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DiMM
Winter Mountaineering and Rescue

The Winter Skills and Rescue Course of the Northeast Diploma in Mountain Medicine is tailored for physicians, advanced practice providers, nurses, and paramedics pursuing this specialized qualification. Set against the backdrop of the challenging Presidential Range and surrounding mountains, the course begins with a focus on refining winter skills and navigating alpine environments of snow and ice. Participants will then engage in both personal and team rescue practice, culminating in realistic mock rescue scenarios.

Our intensive, field-based curriculum will address the unique challenges faced by mountain rescuers in winter environments. The course emphasizes building strong individual skills, team dynamics, and the role of medical personnel in mountain rescue, and integrating these efforts into a cohesive rescue operation.

 

IMG_2578
Constructing a ski sled
Preparing to move patient into a tarp/snow cave shelter
One of many belay methods on steep snow
 Date LocationRate 
 March 23 – 30, 2025Mount Washington Valley, NHMD/DO: $3400
PA/NP: $3100
Resident/RN/Medic/AEMT: $3000

Specific Info

General Info

The DiMM Winter Mountaineering Skills and Rescue course is open to physicians, advanced practice providers, nurses and paramedics. Participants must have been accepted into the Northeast DiMM program.

Experience

Participants should have familiarity with the basic principles of backcountry travel and basic mountaineering skills. Winter hiking / backpacking experience is highly recommended. While participants are not expected to be expert climbers, they should be comfortable with basic climbing skills such as tying in, belaying and rappelling.  

The location of the course is subject to weather and terrain. We plan to spend a portion of our time either in Crawford Notch or Grafton Notch where we typically have good climbing conditions and short approaches giving us more field time. We also plan to spend a significant amount of time in Tuckerman and Huntington Ravines on Mount Washington.

 Plan to be in the field for the entire course – rain or shine. Bring clothing and food/drink appropriate for both being active and not active regardless of weather.

Gear may be inspected on the first morning of the course and is expected to be in good condition. Mark all of your gear!

Here’s a list of items you’ll need for this course. It’s important to familiarize yourself with your gear—pack your bag and wear your clothes in advance and in challenging weather. Ensure that your footwear system works well. Please bring only what you need as too much gear potentially becomes a group problem.

 

If you are in need of gear, participants receive a 25% discount at AlpenglowGear.com. Rentals are also available for some of the gear.

 

PERSONAL CLOTHING

 

Wicking Base Layer – recommended materials: Merino, Capilene, etc. not cotton

  • Liner socks – some people like a two layer system
  • Vapor barrier sock if using boots that won’t easily dry overnight
  • Liner gloves
  • Long sleeve top
  • Bottoms

Insulating Layer – recommended material: any type of fleece such as Polartec or wool, not cotton.

  • Hat
  • Balaclava – full-face covering
  • Medium-heavy weight synthetic or down puffy jacket
  • Heavy wool or synthetic insulating socks
  • Extra insulating socks
  • Warm mittens with waterproof shell over mitts
  • Extra inner mittens
  • Warm ski like gloves
  • Pants with side zip or good quality softshell pants ideally with an integrated gaiter

Shell Layer

  • Goggles & Sunglasses with side protection
  • Waterproof / breathable shell to large enough to cover puffy jacket
  • Waterproof / breathable shell pants (full-length side zips useful for venting)
  • Gaiters (if no built-in pant gaiter)

Street clothes– for evenings after class.

