Space medicine is a unique field of medicine
applying a broad understanding of medicine to the
extreme environment of space. Physicians involved in
space medicine play a pivotal role in understanding the
effects of space flight on humans as well as mitigating
problems associated with space flight, and managing
any health effects that might develop on a mission (1).
In addition to the many physiological effects, space
medicine includes practicing medicine in this extreme
environment. Prevention, diagnosis and treatment must
be taken into consideration. It is therefore important to
understand the mechanisms of altered human
physiological functions in space to establish a new
“normal” in reduced microgravity, and to then discover
new ways of treating astronauts in space. The space
environment has a vast array of effects on almost every
component of normal human physiology:cardiopulmonary function (2, 3)neurophysiology (2)bone and mineral metabolism (3-5)muscle structure and function (4, 5)hematological and immunologic function (4, 6)biological effects of radiation (7)circadian rhythm (7)psychological effects (8)It is critical to launch a new era of medicine in
Canada. There are many applications of space medicine
to medical concerns on Earth. The physiological
changes observed in space can shed light on common
diseases supporting developments of treatments. First,
osteoporosis is a public health concern affecting
menopausal women, and the complete absence of
microgravity is a model of accelerated osteoporosis.
Osteoporosis is a slow, progressive disease except in
situations such as short and long-duration space
missions and immobilization (9). New treatments
addressing these issues and further prevention can be a
significant benefit to all women suffering from this
disease. Motion sickness is also an obstacle for
astronauts and cosmonauts living in microgravity.
Pharmaceuticals aimed to prevent space motion
sickness can prove useful to terrestrial motion sickness,
which affects individuals on long journeys by air, sea,
and motor vehicles (10). Additionally, reduced gravity
influences the cardiovascular system leading to an
understanding of cardiovascular functions in different circumstances. Prolonged hospitalizations can lead to
adaptation problems requiring rehabilitation for the
cardiovascular system and for muscles. Exercise
equipment specifically designed for astronauts in space
may be a useful addition to rehabilitation medical
equipment (10).Currently, there is no Canadian residency for
aerospace medicine. However, the Canadian Space
Agency (CSA) does offer an aerospace medicine
medical elective for fourth year medical students or
residents. The CSA sends selected students to the
Johnson Space Center or the Kennedy Space Center to
promote awareness of this branch of medicine and to
encourage career pursuits in aerospace medicine (11).
In spite of this, if a student hopes to pursue a career as
an aerospace physician, the only residencies offered are
in the USA. The Centre for Altitude, Space and Extreme
Environment Medicine (CASE Medicine) offers a
medical elective in space medicine and extreme
environment physiology for medical students at
University College London. Finally, some students and
residents interested in this field complete a diploma of
space studies at the International Space University.The only two American civilian universities that offer
aerospace medicine programs are the University of
Texas Medical Branch (UTMB) and Wright State
University. UTMB focuses more on space medicine
whereas the Wright State program centers on aviation
medicine. These are competitive programs accepting
few candidates from around the world on a per-year
basis (12, 13).The space shuttle is retiring in 2010 and it will be
making way for the new Ares Launch Vehicles, which
will return humans to the Moon and to other
destinations (14). Canada has made significant
contributions to the development and enhancement of
space exploration through pioneering technology;
however, new aerospace medicine initiatives should be
supported, such as a Canadian fellowship or residency
in aerospace medicine.Even though Canada has a small number of
astronauts, Canada should establish a training program
to train specialists in both an occupational and research
setting. There are still many medical challenges
associated with space flight, and increased Canadian
participation in aerospace medicine research would help
in understanding and mitigating the effects of space
environment on human physiology. Furthermore,
applications of this research could also be beneficial to
Earth-related issues. Although Canada should support new training initiatives, political pressure is geared
towards addressing the shortage of physicians. For that
reason, students interested in this field must be prepared
to pursue a unique training path that might not initially
include space medicine, but it would be great if students
were supported in these pursuits.It is also essential to optimize the health and safety of
astronauts before, during, and after space travel. The
future of space medicine is for those who would like to
embark on a journey to become a pioneer, a student, a
teacher, and an explorer in pursuit of understanding the
effects of space travel on human physiology, practicing
medicine in extreme environments, and applying new
knowledge acquired to health care on Earth.Sincerely,