Many people who come to my office are surprised that there is an area of Medicine called Travel Medicine or that anyone is actually a Travel Medicine Specialist. Most know that you can get shots before you start a trip abroad, but few are aware that there is much more to preparing for travel than just packing, airplane tickets, etc.. I hope the following summary sheds a bit of light on this new and developing field.
THE FIELD: HISTORY and DEFINITION.
Infectious diseases have been studied for hundreds of years, long before we figured out that microbes (microorganisms) actually caused them. Tropical Medicine, dealing initially with diseases transmitted in tropical areas of the planet, both among native inhabitants and travelers, began as a separate field in the late 1800’s/early 1900’s.
Travel Medicine is essentially the field of Medicine devoted to keeping travelers safe and healthy. Travel Medicine likely began as a separate field in the mid 1900’s and became more well-defined and recognized in the late 1980’s with the formation of the ISTM (International Society of Travel Medicine). It encompasses multiple disciplines, including, but not limited to: diving medicine, emergency medicine, environmental health, high altitude medicine, infectious disease, migration medicine, military healthcare, occupational medicine, pediatrics, public health, psychiatry, tropical medicine, and travel-related obstetrics.
A Travel Medicine Specialist brings together information from these disciplines/medical fields and uses it to help keep you safe and healthy during your trip. This is usually done during a Travel Medicine Consultation.
Optimizing your health and safety during a trip is accomplished in several ways:
-Medications (Malaria, diarrhea, altitude, etc.).
-Review of your medical status and trip details.
-Education to identify potential health and safety issues during a trip, how to avoid these issues (if possible), and what to do if a health or safety problem does arise (despite your best efforts!).
It’s this last aspect, EDUCATION, that is the most important part of a Travel Medicine Consultation. Bad things rarely happen during trips (if they did, no one would travel!)…but, when they do, it can be a disaster. How do I protect myself against malaria? What is considered safe to eat? How do I avoid being a crime victim? What symptoms of illness should I look for when I return home? These and other questions should be addressed during a visit to a Travel Medicine practitioner.
WHO PRACTICES TRAVEL MEDICINE?
Who can you see for answers to these type of questions, for appropriate vaccinations, and for medication? There are a wide variety of practitioners who can see you before you leave on your journey. Pharmacists, nurses, physician assistants, nurse practitioners, and doctors can all be involved in the process of preparing travelers. Sometimes, different types of practitioners work together in a Travel Medicine center. In most instances, physicians or other practitioners under the supervision of physicians are the only ones who can prescribe medications.
WHAT ARE THE REQUIREMENTS TO PRACTICE TRAVEL MEDICINE?
The CDC (Centers for Disease Control and Prevention) and other Travel Medicine organizations recommend formal education and testing for individuals who are interested in preparing travelers for their journeys.CDC
Some Travel Medicine practitioners take a formal examination as part of their ongoing education in the field. The two main organizations which operate in the US and administer tests to potential Travel Medicine practitioners are the ISTM (International Society of Travel Medicine) and the ASTMH (American Society of Tropical Medicine and Hygiene). The first of the two organizations focuses broadly on Travel Medicine, which includes pre-trip preparation and post-trip care. The second organization focuses specifically on treatment of diseases a traveler can acquire on his or her journey. Experts in tropical medicine are usually physicians who practice Internal Medicine and sometimes, but not always, Infectious Disease Medicine (a specialty in Internal Medicine).
Both organization’s tests require a significant amount of study and preparation and set a standard of depth of knowledge for Travel Medicine practitioners (ISTM) and Tropical Medicine practitioners (ASTMH). You do not need to be a Physician to take an examination. Neither test is mandatory in order to be involved in travelers’ healthcare.
There is currently no fellowship (as there is for Cardiology, Gastroenterology, and other subspecialties in Internal Medicine). There is also no ABIM (American Board of Internal Medicine) testing or certification. (I am a Board Certified Internist…but that certification does not exist for the relatively new field of travel medicine).
So, there you have it. Travel Medicine is a new (and exciting!) field of Medicine devoted to keeping you as healthy and safe as possible during your journey, involving multiple disciplines and a wide variety of practitioners. Though there is no required coursework or testing involved to become a Travel Medicine practitioner, ongoing education and sitting for formal examinations are recommended in order to best serve travelers.