Dr Katharine Ganly / Anaesthetics Registrar / West Scotland
Dr Katharine Ganly worked as a medical officer with the British Antarctic Survey Medical Unit (BASMU) from 2019 to 2021. She experienced both summer and winter in Antarctica, and also spent time working as the ship’s doctor on the RRS James Clark Ross. In this article, Dr Ganly describes what it’s like to be a doctor with BASMU, sharing her advice and experiences of working in one of the wildest places on Earth.
Ever wondered what it is like to live and work at the very edge of the world? The British Antarctic Survey Medical Unit appoints doctors annually to deploy to Antarctica, working on remote research stations and polar vessels. This is a dream job for adventurous medics with a love of cold, remote places.
What is the British Antarctic Survey?
The British Antarctic Survey (BAS) is the UK’s national Antarctic program. It is part of the National Environment Research Council and is the responsible body for the UK’s scientific research in Antarctica. BAS is headquartered in Cambridge and conducts scientific research in several areas of polar science, including marine biology, oceanography, meteorology, and atmospheric science. BAS scientists are credited with the discovery of the ozone hole in the 1970s, drawing attention to the impact of human activity on the global environment. BAS continues to undertake several long-term data collection projects relating to the polar regions and climate change.
There exist five permanent BAS research stations: Rothera and Halley on the Antarctic peninsula and Brunt Ice Shelf respectively, and the island stations of Signy in the South Orkneys, King Edward Point (KEP) at South Georgia, and Bird Island (BI) research station. The three stations of Rothera, KEP, and BI are staffed year-round, whilst Signy and Halley are operational throughout the austral summer alone. In addition to these stations, there is ongoing scientific research conducted from temporary field-based summer camps and outposts. The UK’s new polar research vessel The Sir David Attenborough (yes, the one that narrowly escaped being called ‘Boaty Mc Boatface’, thanks to the humour of the British public) heads south annually in the autumn to arrive in Antarctic waters for the period of the Antarctic summer (typically November-May) and has the dual role of conducting polar research and providing the annual resupply of equipment and staff.
BAS deploys up to 600 scientists and staff to the polar south annually. Personnel are not limited to scientists and include everyone essential to keeping life running and research going at the remote extremes of the world: chefs, field guides, mechanics, electricians, diving and boating officers, management personnel, engineers, and (thankfully for those reading this) polar-loving doctors.
What is daily life like in the Antarctic?
The UK working week is impractical in the Antarctic and as such, work fluctuates according to the weather and season. Exact details of routine are specific to each station, but the Antarctic has a steady overall rhythm splitting summer and winter. Summer is busy: this is the time of maximal activity. At Rothera, this means there are over 200 people on station, with many more transiting through this Antarctic hub. Personnel arrive on station via Dash-7 plane from Punta Arenas, Chile (around 4.5 hours flying time), or from the UK on the RRS Sir David Attenborough (a voyage of many weeks) with the annual resupply. Onward travel to the field is via a Twin Otter plane. At KEP the population is smaller, with approximately 30 on station during summer. South Georgia is solely accessible by sea, and personnel arrive via ship from the Falklands (around four to five days if the sea conditions are good).
All stations eat meals in a central dining area, with a chef at the larger stations and a cooking rota for personnel on the smaller sites. There is ample access to recreation on all sites including gym equipment, the opportunity to ski, and access to books, movies, and other media. Station life is dependent on everyone helping to keep things running. As a doctor in the Antarctic, you will find yourself cleaning, cooking, and taking inventory as well as running clinics. If you are lucky, this is made up for by the opportunity to fly in a Twin Otter at Rothera or pilot a rigid-hulled inflatable boat (RHIB) around unchartered waters at KEP (yes, really). You’ll also get the privilege of seeing some of the most remarkable wildlife in the world: Antarctic marine mammals and birds are the most incredible you’ll ever see.
Winter is a quieter time, with core personnel of around 25 at Rothera and eight at KEP. Work continues, but the pace is slowed. Personnel finally get their own room after a summer of sharing space with another. It gets colder and darker, and often tempers shorten along with the daylight. Navigating this as a doctor whilst living amongst your patients does pose its challenges. It’s a unique, special experience. The winter solstice is a time of midwinter celebration amongst your small team, as you look forward to longer days and dream of the fresh food you haven’t seen for months.
