
    • Altitude Medicine – physiology and management of AMS, HACE, and HAPE
    • Frostbite and non-freezing cold injuries – pernio, polar thigh
    • Expedition planning, leadership, and mental health
    • A-E of expedition medical kits
    • Expedition nutrition
  • Course content included: 
    • Ski touring
    • Practical expedition logistics and leadership scenarios
    • Managing and extricating casualties on steep ground
    • Avalanche rescue

Hitting The Slopes

For many of us, this was the first time ski touring so we were grateful to spend the first full day familiarising ourselves with the new equipment on the slopes. Our mountain guide, Guillaume, used this day to evaluate the group’s skiing ability and give individualised skiing tuition as we traversed the pistes on the French/Swiss border. By the afternoon we were confidently zipping about and skiing small off-piste sections.

We were blessed with clear skies, and bright sun providing glorious mountain views for miles allowing the famous Swiss peak, The Eiger, to come into view. 

Guillaume taught us the fundamental principles of using avalanche kits to find and extract a casualty. There are three parts to an avalanche kit, a transceiver (a.k.a beacon in North America), a probe, and a snow shovel. For a successful avalanche rescue, a casualty should be extracted within 15 minutes of the avalanche burying them to prevent asphyxiation. We learnt the importance of setting your transceiver to the correct mode before ski touring and keeping it far from any potential interference such as smart phones or credit cards. We hid and buried a transceiver in the snow. Guillaume expertly demonstrated switching his transceiver to SEARCH mode before successfully quadrangulating the position and rescuing the buried transceiver all in under 2 minutes. Our timings were slightly longer when we each attempted this! 

The first day was rounded off by a group trip into Morzine to watch a professional Ice Hockey game at the local rink. We cheered Morzine on to a home win whilst enjoying American-style hot dogs and an alpine beer.

The Monastery in the Mountains

On the second day, we set off from Morzine by car over the border into Switzerland for a three-day ski-touring expedition. Our resting place for the following two nights would be a 1000-year-old mountain hut that was home to several catholic monks. The Monastery is situated at an elevation of 8,100 ft, at the Great St Bernard Pass in the Pennine Alps, the border with Italy just a few hundred metres South.

After parking a few miles downslope from the Monastery, we donned skins to the soles of our skis, set them to walk mode, and made our way at a steady pace across the snow. We ascended over 500m en route to the Monastery, rehydrating and refueling on the way with snacks and baguettes packed that morning. Arriving at the refuge was a sight to behold, balanced on the ridgeline between two sharp peaks dividing Italy and Switzerland emerged several large monastic buildings. We were greeted with tea and soup from the Monastery staff including the charismatic Monk Raphael, before being shown to our spacious dorm rooms and shower facilities.

That evening, after dinner, the group broke off, some choosing to join the Monks’ daily prayer ceremony and others viewing the incredible museum. The museum, divided into two levels, documented the Monastery’s astounding history since founded in 1049 and boasted an array of taxidermy of the local wildlife. Following this, we stepped outside under the clear skies for a spot of stargazing before retiring to bed.

The next two days of the expedition followed a similar pattern. Rising early, we enjoyed a communal breakfast with the other hut guests before skiing over the border into Italy with a total elevation gain of 1000m. At the summit, we would soak in the incredible mountain views, de-skin our skis, and stow them away in our backpacks. We put our pre-course learning into action on the summits, carrying out scenarios such as a mountaineer suffering from high altitude cerebral oedema. Refueled on a packed lunch of cheese, salami, and exquisite Swiss chocolate provided by the Monks, we switched our skis into downhill mode and headed back down.

At the end of the three days, our guide returned us to Morzine by car. There was one last surprise in store that evening as Lucy drove us just out of town for a final group meal. Walking 10 minutes up a mountain track we reached a secret restaurant with Tibetan prayer flags blowing in the wind outside. The restaurant was a traditional mountain hut where we had a delicious set menu accompanied by a bottomless carafe of red wine. 

After the main course, the restaurant host appeared with a guitar around his neck and revealed a book of classic song lyrics. He explained it was a tradition that you must choose a song to sing to earn your dessert! Needless to say, we sang, enjoyed dessert, and continued to sing along to our host’s guitar as the red wine continued to flow. A fitting end to a fantastic expedition and a successful first iteration of the Altitude in Practice course by Endeavour Medical.

The Verdict

The course format was ideal for a physically active educational 5 days. With most of the theoretical learning done beforehand, there was very little pressure to squeeze in lectures in the afternoon or evening. This allowed for rest, recovery, and personal admin time after a long day skiing. It also meant that practical teaching sessions, like simulated casualties and avalanche scenarios, were taught throughout the day of ski touring and could occur during natural pauses when the group gathered together for a break on the piste.

These mountain-side teaching scenarios were supplemented by evening talks from Dr Shona Main and Dr Nathan Hudson-Peacock on medical kits, indemnity, and the practicalities of joining your first expedition as a medic. Thanks to the pre-course lectures these talks could be pitched as interactive group discussions and could use examples from the day’s events as learning points.

We all gained invaluable knowledge and experience through attending this course. We were all truly inspired by the experiences of the faculty and other course delegates by sharing stories of past expeditions and future endeavors. But more than this, we have each gained friends and connections with like-minded people who are each carving their own way on the expedition medicine path.

Top tips

  • Hire tight ski boots – oversized boots lead to blisters when ski touring
  • Bring a very spacious daypack 30-40l for the avalanche kit – shovel, probe, transceiver, skins, ski crampons, water, snacks, first aid kit, and helmet.
  • Go early to explore Geneva, or stay in Morzine for more downhill skiing
  • Embrace the monks’ evensong prayers at the Great St Bernard Hospice
  • Make time to watch all the lectures before the course
  • Log your CPD and add your certificate to your wilderness CV

To find out more about Endeavour’s Altitude in Practice  course in Morzine, see Endeavour’s website

Dr Chris Grecio at the time of writing is an FY2 Doctor in Taunton, Somerset. When not working as a doctor he leads educational foraging courses. @GriecoDr on twitter and @Tutti.fungi on instagram.

Photos courtesy of Chris Grecio, Lucy Obolensky and Johnathan Groves