 

PERSONAL GEAR

  • Daily lunch snacks
  • Personal Sol style bivy sack or heavy-duty contractor bag
  • Unbreakable bowl, insulated cup, & spoon (we will camp at least one night)
  • Personal toiletries, sunscreen, & lip balm, wipes
  • Wag Bag for personal waste
  • 2 Insulated, wide-mouthed 1 liter water bottles or 1 thermos and 1 wide mouth bottle
  • 2-4 nylon stuff sacks to sort and organize gear
  • EVA 1/2” foam full-length ground pad (rental available)
  • EVA 1/4” foam pad 3/4 length or ThermaRest ground pad (rental available)
  • Sleeping Bag (0°F +/- synthetic or down (rental available)
  • Headlamp with fresh and extra batteries
  • Hand warmers and Toe Warmers (optional)
  • Adjustable Ski poles (optional)
  • Small lighter (optional)
  • Multi Tool (optional)
  • Small Personal First-Aid Kit/ Medications – Bring only a small kit with blister care and any regular personal medications. Guides will carry a first aid kit with trauma, bleeding control, wound care/bandaging, OTC analgesics, antihistamines, epinephrine, ketamine, and TXA.
  • Rite in Rain notebook / pencil

MOUNTAINEERING GEAR

  • Backpack: 40-50 liters (2500 to 3000 cubic inches)
  • Mountaineering Boots: At this time of year warm single boots should suffice. However, if you tend toward cold feet, then double mountaineering boots are recommended. (rental available)
  • Steel Crampons (rental available)
  • Mountaineering Axe – Straight or slightly curved shaft with adze. (rental available)
  • Climbing Harness – with belay and gear loops. It should easily fit under a harness
  • Climbing Helmet
  • 6 Locking HMS Carabiners
  • 6 standard non-locking straight gate carabiners
  • Snow Picket
  • 2 16cm Ice Screws
  • Self-locking Belay Device
  • Prusik minding pulley or progress capture pulley
  • 6m cordellette (either 7mm nylon or 5mm + high strength cord)  or 240cm Dyneema sling
  • 7m of 7mm cord to be used for making Prusiks and Purcells
  • 48” nylon or Spectre sewn sling
  • FRS radio
  • Avalanche safety equipment (transceiver, probe, shovel) – (rental available)
 

Pre-course required online modules

1. Winter Equipment

2. Knots and Hitches

3. Mechanical Advantage
4. Weather

Day 1      (Grafton or Willey’s Slide)
1 hrs        Meet & Greet
1.5 hrs    Equipment Review
1.0 hrs    Knots review
2.5 hrs    Crampon and Axe Use / Self arrest / Self Belay
2.0 hrs    Snow Anchors / Belaying

Day 2      (Grafton or Willey’s Slide)
6.0 hrs    Multi-Pitch Ice/Snow Climb/Rappel
2.0 hrs    Glacier / Crevasse Rescue

 

Day 3      (Grafton or Frankestein) 

6.0 hrs    Steep Ice Climb / Rappel / Ice Anchoring

2.0 hrs    Ascending

2.0 hrs    Navigation / Whiteouts  

 

Day 4      (Wildcat or Sunday River)

3.0 hrs    Lifting and Moving / Cold Weather Packaging
6.0 hrs    Rescue Sled Lowering / Raising / Transitions / Improvised Sleds

 

Day 5     (Mount Washington Valley)

3.0 hrs    Companion rescue practice – beacon park

4.0 hrs    Skills Review / Medical & Trauma management

3.0 hrs    Winter Shelters / Fire Making

Overnight camp at Dolly Copp

 

Day 6      (Mount Washington)

10.0 hrs Technical Ascent w rescue incorporated / Debriefing

 

Day 7 – Individual & Team Practice / Practical Assessment / Debriefing

8 hrs

 

Lodging is included in the course. We aim to stay in a large house or lodge depending upon numbers and availability. We will also be camping at least one or two nights during the course. 

Participants will be responsible for providing their own meals. Food stores, restaurants and pubs are plentiful in the area. 

Pre-course study 

At a minimum, complete the following online DiMM modules: 

  • Winter Equipment
  • Knots and Hitches
  • Mechanical Advantage
  • Weather

Fitness
Be prepared both physically and mentally for long days in the mountains. Being in good physical condition will help you concentrate on learning. Each training day will be demanding, lasting between up to 12 hours. Expect hikes of up to 6 miles, packs weighing as much as 40 pounds, ascents of up to 4000’, and the need to carry litters. Inadequate fitness could limit your ability to participate. Refunds will not be given due to lack of readiness. Start your training early and include both cardiovascular and strength training.

