Dr Shona Main is MBChB class of 2015 and currently an emergency medicine registrar, an expedition doctor, plus Head of Operations at the award-winning magazine, The Adventure Medic.
Tell us a bit about your time at university
I never planned to be a doctor, I was inspired to do medicine when I realised nearly all of the grown-ups whose qualities I aspired to were doctors. They were disarmingly calm in a crisis, pragmatic, endlessly kind, always ethically considered and saw the fun in everything. I hoped some of this would rub off on me in training. I spent University combining my previous plans to do sport, anthropology and art through research expeditions, travel grants to learn from alternative healthcare systems, Scotland lacrosse and adventurous training through the military. Desperate to do a year in London for personal reasons, I was grateful to intercalate at King’s and get a flavour of academic life for the first time. Back in Scotland, Professor Kenneth Baillie took me under his wing at the Roslin Institute and APEX 4 soon followed.
What have you been up to since graduation?
Foundation years had the perks of regular water sports, team leagues in various sports and a rapidly developed group of close colleagues in a district general on the South Coast. An Antipodean adventure followed working Down Under. It served as a real insight into quite how hard our international medical graduate colleagues can have it when guidelines, brand names, drug dosing and systems can be different and we didn’t suffer any of the language or cultural barriers or visa challenges!
An expedition/emergency fellow post in Bristol was an absolute dream job with huge thanks to Lt. Col. Harvey Pynn. Expedition and event work started to include supporting these as a doctor and in time, medical consultancy to expedition companies. Emergency medicine (EM) training made regular team sports and contact with friends challenging, let alone expedition, pre-hospital and global health interests. I managed to squeeze in a couple of trips a year with lots of swaps, a supportive partner and endless chocolate offerings.
The EM training less-than-full-time pilot, along with self-rostering, revolutionised how I felt about my future career. It enabled me to enjoy EM again, provided time for expeditions that both gave me skills to improve my NHS practice while highlighting the benefits of the training pathway and, maybe most importantly, made making important events with friends and family more feasible. I now work on a couple of expeditions a year, teach in the UK and Alps including on the Plymouth Global Health MSc and run the magazine that showed me the path into this life, The Adventure Medic.
Tell us a bit about working in emergency medicine. Why did you choose this specialty?
It’s noisy, demanding, time-pressured, anti-social hours and can be emotionally heavy … all worsened by morale injury from the effect of limited resources with corridor care and long waits now the norm. However, it’s also a hub for humanity, a true team environment and provides the opportunity to really think before tests provide the data. It offers insight into the difficulties facing each area of society, practical skills and huge diversity. The buzz and challenge it provides while also being sessional make it an ideal match.
What about expedition medicine – what are the best bits? And the challenges?
The simplicity of life on expedition is grounding. Summiting peaks at first light, watching penguins porpoise and whales blow from a bivvy in the glistening snow and listening to the sounds of the jungle from a hammock are all magical. I love the logistics of trips and pouring over maps while being inspired by teammates and developing an understanding of new perspectives is one of my favourite parts.
Whether providing medical cover or leading, you are on call 24-7 not just to react but to see and prevent issues before they happen. Your colleagues are your patients and on long trips, your clients are also your friends. I used to lie awake night after night mesmerised by natural sights or teammates’ tales but soon found I needed to make clear boundaries, set expectations for clients and myself and ensure I got enough kip.
Expedition work reignited interest in being up to date with guidelines and management strategies for minor injuries for when support resources aren’t easily available. It has been hugely beneficial for developing my risk management and decision-making skills under pressure and I’ve had the privilege of learning survival and communication skills from some of the most experienced guides in the field. Seeing how other industries manage risk has also been fascinating and informative.
You’ve worked on expeditions all around the globe. Can you give us an insight into a few and any particularly memorable moments?
Helping train Tanzania’s first COVID-19 response team, managing a remote major trauma (thankfully with fantastic colleagues) and being held at gunpoint have been some of the more dramatic sides.
My favourite memories are from times appreciating the magic of nature around us, laughing with truly inspiring individuals and being immersed in new cultures with different flavours, priorities and customs. Dancing with a Shona tribe in South Africa with the sun setting over the Savannah was pretty special, especially when it was triggered merely by a single word, my name (thanks parents – it’s been a talking point around the world being an ethnic group, language and a word in numerous dialects).
Back in your time at Edinburgh Medical School, you led the APEX 4 expedition – how was that? Is this where your love for expeditions began?
APEX 4 was a phenomenal platform to explore research, expedition and management worlds. We were hugely supported by Professor Kenneth Baillie alongside multiple other researchers, medical school leads and university departments. Media training was a novel highlight. I had been lucky to go on previous military expeditions and APEX 3 but this was my first real insight into the life of an expedition doctor and international research collaborations. Drs Ellie Heath and Matt Wilkes were phenomenal partners in the venture and remain inspirations today.
What are your aspirations for the future?
The dream would be to self-power on all expeditions in a way that embraces the journey and enables learning from the people and environment I have the pleasure to encounter. I’d also like to do more youth development trips, scientific research and media expeditions showcasing the beauty of the planet. Whether these be around my main job, part of it or on OOPE/sabbaticals we shall see…
I’ve enjoyed the balance of emergency medicine and remote expedition work and am pursuing my interest in PHEM with the goal of a split consultant role between the two. Healthcare technology in the remote setting is an area I’m keen to explore further. I’m looking into ways I can combine these interests in a realistic and output-positive way.
Adventure Medic continues to grow and we would like to use the volunteer-run resource as a platform for advocacy work to improve options for medics and care of clients when working in remote settings. We are shortly releasing pieces on indemnity, pay and preparations and are looking to delve deeper into financial considerations, legalities surrounding medical kits and more. If you have a tale of adventure to share, a job opportunity or an upcoming event that you feel may benefit the community, please drop us a line. Adventurous, remote and sustainable elective reports welcome.
We have stunning locations in the UK and I’m looking forward to more local micro-adventures with wild camps, swim-run ganders, sailing, cycle touring and more over the summer months with friends and family.
Any advice for current medical students?
Consider regularly what both your grand and near goals are. There are so many opportunities available, throw yourself into ones that make you happy, put in the grind if there is a purpose but don’t forget that there’s a whole world out there to enjoy. The ladders are only worth climbing if the top is where you want to be.
