WMS Conference Ambassador Negin Ceraolo interviews Dr. Geoff Comp, a featured speaker at the upcoming Summer Conference, about how wilderness medicine shapes resilient emergency physicians and prepares us for the growing challenges of climate-related care.
Dr. Negin Ceraolo (NC): What first drew you to wilderness medicine, and how did it influence your path in emergency medicine?
Dr. Geoff Comp (GC): I grew up camping and spending time outdoors, which gave me an early appreciation for the intersection of nature, resilience, and self-reliance. That love for the outdoors carried into medical school, where I got involved with the Wilderness Medical Society (WMS) and discovered a thriving community of like-minded learners. I’ve been fortunate to stay engaged with WMS throughout my career and to hold leadership roles in both that organization and within emergency medicine residency programs focused on wilderness and austere care. During residency, I completed a wilderness/EMS specialty track and earned my Fellowship in the Academy of Wilderness Medicine (FAWM), which helped solidify my identity as both a clinician and educator in this space. Wilderness medicine shaped how I approach complex, resource-limited problems and emphasized a mindset of adaptability and leadership, traits that are invaluable in emergency medicine.
(NC): What’s one practical skill from wilderness medicine that you use regularly in the ED?
(GC): One of the most consistently valuable skills I’ve carried over from wilderness medicine into the emergency department is the ability to improvise and adapt under pressure, especially when ideal resources aren’t available. That might mean splinting a fracture with what’s on hand when ortho gear is unavailable, troubleshooting airway or hemorrhage control in an understaffed resus, or adapting standard protocols during a mass casualty or disaster event. Wilderness medicine teaches you early on to stay calm, think clearly, and apply creative solutions grounded in core medical principles, even if you don’t have everything you need.
Beyond the tangible skills, wilderness medicine also reinforced the importance of preparation, leadership, and teamwork. In both wilderness and emergency environments, success often depends on medical knowledge and your ability to lead a team through uncertainty, maintain situational awareness, and communicate clearly when the stakes are high. That mindset has helped me navigate high-acuity traumas, resource-limited night shifts, and real-time decision-making during heat waves and other climate-related surges here in Phoenix. Wilderness medicine doesn’t just teach you how to treat, and it teaches you how to think.
(NC): Which current wilderness medicine topic or trend do you think deserves more attention?
(GC): Climate-related illness, particularly extreme heat, is a rapidly evolving challenge that deserves significantly more attention in both wilderness and traditional emergency medicine. Practicing in Phoenix, I’ve seen firsthand how climate change transforms health risks, not just in the backcountry, but in urban environments, especially among vulnerable populations. Our team has implemented and studied total-body cold-water immersion in the ED, a treatment born from wilderness protocols but underutilized in most hospital settings.
Wilderness medicine offers unique insight into prevention, patient education, and low-resource treatment strategies that are increasingly relevant as infrastructure gets stressed by environmental extremes. We must shift the narrative from “wilderness equals remote” to understanding that wilderness principles apply anywhere resources are limited or systems are strained, whether you're five miles into the backcountry or five minutes from downtown. Expanding education, research, and protocols around environmental illness will be essential as climate-driven health emergencies become more common.
(NC): How should EM trainees balance traditional residency training with wilderness or austere care experiences?
(GC): The key is to view wilderness medicine as a framework, not a detour. EM residency lays the foundation for high-acuity clinical skills, systems thinking, and teamwork, all deeply enriched by exposure to austere care principles. I encourage residents to engage with wilderness medicine in a way that complements their training: participate in a structured elective, attend a MedWAR event, join a specialty track, or take on a research or curriculum project. These experiences aren’t just fun diversions; they build leadership, adaptability, and critical thinking that directly translate to the ED.
For this reason, we’ve built wilderness medicine pathways into our residency curriculum. The benefits aren’t limited to those pursuing a wilderness-focused career. Any resident, regardless of future practice setting, can benefit from learning how to manage uncertainty, improvise effectively, and provide care in resource-limited conditions. The balance comes from recognizing that wilderness medicine isn’t about stepping away from EM training, it’s about leaning in more deeply.
(NC): What’s your top advice for residents hoping to build a career in wilderness medicine?
(GC): Start by showing up consistently and authentically. Attend events, volunteer for courses or simulations, and find active mentors in the field. It doesn’t require a formal fellowship or predefined path to get started; it requires initiative and curiosity. During residency, I found ways to align my interests with available opportunities, joining the WMS, earning my FAWM, helping run MedWARs, and creating educational content. Those early experiences opened doors I never expected and helped me build a lasting presence in the community.
It’s also helpful to identify a few core areas that excite you — maybe it’s high-altitude illness, heat emergencies, envenomations, or wilderness education. Then dive in: read, teach, publish, and collaborate. The wilderness medicine community is incredibly supportive, but it rewards those who contribute like any field. Finally, recognize that your path will be unique, and that’s part of the beauty of this career. Wilderness medicine thrives on people bringing their own strengths, perspectives, and creativity into the mix.
(NC): How can wilderness medicine better prepare clinicians for climate-related disasters?
(GC): Wilderness medicine trains us to think without assuming access, no power, no backup, no transport. That mindset is exactly what we need as climate change challenges infrastructure and stretches healthcare systems. By formalizing wilderness medicine principles into disaster planning, emergency protocols, and public health outreach, we can better equip clinicians to care for vulnerable populations facing floods, heat waves, wildfires, and more. It’s not just about practicing “in the wild,” it’s about being ready when the system breaks.
(NC): What do you look for in a mentee who wants to break into this field?
(GC): I look for initiative, curiosity, and follow-through. Some of the most successful mentees I’ve worked with weren’t the most experienced hikers or climbers; they were the ones who showed up, asked good questions, and said yes to opportunities, whether that meant co-developing curriculum, helping run MedWAR, or diving into a research project. Wilderness medicine requires both independence and teamwork, and I look for learners who can collaborate, adapt, and take ownership of their growth. You don’t need to have it all figured out, but you do need to be engaged and open. The field is rich with opportunity, and there’s room for a wide variety of passions, education, advocacy, clinical care, or public health. What matters most is that you’re willing to lean in and contribute.
(NC): What’s one wilderness medicine experience that reshaped your approach to patient care?
(GC): Helping design and implement a cold-water immersion protocol for heat stroke in our urban emergency department was a defining moment. It was a perfect example of wilderness principles directly improving outcomes in a hospital setting. When you see someone with exertional heat stroke drop their core temperature and walk out neurologically intact, it sticks with you. That experience reinforced how wilderness medicine is more than a niche, it’s a critical piece of modern emergency care.
It also reframed how I think about systems change. We didn’t just apply a protocol we brought wilderness-informed innovation into a high-volume, urban hospital and proved it could work. That experience reminded me that wilderness medicine is about more than technical skills; it’s about leadership, advocacy, and improving care in unconventional ways. Whether you're in the backcountry or the city, the mindset matters, and that shift has fundamentally changed how I teach, mentor, and practice.
A huge thank you to Dr. Geoff Comp for this thoughtful conversation! For more insights into how wilderness medicine is shaping the future of clinical care—whether in the mountains or the middle of a heat wave—catch Dr. Comp’s session at the upcoming WMS Conference.