Understanding Pay, Risk, and the Future of Medical Roles in Remote Environments
From the snow-capped peaks of Kilimanjaro to ultra-marathons in desert heat, expedition medics operate in some of the world’s most extreme environments. But while the terrain may be rugged, so too is the conversation around pay, professionalism, and fair treatment.
At WEM24, our expert panel, including Alex Taylor, Ben Alba, Will Duffin, and WEM founder Mark Hannaford, opened the floor to one of the most talked-about topics in the expedition medicine world: remuneration.
Why Is This a Debate?
Historically, expedition medics were expected to work for free, or even pay to join trips.
“It sounds ridiculous now,” says Mark Hannaford, “but 30 years ago, [WEM] were the only company globally paying medics for their time.”
The industry has evolved, but many medics still report volunteering, covering their own expenses, or receiving nominal fees far below what’s proportionate to the risks and responsibilities involved.
The Cost of ‘Experience’
Junior clinicians are often eager to build their CVs and gain field experience. But that enthusiasm can come at a cost.
As Alex Taylor explains, “We’re doing MScs, diplomas, advanced qualifications… and still being asked to work unpaid. This normalises a cycle where the least experienced, and most legally vulnerable, are often the most exploited.”
Ben Alba shared one example of a company asking doctors to pay £4,000 to join a 21-day high-altitude trip, despite the significant medical responsibilities and legal risks involved.
What Should You Be Paid?
While exact figures vary, many panellists agreed that linking expedition medic pay to established guide rates (e.g. £150–£300/day) offers a fair and scalable benchmark.
Key considerations for fair pay:
- Time off from salaried NHS work
- Indemnity insurance
- Risk of legal liability abroad
- Pre-trip planning and post-trip follow-up
- Activity-specific skills (altitude, dive, ski, etc.)
So, What’s the Way Forward?
- Talk about it: This debate shouldn’t stay in the shadows. Have open conversations with fellow medics, providers, and trip leaders.
- Ask for what you’re worth: If a provider can’t pay, ask why. Request a breakdown of costs. And walk away if needed.
- Know your risk: Always arrange your own indemnity insurance. If a provider offers coverage, request the contract and make sure it protects your scope of practice.
- Evaluate yourself honestly: Are you experienced enough for the trip? Can you safely handle others at altitude, at sea, or in a jungle environment?
- Support collective change: Join discussions, share salary expectations transparently, and advocate for formal standards. Some are now calling for a badge system or registry to recognise companies that pay fairly and act responsibly.
Watch the Full World Extreme Medicine Conference Session
The entire conversation is now available to watch for free. Whether you’re just starting out or have years of experience under your belt, it’s essential viewing ⤵
Let’s Keep the Conversation Going
This isn’t just a debate. It’s a movement, and your voice matters.
Have your say using #ExpedPay and tag us in your thoughts. Let’s redefine what it means to work with value in expedition medicine.
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