What does the role of a BASMU medical officer entail?
Recruitment
The BAS Medical Unit is based at University Hospitals Plymouth NHS Trust. BASMU recruits Antarctic medical staff annually in the late summer, and three doctors get selected to become the season’s doctors for Rothera, KEP, and the RRS Sir David Attenborough. Station doctors spend between 12 and 18 months in the Antarctic, and the ship doctor deploys for around eight months.
Pre-deployment and training
All BASMU medical officers have six months of pre-deployment training in Plymouth, which takes place predominantly at Derriford Hospital. Though there are certain skills all doctors must learn, during these months of gearing up for departure, you are largely responsible for taking charge of your training. Your role is predominantly spent in the emergency department (ED) but you are in the privileged position of being entirely supernumerary. This means you get the opportunity to place yourself wherever you have a training need, be it dealing with minor injuries, joint manipulations and plastering, or getting stuck into resus. You can tailor sessions outside the ED with other specialties to gain exposure to any areas required, be it a week or two with ENT, learning basic hand surgery from plastics, or taking swabs and gram-staining in the sexual health clinic. All doctors undergo an intensive dental course where you gain the essentials in dental examination, hygiene, fillings, and dental emergencies including extractions. Equally, all doctors rotate through basic training in radiography and physiotherapy. You will also be taught how to operate a hyperbaric recompression chamber at the Diving Diseases Research Centre (DDRC), as diving for both science and construction takes place at the main wintering stations. In addition to all this, you get a modest study budget and study leave that you can use for any further courses or skills required for departure. Historically, some doctors have used this for associated ‘extracurricular’ skills such as baking (if you winter at KEP, you are expected to bake bread regularly!).
As if this wasn’t enough to get stuck into, you also go through BAS winter pre-deployment training, which involves generic skills for all personnel deploying to Antarctic stations. Depending on which position you are heading to, you may undergo other station-specific training such as sea survival certifications, powerboating qualifications, or crevasse rescue.
Other UK responsibilities include pre-departure medical screening for BAS personnel. This takes place at BAS Cambridge and usually works out as spending between one and two weeks a month in Cambridge in the months leading up to departure. Accommodation is provided and travel costs are reimbursed. There is a BASMU car that can be used for work travel, or mileage is reimbursed if your own vehicle is used. This allows you to meet some of the BAS personnel and identify any extra medical investigations or precautions that are needed before departure.
Working in Antarctica
Once deployed, your role as medical officer in the Antarctic is unlike any other you will have filled. For the vast majority of your deployed time, you will be the sole medic within hundreds of miles. My deployment to South Georgia meant I was the only doctor in the entire territory, with the nearest other physician being over 800km away on the Falkland Islands, at best a 4-day ship’s passage away over the roughest seas in the world.
Day-to-day medical work is light compared to jobs in the UK, and the bulk of your ‘office’ time is much more likely being spent taking stock of pharmacy, reviewing major incident protocols and equipment, and training your winter team in advanced first aid (you need to have someone who can give you a hand if an emergency occurs, or even to look after you should you break something). Your population in the Antarctic is small, medically screened, and largely risk-averse. Most consultations fall under the realms of general practice: GI upsets, sleep disturbance, dermatology, and some minor injuries. Dental complaints are relatively common occurrences and are rewarding to treat thanks to excellent pre-departure dental training. Other common consultations include psychological issues, sexual health, and support around general well-being for a population living in very unusual circumstances. Everything in the Antarctic is complicated by its remoteness. What would be considered a seemingly minor complaint in the UK requires more careful consideration on the ice. The potential for things to develop into something more concerning needs to be carefully evaluated when you know any definitive treatment may involve a medevac that could span weeks. Away from the hospital and the majority of diagnostic tools that we are accustomed to, reliance on good clinical skills becomes paramount.
