Courses, News & Features — 19 May 2023 at 11:00 am

Healthcare in Remote and Extreme Environments MSc, University of Tasmania: An Overview

Dr Georgina East / General Practitioner and Expedition Medic / Queenstown, New Zealand

Dr Daniel Lack / General Practitioner and Technical Rescue Specialist / Tasmania

Dr Robert Dickson / General Practitioner /  Australian Antarctic Division, Tasmania

The Healthcare in Remote and Extreme Environments (HREE) programme at the University of Tasmania (UTAS) has been developed by organisations collaborating at the Centre for Antarctic Remote and Maritime Medicine. Nurses, paramedics, and doctors can complete a range of postgraduate short-courses and full-credit university subjects which contribute to a Graduate Certificate, Graduate Diploma, or Master’s Degree in Healthcare in Remote and Extreme Environments. Courses and subjects can also be completed as standalone units. The coursework mixes online distance learning with in-person residential courses and camps. The residential components are also open to outdoor professionals, enthusiasts, and others looking to develop their skillset. You meet like-minded individuals, you share some incredible experiences in the glorious outdoor playground of Tasmania, and, importantly, you have the opportunity to formalise your learning and training in the burgeoning sector of outdoor/wilderness/remote/extreme medicine.

Course content

The HREE programme provides a diverse selection of units of study all united thematically under the banner of ‘remote and extreme environments’.

The foundational units in the Graduate Certificate focus on the clinical, technical, and logistical aspects of providing healthcare in remote and extreme environments.

The specialised elective units, which are encountered if continuing on to the Diploma, constitute a deeper dive into specific domains such as extreme sports, space, psychology, and maritime healthcare.

Some courses have residential components, while others are completed entirely online. There are some palpably consistent themes at the core of remote and extreme environment healthcare that tie the coursework together. These are:

  • How context influences clinical decision making
  • How to approach and manage risk in extreme and remote settings
  • How to expand our thinking to encompass the broader considerations of providing healthcare in diverse settings – ie. All the extra things to consider that work in a conventional, well-resourced healthcare system does not prepare you for.

The courses all provide a definitive overview of their topic content – mixing the key learnings, guidelines, experiences, and literature to provide engaging and comprehensive units of study. While most of the content is delivered online, the HREE programme requires you to actually go to Tasmania and meet your peers while gaining some hands-on experience. This is quite possibly the best aspect of the programme. While self-paced online learning is convenient, it is inspiring to meet a diverse group of like-minded people, also enthusiastically chasing their interests in the outdoors and exploring unique ways to practice healthcare

Prerequisites

This is a postgraduate programme open to nurses, paramedics, and doctors with at least two years of postgraduate experience. Some personal and professional experience living, working, and/or exploring remote, extreme, foreign, or diverse contexts will help you get more out of the course. To complete a Graduate Certificate, Diploma, or Masters you will need to travel to Tasmania to attend the residential components of some courses.

At the moment the programme is only open to Australian and New Zealand residents, although this may well soon change. Fortunately, three of the courses with residential components can be taken as stand-alone units by anyone keen to visit Tasmania. These courses are Expedition Medicine, Medical Care in Offshore and Inland Waters, and Extreme Sports Medicine. They are run in succession during the year, potentially allowing someone to complete all courses over several weeks.

Duration and Time Commitment

The HREE programme will offer the most to those who are able to make a significant commitment to the learnings. From crossing paths with many HREE students over the years, the majority are either already working in remote and extreme environments, or actively looking to explore that kind of work in the future. The time commitment is justifiable if you are following a strong interest and/or it has direct practical relevance to your day job.

In terms of full-time equivalent study:

Graduate Certificate:

4 units of study => 6 months post-graduate education full-time equivalent               

Diploma:

8 units of study => 12 months post-graduate education full-time equivalent

Masters:

8 units of study plus 12 months Master’s by research or professional portfolio => 24 months post-graduate education full-time equivalent

This amounts to a minimum of 10 hours of study a week for each 13-week semester.
Most students will complete one or two units at a time, slowly working towards a certification.

