AAEM/RSA PRESIDENT'S MESSAGE
Aerospace Medicine — The Final Frontier of Emergency Medicine Haig Aintablian, MD — AAEM/RSA President
Today, there are five residency programs for aerospace medicine in the U.S., two of which are military, and three of which are civilian. The civilian programs include the Mayo Clinic in Rochester, Minnesota, the University of Texas-Medical Branch (UTMB) in Galveston, Texas, and the Wright State Program in Dayton, Ohio. The military programs are the Air Force program at Wright-Patterson Air Force Base in Ohio, and the combined Army/Navy program in Pensacola, Florida. Many of these programs are two years long with an integrated Master’s program with an emphasis on public health and preventative medicine. The main differences between these programs are the degrees to which they cover the components of air-flight versus space-flight in their curriculum.
Many people enter the specialty
of emergency medicine to work in the most thrilling department of the hospital. The broad patient presentations, the interesting pathologies, and the breadth of patient encounters makes emergency medicine an exciting and fulfilling profession. The fellowship opportunities in EM are just as diverse as our patients. Aside from health care administration, EMS, ultrasound, and simulation, our specialty offers fellowships in all things land, sea, air, and even space. Wilderness medicine covers interesting pathologies and clever solutions to survive and treat them on land. Hyperbarics tackles complex disorders that occur due to burns, infections, and diving in the sea. And aerospace medicine handles the limitations of human physiology in air and space. For many in the field of emergency medicine, the sky is the limit regarding the options available for fellowship. For many, it comes as a surprise that aerospace medicine is not actually a new specialty. Paul Bert, a 19th century French physiologist is generally regarded as the father of modern aerospace (more aero than space) medicine. His work initially focused on the effects of pressure at low and high altitude on the effects of balloon pilots. Much of his work was referenced during World War II as more complex aircraft that could reach higher altitudes began to display the limitations of human physiology. In 1929, the Aerospace Medical Association was formed (and today has become the leading international academic organization in aerospace medicine). In 1948, aerospace medicine was born as a medical subspecialty with prompt designation as a board certified specialty within the American Board of Preventive Medicine in 1955. It was this year when the U.S. Navy also created their first aerospace medicine residency program. Over the decades, this subspecialty has mastered concepts relating to pressure changes, ionizing radiation exposure, and gravitational forces on normal human physiology. More complex pathologies like Spaceflight Associated Neuro-occular Syndrome (SANS) and other immunologic derangements related to space travel still have discoveries to be made. With the more time humans are spending in space, the more pathologies are continuing to unravel.
With the more time humans are spending in space, the more pathologies are continuing to unravel. As our presence in space continues to grow, so will the importance of proper medical training in the complexities of air and space travel. With the recent introduction of the Space Force, as well as the significantly increasing presence of private companies in space, the demand for aerospace trained physicians over the next one to two decades will sky-rocket. For emergency physicians looking for more than just terrestrial illnesses and who want to dive deeper into the unknowns of human physiology in space, aerospace medicine may be the perfect fellowship to take their skills into the final frontier. References • https://www.asma.org/about-asma/history#:~:text=The%20Aerospace%20 Medical%20Association%20%28AsMA%29%20was%20founded%20 in,of%20Commerce%20%28which%20later%20became%20the%20FAA%29.%20Dr. • https://www.asma.org/about-asma/history/aerospace-medicine-milestones • https://goflightmedicine.com/aerospace-medicine/history-of-flight-medicine/ • https://www.britannica.com/science/aerospace-medicine • https://www.mayoclinic.org/departments-centers/preventive-occupationalaerospace-medicine/aerospace-medicine/overview • https://www.asma.org/for-students-and-residents • https://www.asma.org/about-asma/careers/aerospace-medicine/residencyprograms-related-courses#:~:text=There%20are%20currently%20 five%20accredited%20U.S.%20residency%20programs,and%20the%20 combined%20Army%2FNavy%20program%20in%20Pensacola%2C% 20FL.
As our presence in space continues to grow, so will the importance of proper medical training in the complexities of air and space travel. 38
COMMON SENSE NOVEMBER/DECEMBER 2020
