What began in 1997 as an effort to better prepare medical students for care in unpredictable environments has grown into one of the most distinctive experiences at the ҹɫÊÓƵ School of Medicine (UNR Med). The Wilderness Medicine Elective, founded by David Fiore, M.D., and Gary Johnson, M.D., continues to challenge students to rethink how medicine is practiced in remote and harsh environments.
“Our goal is to learn, develop and share knowledge related to the provision of medical care in austere environments,” Johnson said. “We want students to think through an approach where the usual resources associated with health care are not available.”
That philosophy still anchors the course today. Rather than focusing solely on memorizing clinical protocols, students are encouraged to develop adaptability and problem-solving skills when standard systems, equipment and support are no longer available.
Decades of wilderness medicine training and mentorship
Since its founding, the elective has continued to grow while maintaining its core structure. Fiore teaches the winter wilderness medicine course, while Johnson leads the two-week spring version. A camping experience has remained central to the curriculum from the very beginning.
About a decade ago, the course gained another major contributor when Arthur “Tony” Islas, M.D., joined the Department of Family and Community Medicine faculty. A nationally recognized wilderness medicine expert, Islas founded the at UNR Med. Drawing from his experience providing medical care for trekkers in Nepal and other remote settings, Islas helped elevate both the elective and campout into a more advanced training experience for students interested in wilderness and expedition medicine.
Now approaching its 30th year, Johnson still coordinates much of the elective, from lectures and guest speakers to the final campout. Along the way, the course has developed its own traditions, including an unexpectedly competitive music trivia quiz.
“No one has yet failed the course for not recognizing the Doobie Brothers, but it could still happen,” Johnson said.
For students, those lighthearted moments are part of what makes the experience memorable. As Class of 2026 graduate Finnley Bourne, M.D., who recently matched into emergency medicine at Penn State Milton S. Hershey Medical Center, described it, the elective quickly becomes more than just a class.
“The opportunity to blend some of my favorite hobbies into the learning environment immediately drew me in,” Bourne said. “Getting to be outside for lectures while learning genuinely useful skills for the environments I enjoy most made it feel far less like a traditional elective and more like something I would actively seek out even outside of medical school.”
Learning to improvise when resources are limited
The classroom portion of the elective covers topics ranging from high-altitude illness to snake bites to poison oak exposure - conditions that become especially complex in remote settings. But the course’s lessons become most tangible during the culminating campout at Desert Creek in rural Nevada, about 90 minutes south of Reno. Students operate without facilities or reliable infrastructure, intentionally pushing them to think creatively and work as a team in unpredictable conditions.
“We want people to learn how to think on their feet and improvise when emergencies happen — but perhaps even more importantly, to prepare well enough to avoid many of those emergencies in the first place,” Johnson said. “We like to say the most valuable tools in wilderness medicine are your car keys and your cell phone.”
Students rotate through practical skills stations focused on rope work, improvised transport and environmental assessment while also learning to navigate daily life in a resource-limited environment.
“Practicing medicine in a remote environment reinforced how important adaptability and problem-solving are when resources are limited,” Bourne said. “I’ve always appreciated the taste of a little MacGyver style medicine, and wilderness medicine continuously serves it up.”
For Mimi Hoppe, M.D., a Class of 2026 graduate who recently matched into family medicine at the University of California, Los Angeles, the elective reinforced the importance of doing what you can with the resources available.
“It definitely changed my perspective because I’ve learned that doing what you can, with what you have, is a better approach than doing nothing,” Hoppe said.
Shared meals, campfires and connection in the Nevada wilderness
While medicine is the focus, students say some of the most memorable moments happen around campfires and shared meals. Camp cooking has become one of the course’s signature traditions, with students contributing to a communal potluck and learning Dutch oven techniques along the way.
“Food is another important part of the experience,” Johnson said. “The Friday night potluck buffet is often surprisingly gourmet — and gluttonous.”
Hoppe added, “It was so fun to do a potluck and get to try incredible food — I didn’t know food cooked in a Dutch oven over a fire could be so delicious.”
Bourne found that the most lasting takeaways often came from those informal moments around camp stoves and fires. “Honestly, one of the most underrated lessons was how much food brings people together,” he said. “Some of the best conversations and bonding happened around camp stoves and grills.”
One of Bourne’s favorite memories came from fully embracing the course’s resource-limited mindset.
“While a few people arrived with impressive camp kitchens, grills and camp trailers, I proudly contributed by spit roasting a rabbit,” Bourne said. “Standing around the fire slowly rotating a rabbit by hand felt oddly fitting for wilderness medicine as a whole.”
A meaningful way to close out medical school
For many students, the elective becomes more than a course — it becomes a meaningful way to close out medical school.
“The camping trip honestly felt like the perfect way to close out medical school,” Bourne said. “You get to camp under the stars, practice hands-on medicine, laugh a lot and spend real quality time with some of the best professors and classmates you could ask for.”
Hoppe added, “Our class is extremely close, so getting to spend quality time with them was a sentimental and special moment.”
What began as an effort to teach medicine in austere environments has evolved into something larger: a shared experience that challenges students to think creatively, adapt under pressure and better understand both medicine and one another.