Managing medical emergencies
Though infrequent, acute illness and major injury do occur. Recent seasons have faced major GI haemorrhage, respiratory emergencies, sepsis, and major lower limb trauma requiring evacuation. I was faced with a case of cold-induced angioedema: an unusual anaphylactoid reaction to extreme cold, and not something you want when the temperature rarely gets above freezing. Generally due to good training and PPE, other cold-related emergencies are uncommon, and hypothermia and frostbite are rarely seen amongst BAS personnel. Whatever situation arises, you need to be able to manage as a solo medic with limited resources. There are no CT scanners or biochemistry labs in your clinic. You will have plain-film X-rays (which you will learn how to take and develop yourself) and basic point-of-care testing. Most sophisticated medical equipment is not designed for the extreme remoteness of the far south, and some kit that works at the start of your deployment may no longer do so come winter. You will nonetheless have a pharmacy that is well-stocked with both emergency drugs and supplies for more common ailments. You will also have access to a team of enthusiastic first aiders, should you choose to train them.
Thanks to modern telecommunications, you have several experienced BASMU clinicians as well as specialists at your fingertips. Responses to clinical queries are normally within a few days. Telephone can always be used for more urgent concerns, with 24/7 top-cover support in an emergency. Video consultations have been used when the satellites are well aligned.
The role of a BAS medical officer requires a large degree of robustness and adaptability. Challenges include isolation, skill fade, unconventional patient-doctor relationships, and the unpredictability of Antarctic deployment. You have to be able to respond to anything, including the emergence of a global pandemic whilst deployed – not something any of the doctors had envisaged when travelling south in 2019. The benefits of learning a range of diverse skills, and the privilege of living in a truly awe-inducing location far outweigh any difficulties faced. The opportunity to work with a team of dedicated scientists and support staff, and to play a part in keeping vital research ongoing in such a special place makes this job truly one of a kind.
Practical Information
Candidate information: to meet the requirements, you’ll need to be a fully registered medical practitioner and have a minimum of 3 years post-qualification. Doctors from a wide variety of specialties and backgrounds are considered by BASMU for the posts. Acute specialty experience is probably useful, as you need to be able to keep calm under pressure, but not essential. Key useful traits are resourcefulness and flexibility.
Timelines: BASMU advertises at the end of summer in the BMJ, with interviews in the autumn. Jobs will then usually start on the 1st of May, with pre-deployment training running from May through to October. Deployment begins in November or December and is for 12-18 months. There is a huge amount of organisational development and expansion at BAS at present and the medical unit is required to be reactive and flexible to this. As such, the exact deployment duration and details are always subject to change.
Doctors in training: some deaneries will approve an OOPE (Out of Programme Experience) for BASMU employment, so it is worth applying even if you are in training. This allows you to keep your training number and return to your role when you are home. A benefit of this option is that you can usually access ‘supported return to training’ once you return to the UK, easing the transition back into hospital practice. I would recommend this.
Administrative info: as a BASMU doctor, your employer is Plymouth Hospitals NHS Trust. This means you retain your continuous NHS employment for the duration of this position. If you are deployed for over 12 months, you do not need to pay UK tax, although you will need to pay ‘BAT tax’ (British Antarctic Territory Tax) of 7% instead. You will have essentially no expenses when you are away.
Academic: the complete program of training, clinical responsibility and research is designed to enable doctors to obtain a certificate, diploma, or master of science degree in remote and global healthcare, awarded by the Peninsula Graduate School for Antarctic Deployments. Alternatively, you can use these funds to undertake another distance learning program of your choice. There is the opportunity to get involved with BASMU research, which recently has focused on cold injury, drug tolerance, and respiratory virus transmission.
Author Information
Dr Katharine Ganly worked as a medical officer for The British Antarctic Survey between 2019-2021. She overwintered at King Edward Point and was the first station doctor on Bird Island, where she spent her second Antarctic summer. Doc Kat was the ship’s doctor on the RRS James Clark Ross on her exit from Antarctica. She completed her MSc in Global and Remote Health whilst working for BASMU, alongside conducting research into drug stability in remote environments and respiratory viral transmission amongst an isolated population during the COVID-19 pandemic. She has now returned to work as an anaesthetics registrar in the west of Scotland.