Mountaineering: The Freedom of the Hills. 10th Edition, Mountaineers Books. 

Alpine Climbing: Techniques to Take You Higher. Mountaineers Books, 2012, Cosley and Houston

The Mountain Guide Manual: The Comprehensive Reference–From Belaying to Rope Systems and Self-Rescue. 2017, Falcon Books, Chauvin and Coppolillo. 

Glacier Mountaineering: An Illustrated Guide To Glacier Travel And Crevasse Rescue. 2009, Tyson and Clelland.

Mountain Emergency Medicine. Brugger, Hermann; Zafren, Ken; Festi, Luigi; Paal, Peter; Strapazzon, 2021, Giacomo
Editorial Edra.

 

Winter Mountain Skills and Rescue Course Scoring

Practical Pass:
On the final day of the course, candidate must complete the practical skills assessment with a passing score of 70% or higher in the following categories.

  • Risk Management
  • Personal Technical Systems
  • Technical Rescue Systems
  • Field Medical Management
  • Personal Preparation / Pacing
  • Leadership and Teamwork

Practical Remediation:
A candidate who receives a practical score of 5 (50%) or 6 may retake the practical exam one time.

 

Practical Sub Standard:
A candidate who receives a practical score of 4 (40%) or less must retake the course prior to taken a second exam

 

Written Exam:
Candidates will also take an on-line exam within 60 days.  Exam is multiple-choice questions and case studies covering material from the reading material and the course. A score of 70% is required. There is a 2 hour time limit. Candidates that do not achieve a 70% on their first attempt for any reason will be allowed a second attempt to achieve a minimum 80%.

 

Logistical challenges such as interruptions, computer problems, loss of internet connectivity, not taking the test within the designated timeframe, etc. will generally not be seen as reasons to allow a third attempt.

The Winter Mountaineering Skills and Rescue course is limited to 12 participants with a staff of 2 – 3 instructors.


Each participant will be required to sign a waiver from Acadia Mountain Guides and Dartmouth Health at the start of the program. 

All participants are required to carry evacuation and medical insurance coverage as well as trip interruption/cancellation insurance such as provided by Global Rescue. 

YOU MAY BE EXPOSED TO SUBSTANTIAL PERSONAL RISK OR DEATH DURING THIS COURSE. 

You are choosing to engage in an activity in which you may be injured and killed. While such accidents are rare, they may occur at any time and be out of our control. You will be working close to cliff edges and on steep, exposed ledges. You may be asked to construct anchors and to rappel and belay from them without direct supervision from the instructor. This is not an introductory-level program. You cannot abdicate responsibility for yourself and must take full responsibility for your own security. If, in the instructor’s opinion, you do not display the skill and prudence necessary for the course, you may be asked to leave the course.

Please be sure that you are fully aware of such risks. It is our goal to interpret the environmental, situational, and group variables and to make educated decisions to minimize dangers to you while at the same time providing an enjoyable and memorable experience.  

Your instructors draw upon extensive education and experience to manage significant hazards inherent to mountain travel. You are also expected to take an active part in risk management of yourself and the group. Some of the hazards that can lead to injury or death associated with this course include but are not limited to falls, being struck by falling objects, poor technique application by yourself or others, uneven terrain, anchor failure, equipment failure, extreme weather, demanding physical activity, and vehicle transportation. Again, please be sure that you are fully aware of such risks.  

No one starts the day expecting to get hurt in an instructional climbing course. However, despite all we know and all we do, accidents can still happen. At AMG, we take your security seriously. Our goal is to interpret the environmental, situational,  group and individual variables and make decisions to minimize risk while providing an educational, enjoyable and memorable experience.