Location and Cost

Graduate Certificate

  • Operational Aspects of Healthcare in Remote Environments – online: $3,456 AUD
  • Medicine in Extreme Environments – online: $3,456 AUD
  • Expedition Medicine – pre-course online learning and 8-day residential in Tasmania: $5,990 AUD (for health professionals), $5434 AUD (if taking it as a subject as part of Grad Cert), $2995 AUD (non health professionals)

Diploma

  • Human Behaviour in Extreme Environments – online: $2,546 AUD
  • Humans in Space – online with compulsory attendance at a virtual conference: $5434 AUD
  • Extreme Sports Medicine – online with a residential short course in Tasmania: $3550 AUD or $5,434 AUD (if part of the diploma)
  • Medical Care on Inland and Offshore Waters – pre-course online learning, 8-day residential in Tasmania: $5990 AUD (health professionals), $2995 AUD (non-health professionals), or $5434 (if taking it as a subject as part of Grad Cert)
  • Advanced Clinical Reasoning in Out-of-Hospital Practice (Paramedics only): $2,522 AUD

Masters  

  • Completion of the Diploma, a general university unit of study in research methods, and then the achievement of a Master’s by professional portfolio or research.

The programme was developed with input from the Australian Antarctic Program. Doctors employed by the Australian Antarctic Programme can complete these courses for free. For Australian and New Zealand residents it is likely that this coursework could be claimed as a tax deduction if you are working in a related field. Of course, it is worth checking on a website or with an accountant.

The Instructors and Facilitators

The HREE programme is ‘by the people, for the people’. The main facilitators are nurses, paramedics, and doctors themselves with diverse lived experiences in remote and extreme areas. The expedition and maritime courses additionally enlist the educative services of the technical outdoors and seafaring experts respectively. The specialised units with residential components also pool together an impressive array of field leaders to help deliver the content.

General Overview

These days there are more and more people working, living, deploying, and playing in remote and extreme environments. These people need healthcare. There is a growing mandate for this healthcare to be best practice, and for healthcare providers to have the right training and knowledge for the job. Whether it be providing medical coverage for an endurance sports event, on a cruise ship, or expedition, volunteering in a low-resource setting, or even medically clearing someone as safe for space – you need to be able to do it competently and safely. The HREE programme sets a strong professional standard for healthcare in remote and extreme contexts, as well as providing an avenue to explore interests and open opportunities. The coursework does not focus on fundamental clinical skills – that is assumed knowledge – but challenges students to apply core knowledge to dynamic and dramatically different new contexts.

All of the in-person residential coursework is excellent. The success is driven by the joy of experience-based learning among like-minded people. Students come into the programme with diverse backgrounds and experiences, ready to share knowledge. It needs to be said that online learning can be quite impersonal, so having met a few people already through the residential courses is a real bonus. Subsequently, students tend to be more open and enthusiastic about engaging with peers on the discussion boards – and they get much more out of the coursework.

Very generally speaking there are two types of potential students – those early in their careers with limited experience of working in remote and extreme environments, but looking for a way into that world, and those with experience behind them who are looking to consolidate and develop their knowledge further. To understand the concepts and considerations central to the HREE programme, it pays to have seen remote and extreme areas a bit yourself. If you are in your first few years of working and have only ever seen things from an urban healthcare vantage point then it is worth getting some broader experience first.

As this is a postgraduate course, almost everyone will be juggling work commitments and study. Most people will work their way through units at a steady pace, and this is probably the recommended route. There is a lot of coursework to explore. The assignments are designed to reflect real-world situations and they employ skills and thinking central to the programme. It is clear that they are not typical University essays. For this reason, you will want to be able to invest the right amount of time to do the tasks properly – it is worth maximising the experience.

The HREE programme is ambitious not just in its scope, but in its attempt to impart the kind of knowledge you traditionally could only ‘get’ by experiencing it firsthand. The programme gives you building blocks, opportunities, and a community – making it entirely possible for students to truly develop themselves if they are up for the challenge.

These courses expand your horizons as to what is possible in healthcare. The formal qualification at the end of it does not specifically ‘qualify’ you for anything, but it is reasonable to expect that some kind of formal training will become the standard for practitioners working in the remote and extreme healthcare space.

See next week’s release for our full review of the course.

Links for Further Information

UTAS information page: https://www.utas.edu.au/health/study/postgraduate-coursework/healthcare-in-remote-and-extreme-environments

Course Handbook: https://www.utas.edu.au/__data/assets/pdf_file/0011/1581392/HREE-Handbook- 2022.pdf

Centre for Antarctic Remote and Maritime Medicine: https://www.carmm.org.au

Photos courtesy of: Dr. Georgina East, Dr Daniel Lack, and Dr Robert Dickson