Wilderness medicine programs are proliferating for several reasons: more and more people (including those with medical problems or disabilities) are engaging in wilderness recreation; medical students who participate in a wilderness medicine elective often rate it as the best course they ever took1.McGraw D. Gluckman S.J. The perceived benefits of a medical school course in wilderness medicine.Wilderness Environ Med. 2005; 16: 106-110Abstract Full Text Full Text PDF PubMed Scopus (12) Google Scholar; wilderness medicine skills apply to many other situations, such as disaster responses, foreign travel, and rural emergency medical services (EMS) with long or chancy transport to hospitals; urban hospitals deal with many problems that people bring back from the wilderness; and outdoor recreation programs are natural partners for wilderness medicine programs, which encourages them to pool their resources and faculty. Moreover, wilderness medicine has long been taught to lay people as well as physicians, because physicians are almost never available in outdoor emergencies. Most of these themes run through the present article. For example, the collaboration of medical faculty with outdoor instructors, which the fortuitous existence of an outdoor program at Cornell University made possible for the authors’ program, is standard practice in European Mountain Medicine courses for physicians.2.Peters P. Mountaineering and climbing techniques in the curriculum of mountain medicine education programs: a survey of the European courses for mountain medicine.Wilderness Environ Med. 2002; 13: 59-65Abstract Full Text Full Text PDF PubMed Scopus (9) Google Scholar This combination of medical and outdoor skills training has been featured at Wilderness Medical Society conferences as well, because in order to take care of other people in wilderness situations, you must first be able to take care of yourself. Making a modified wilderness medicine curriculum available to Cornell undergraduates also reminds us of the growing demand for realistic emergency care training from people who do outdoor recreation, which has caused courses for lay people to multiply. Some of these courses, pioneered many years ago by groups like The Mountaineers in Seattle, teach techniques (such as reducing dislocations) that even paramedics are not allowed to do in urban situations. Another collaboration described by the authors is with their hospital's Hazardous Materials Team and their EMS Special Operations Team, which reminds us that major disaster scenes are (from a medical perspective) wilderness situations and that many people involved in disaster response, as well as emergency medical technicians and nurses, are taking wilderness medicine courses. The authors also mention that these collaborations have created opportunities for relevant research. All of these themes have one thing in common—the recognition by more and more people that wilderness medicine is relevant to their lives and (in many cases) necessary to their occupations. In a way, this is a reversal of the trend for medicine to become more and more specialized and compartmentalized, which has isolated it from the lives and educations of people outside the profession. In previous centuries, when doctors were scarce, there were many medical guides written for lay people. Perhaps the earliest example in North America was Every Man His Own Doctor: Or, The Poor Planter's Physician.3.Tennent J. Every Man His Own Doctor: Or, The Poor Planter's Physician. William Parks, Williamsburg, VA1736Google Scholar By the early 20th century, these guides had grown into massive tomes containing much of what was in the contemporary medical curriculum (one example being owned by this writer's paternal grandfather). Then, with the expansion of medical training and hospital facilities, followed by the development of the EMS system in the 1970s, the boundary between medical practice and first aid training for lay people was more and more sharply drawn. But now that boundary is shifting, as people realize that for wilderness emergencies or disaster situations, they will need training in wilderness medicine to take care of anyone who is injured.