Self-reliance in the face of adversity is expected on the part of the wilderness traveler entering the wilderness. Rescue is not automatic. Our party is often alone for all practical purposes and must depend upon our own resources for self-rescue and be equipped for an extended emergency. Cellular phones and radios should not be relied upon in an emergency.  

  

Finally, this is a group program, and good expedition behavior is critical. Participants are also asked to stay with the group until everyone has safely exited the field.

In order register for the course participants must first be accepted into the DiMM program. 

DiMM Eligibility

Applicants to our program are required to be a board certified/board eligible physician, nurse practitioner, physician assistant, registered nurse, licensed paramedic or advanced EMT.


DiMM Application Format

2025 DiMM applications open October 1st, 2024 and are due by December 31st, 2024.  

To apply, please email the following information to Emergency Medicine Program Specialist Anne Hill – anne.a.hill@hitchcock.org

  1. CV
  2. Personal Statement: describe why you are interested in the Dartmouth Hitchcock DiMM Program and how you will potentially use the knowledge and skills.
  3. Share your experience in emergency, prehospital and/or wilderness medicine.
  4. Describe your experience in rock/ice climbing, snow travel, rope systems, technical rescue, and avalanche.
  5. Describe any additional pertinent backcountry travel and/or technical rescue experience.
  6. List any physical or medical limitations you have that will prevent your full participation in this program.
  7. Include 2 letters of recommendation.

Candidates will be contacted via email regarding follow up interviews, decisions, next steps and acceptance.

Upon acceptance into the Northeast DiMM, participants will pay a $200.00 processing fee. This fee may then be applied toward either the Summer or Winter Mountain Skills and Rescue Course fees.

A non-refundable deposit of 50% is required to register for the course. 

Final payment is due 60 days prior to the course start date.

When you book a course with Acadia Mountain Guides, you agree to our cancellation policy. Please realize that if your travel does not go according to plan in any way and for any reason, we are unable to provide credits or refunds outside of what is described below. We strongly recommend that you purchase trip insurance to protect your activity purchase against unforeseeable circumstances, which include but are not limited to:

  • The anticipation of Inclement Weather
  • Flight and Travel Delays and Conditions
  • Personal or work schedule changes
  • Injury or illness of self or family member
If you cancel more than 60 days in advance, you may put the deposit toward a future course. Cancellations made within sixty (60) days of the program forfeit the full tuition rate. Alternatively, if you find a replacement, you will receive a 100% refund. A full refund will be given if Acadia Mountain Guides Climbing School must cancel the course.
 

The goals and objectives of this program are to learn instructional climbing and rescue skills. We will make every reasonable effort to maximize your learning. However, extreme weather, inadequate personal fitness, difficult terrain, or park weather/travel closures may make it impossible to achieve our desired objectives.

People often ask if it’s appropriate to tip the instructor(s). Tipping is never expected but always greatly appreciated.

This is your course. The more you let your instructor(s) know what your needs are, the more he or she can help you. If you don’t understand, ask questions. If you have special interests, let your instructor know. If your instructor has provided you with a great experience and shared his or her knowledge and joy of the mountain world with you, a thank-you note or gratuity is always well received. 

A minimum of four (4) participants are needed to run this program and there is a maximum of twelve (12). The final decision to run the program will be made three weeks prior to the start date. In the case of low registration, you will have the option of joining another course, receiving a refund, or possibly paying an additional amount to allow the program to run with low numbers.

Acadia Mountain Guides Climbing School is accredited through the American Mountain Guide Association and the Professional Climbing Instructor Association. All instructors have been certified through both the AMGA and the PCIA for Single Pitch Instruction. Multi-pitch guides, alpine guides and ski guides meet or exceed the current standards of the AMGA Scope of Practice. Acadia Mountain Guides actively supports furthering their guide’s development throughout their career. That means our guides are constantly taking steps to progress their skills and will provide you with an exceptional experience. AMG is also a proponent of helping clients reach their goals, whether its having an epic day in the mountains or gaining skills to get into other terrain, Acadia Mountain Guides Climbing School can get you there!

