You’re standing in the swamp, rescuing a man that has been bitten in the leg by an alligator. All of a sudden—WHAM! The alligator is attacking you, too.

“The lesson here is pay attention to your surroundings and think before you act,” says Michael Caudell, an emergency room physician and director of the MedWAR Challenge. MedWAR is a bizarre adventure race in East Georgia that blends trekking, canoeing, and mountain biking with wilderness medicine. Over the last decade, the adventure race has grown from Caudell’s pet project into a cult phenomenon amongst doctors and med students, drawn to the race for the chance to test their medical chops in the wild.

Beyond the sheer joy of spending a day running, paddling, and biking in the woods, the MedWAR Challenge is designed to underscore a single fundamental truth: most of us are clueless when it comes to handling emergency situations in the woods. Surprisingly, that rule applies to most doctors too.

Fort Gordon is a U.S. Army base just west of Augusta, Ga., with 56,000 acres of undeveloped wildlands used for training soldiers. The terrain is a brutal combination of sand, dirt canyons, swamp, and creeks—the signature terrain of MedWAR Southeast. Half the teams that start the challenge don’t finish the full course, and the competitors that do cross the finish line usually come out cussing Caudell’s name.

“I’m into all that bored-white-guy high adventure stuff,” says Luke Smith, a second year medical student at the Georgia College of Medicine and two-time MedWAR racer. “MedWAR is exhausting. I’m already training for next year.”

It’s not so much the sand that slows racers down, or the canyons, or the heat, which can be brutal in this corner of Georgia. It’s the swamp. Trekking through waist-deep muck for miles can kill even the fastest runner’s momentum.

“When you first enter the swamp, you try to daintily jump from log to log. But that takes too long, so eventually, you have to jump in and slog through waist deep mud,” Smith says. “It’s awesome. It’s like you’re in Predator, or one of those other Arnold movies I grew up watching.”

And right in the middle of this swamp leg of MedWAR, you and your team of four have to figure out how to stop an alligator attack victim from bleeding to death while not getting bitten yourself. Caudell has six medical scenarios scattered throughout the 15-mile course, along with half a dozen checkpoints with multiple choice questions stapled to a tree. The questions are taken straight out of a wilderness medicine handbook, but they tend to be really obscure. There might be pictures of five plants presented, for example, and you have to choose which one is poisonous. Finding the checkpoint with the questions alone will get you a five-minute time bonus. Answer the question right and you get an additional five-minute time bonus.