Fitness to Work as a High Altitude Medic

Written by and imagery provided by Dr Hannah Lock | The Mountain Doctor

Table of contents

• Physical Fitness: A foundation for safety and performance

• Altitude Acclimatization and Adaptation 

• Technical and Environmental Proficiency 

• Mental Fitness and Resilience

• Medical Competency in Remote Settings

Dr Hannah Lock | The Mountain Doctor

I’m Dr Hannah Lock, a portfolio career doctor. Alongside my role as an NHS Emergency Medicine Speciality Doctor, I work as an Expedition Doctor specialising in high altitude mountainous areas. In my none-clinical roles, I work as a freelance teacher on mountain and expedition medicine courses, and run my own online school of mountain medicine, called The Mountain Doctor, where I create online courses and resources. 

I’m very fortunate that my expedition medicine work has taken me to incredible places such as the Nepal and Indian Himalaya, the summit of Kilimanjaro (twice), mountaineering on active volcanoes in Ecuador, trekking ancient mountain routes in Bhutan and crossing freezing rivers in Iceland. 

Working as a medic in high altitude mountainous environments is a physically and mentally demanding role within prehospital care. Unlike urban settings, expedition medicine requires a unique blend of clinical expertise, physical endurance, technical mountaineering skills, and psychological resilience. This article explores the key components of fitness to work for medics operating in mountainous terrain. 

Physical Fitness: A Foundation for Safety and Performance 

Mountain medics must be able to traverse steep, rugged terrain often at high altitudes and in extremes of temperature. Activities like ascending peaks, carrying a heavy pack with your personal kit plus medical equipment, or reaching an injured casualty quickly in remote areas demand excellent cardiovascular health as well as upper, lower and core body strength.

Whilst the medic doesn’t need to be a professional athlete, fitness, endurance and strength need to be higher than average so that they are not just able to complete the mountain challenge, but so that the activity always feels within their comfort zone to ensure they can step up a gear if needed in an emergency.

Altitude Acclimatization and Adaptation

High-altitude environments present physiological challenges due to reduced oxygen availability, leading to increased cardiac strain, and risk of altitude illness which ranges from mild to life threatening. The body can usually adapt to these changes (within limits) but only given the right amount of time and preparation. 

Medics working at altitude must: 

• Understand, prevent, monitor for and manage altitude illness in self and others 

• Acclimatize by allowing appropriate time before ascending further 

• Be fit enough to maintain performance despite hypoxic stress 

Technical and Environmental Proficiency 

Physical fitness must be complemented by technical mountain skills relevant to the environment they are working in and objective the role demands of them. These skills often require their own form of specialized training and experience. 

Examples of essential skills for mountain medics: 

• Navigation in poor visibility (map, compass, GPS) 

• Use of crampons, ice axes, and other winter mountain equipment 

• Crevasse rescue and glacier travel (in alpine settings) 

• Avalanche awareness and safety 

• Rope access and self-rescue techniques 

Regular practice of these skills ensures the medic is not only capable but confident under pressure. 

Mental Fitness and Resilience 

Mental fitness is critical in any high pressure job. When things don’t go to plan on expeditions, it’s often in challenging environments when people are tired, cold and hungry.

The key to working in these environments is being able to manage your own physical and mental wellbeing so that you can perform at your best under pressure even when the elements are against you. Working in remote environments with limited resources means that the medic often functions autonomously - mental clarity, confidence and resilience are key. 

Medical Competency in Remote Settings

While physical and environmental readiness are vital, the medic's clinical role cannot be understated. Mountain medics must be capable of delivering high-quality care in challenging conditions. 

Core medical skills include: 

• Trauma management  

• Altitude-related illness management 

• Hypothermia and cold injury treatment 

• Management of minor illness and injury 

• Improvisation with limited resources 

• Prolonged field care and evacuation strategies 

Being physically and mentally fit ensures that the medic arrives capable of providing care—being clinically prepared ensures that care is effective. 

Final Thoughts

Being a medic in mountain environments requires far more than just medical knowledge. It's a high-risk, high-responsibility role where fitness and environmental experience isn't optional—it's essential. Physical preparedness, combined with technical competence and mental toughness, ensures the medic can fulfil their duties while safeguarding their own safety and that of the team. 

Continuous training, self-assessment, and environmental adaptability are the pillars of long-term success in this demanding but rewarding field. 

Note: Always consult your organisation’s operational fitness standards and medical guidelines before taking on an expedition or mountain medicine role. 

Connect with Dr Hannah Lock:

Online school: themountaindoctor.teachable.com

Personal website: https://drhannahlock.co.uk