Acadia Mountain Guides  acknowledges that its guiding takes place on the homeland of the Wabanaki, or “People of the Dawnland” which includes the tribes of the Micmac, Maliseet, Passamaquoddy, and Penobscot people.

Indigenous people have lived in close relationship with these lands and waters since time immemorial – in the face of many challenges and injustices – and continue to do so today.

Acadia Mountain Guides was founded on the principle of helping all people develop more enriching and healthier lives through outdoor activities. Our philosophy involves actively creating a culture of acceptance and inclusion while focused on personal growth and enriching group experiences. 

While we hope that our school and camp program has always been equitable and welcoming, we acknowledge that historically we have had limited representation of people of color and that outdoor experience has predominantly been a white experience available only to those with privilege. We seek to change that.

Acadia Mountain Guides welcomes participants representing a diversity of race, color, national origin, religion, sex, sexual orientation, gender identity and expression, military status, age, socioeconomic status, outdoor experience, and life experience. Explicit and implicit racism, bullying, or any kind of discrimination has no place in our community. Acadia Mountain Guides embraces change and will nurture a culture of diversity, equity and inclusion where each person feels seen, heard and supported now. 

Our pledge to inclusion includes:

      Removing financial barriers for families wanting to attend camp by providing scholarship assistance

      Seeking out opportunities to promote diversity and inclusion in our programming and in partnerships with other organizations

      Fostering a culture of community, humility, and open communication among every individual in our program

      Providing training, professional development, and support to help staff with future professional and personal endeavors in the outdoors

      Listening to and serving members of the BIPOC and LGBTQ communities

      Continuing to seek a more diverse community of campers and staff

MEET THE TEAM

The primary instructors for this course will be Jon Tierney, Silas Rossi, Paul Marcolini and Dick Chasse.   

Other team members may be present for portions of the course.  

Jon Tierney
Owner/IFMGA Guide
IFMGA/AMGA Mountain Guide | Flight Paramedic | RN | FAWM | WP-C | FP-C | CEN
Nicholas Daniel
Chief of the Division of Wilderness Medicine at DHMC
DO | DiMM | FAAEM | FAWM
Nicholas Weinberg
MD | DIMM
Silas Rossi
IFMGA/AMGA Mountain Guide | WFR | AMGA Instructor/Examiner
Paul Marcolini
Paramedic | WMAI Lead Instructor
William Galvin
MD | DiMM | FAWM
Johndavid Storn
MD | DiMM | FAWM | NRP
Dick Chasse III
AMGA Tenured/Asst Rock, Alpine and Ski Guide | PCIA SPI Instructor/Examiner | WFR | MDI Search and Rescue

The Northeast DiMM is a collaboration between Dartmouth Hitchcock Medical Center’s Division of Wilderness and Austere Medicine and Acadia Mountain Guides Climbing School. As one of the only tertiary medical centers in a rural, mountainous region, Dartmouth Hitchcock Medical Center provides an ideal setting for wilderness and austere medical training including a fellowship program that is ideally situated to make a lasting impact on the public health and safety of patients in austere settings for our local community, the greater New England region, and the world.

Acadia Mountain Guides Climbing School has consistently been a frontrunner in climbing instruction and guiding in Maine and across the country. Since 1994 we have been designing customized experiences or training for you, your family, your group or company. 

  • AMG led the way in the creation and development of the AMGA Single Pitch Instructor course.
  • AMG was the first program to bring AIARE avalanche education to the Northeast.
  • AMG stepped into new territory for a climbing school by starting a summer-long youth rock climbing and adventure summer camp.
  • And now AMG, in partnership with Dartmouth Hitchcock Medical Center’s Wilderness Medicine program, brings you the first Diploma in Mountain Medicine in the eastern U.S. 

25% Discount on Mountain Gear and Clothing

DiMM candidates and graduates receive a 25% discount off MSRP on purchases in our stores or at AlpenglowGear.com

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