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At the heart of general practice since 1960

We heard nowt about our premises cash ­ seems the NHS is broke to me

Dr Laura Patterson recalls the thrills

and spills of a week spent learning expedition medicine in Norway

Earlier this year I set off on an unusual week's study leave ­ to Alta, northern Norway, just inside the Arctic Circle. The course was designed to equip a medic with enough knowledge to safely lead an expedition in a polar environment. Based around outdoor activities and lectures, it culminated in a challenging rescue designed to use all the team skills. At times I did wonder if the safety of the postgraduate centre would have been wiser.

The group, which consisted mainly of doctors, was split into several smaller groups for the daytime activities. Our team's first venture was skidoo travel. We set off on a 60km round trip, up on to the plateau with our local arctic adviser. We quickly mastered the skidoo, including under the bonnet. I certainly know more about the mechanics of a skidoo than my own car.

Travelling back to base I recall how quickly the weather changed, especially as the sun disappeared. My fingers were cold and painful and the wind biting, and I was very tired. I realised how easy it would be to become disorientated and the next minute our skidoo had gone up on to a ridge and we were separated from our team. We did all return safely.

The second day for our team was spent dog-sledding. This for me was the best day of the whole course. We were each given a team of dogs to harness up, and some instruction on how to operate the dogs and sled. Out on to the plateau the snowy desert was beautiful. The sound of the dogs was all we heard as they glided across the fresh snow. We stopped for lunch on a frozen lake with flasks of hot chocolate and of course a few snowball fights. Our return journey was in the shadow of an amazing red fiery sunset. Descending again into the valley was like a rollercoaster ­ a real test of skill, nerves and upper body strength. The dogs raced downhill through the twisted forest path at high speed. I had a few encounters with deep snow, but once safely back I thanked them with a big feed for the night.

The following day we tried our hand at cross-country skiing. We skied up to the plateau with much laughter as we all kept falling into the snow. After lunch we built several kinds of emergency shelter, including snow holes. We managed to get six of us into one, but it was a bit cosy!

The last form of transport we tried was snowshoeing, which was very effective in deep snow. We had a lovely but exhausting walk through the local forest, with the sun glinting on the snow. There was also an opportunity to immerse yourself in the waters of a frozen lake. It wasn't for the fainthearted, but at least there were plenty of medics on hand if required!

The course culminated in a rescue scenario. All the skills we had learned were vital. I was most fascinated to find that absolutely everyone found their role in the team. With much laughter and falling over in the snow we managed to return our casualties to base, warm and with no further injuries.

Of course this was study leave, and some lectures were included among our outdoor activities. I congratulate the course organisers for achieving such a good balance. We learned about communication systems, clothing systems, hypothermia, public health and frostbite. There were also lectures in pre-expedition and casevac planning and aero-medical evacuation.

After lectures there was plenty of time to relax, shower, jump into the hot tubs or enjoy a drink at the ice bar before dinner. The locals also treated us to some local sports, including a relay race that included an enormous amount of cheating.

The course was advertised in the BMJ or details can be found on Expedition Medicine's website. No other requirements are needed except enthusiasm, willingness to participate and a reasonable level of fitness. The course members were from varied backgrounds ­ GPs, junior doctors and consultants. There were also one or two nurses.

Some of the course members had previous expedition experience, but it is certainly not a requirement. Expedition Medicine sends an impressive induction pack and clearly tells you what kit is required and what is provided. The temperature can go down to -30°C so plenty of layers are important.

Accommodation was in simple cosy wooden chalets. The meals were hearty and enjoyed by all. There was plenty of tea and coffee in the afternoons, and a bar for the evening.

The UK office staff were very helpful and very efficient. I was able to use their agent in Norway to book a night in the ice hotel and arrange transfers.

It was an amazing week and a high-quality course. It is great for networking with others who are interested in expedition medicine, as there is such a wealth of experience ­ not just from the course leaders but from those on the course who have already done expeditions.

Even if you don't plan to use your new skills it is a good reminder of how effective good teamwork can be. It's refreshing to learn some new skills in an extreme environment with a bunch of like-minded individuals.

Details are available from: www.expeditionmedicine.co.uk

Laura Patterson is a GP in Cirencester, Gloucestershire

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