Trip Highlights
Pristine alpine scenery, deep gorges, waterfalls, and solitude in the largest wilderness area in the US
Rich history featuring indigenous pictographs and relics from early explorers
Incredibly clear water and world-class trout fishing & instruction (equipment provided)
Beaches and natural hot springs... the Middle Fork is famous for both!
Over 100 exciting rapids (up to class III+). Experience them from a raft or inflatable kayak - the choice is yours!
Spectacular flight from Stanley to the put-in (as required)
Imagine crystal clear water flowing through a canyon deeper than the Grand Canyon. Picture natural hot springs, fishing for blue ribbon trout, and more than 100 class I to III+ rapids in the largest wilderness area in the US.
The Middle Fork of the Salmon is a spectacular, remote, and pristine wilderness much as it was 100 years ago. Named by National Geographic as one of the top three river trips in the world, the Middle Fork provides the vacation of a lifetime and the perfect backdrop for a CME medical conference.
We allow plenty of time for relaxing, hiking, and soaking in hot springs. Fishing is world-class - it's common to catch over 100 fish during your six days.
The river is also at a "user-friendly" level in the fall giving participants a chance to experience optional inflatable kayaking.

Itinerary Snapshot
Middle Fork Of The Salmon River Raft Expedition
Wilderness Medicine CME

Upon launching our rafts at Indian Creek, 4700 feet above sea level, you'll enter Pungo Canyon which has some fun whitewater before soaking in the Sun Flower Hot Springs, which is a natural shower! After hiking up to Loon Creek Hot Springs, we run Grouse Creek and Tappan Falls rapids. Ample time to explore pioneer homesteads provide the perfect balance to the on-river excitement. Evenings find us eating gourmet river meals relaxing by the campfire, playing horseshoes, listening to the river, and watching for shooting stars!
The Middle Fork is a catch and release Blue Ribbon Cutthroat Trout fishery with anglers catching as much as 100+ fish/day. Because we are high up in the drainage, fish usually max out at around 16 inches. MFRE provides instruction with two company fly rods and numerous flies for those who would like to learn the art of fly fishing. September is the ideal time for fishing on the Middle Fork.
SEPT 4-5 As we drop in elevation, the river widens and the spruce forest opens to vistas of pine-studded mountains and we enter Impassible Canyon, where no trails can be cut as the sheer walls go up over 3,000 feet. This section of the river is deeper than the Grand Canyon! We will navigate fun whitewater such as Haystack, Bernard, Earthquake Rock, Jack Creek, Cutthroat Cove, Redside and Weber rapids. Between rapids, you'll drift quietly over deep pools of transparent water, home to native cutthroat and rainbow trout. Short hikes underneath Waterfall Creek and up to Veil Falls are highlights for many of our guests.
There are many longer optional hiking opportunities throughout the river corridor and all have stunning vistas of the canyon. Some hikes are out and back and others are loop hikes. There is also always optional hiking from camp as the Middle Fork Trail runs along 80 miles of the Middle Fork. There are hundreds of hiking options... too many to list! If you are looking for a more active hiking trip, just let the Trip Leader know and we'll make it happen for you.
SEPT 6 The last day has some of the best and biggest rapids of the trip, including Rubber and Cramer Creek Rapids -- a great whitewater crescendo finale for the week. We arrive at the take-out point at Cache Bar around 10am and drive by bus one hour for a picnic lunch at the North Fork Country Store. After lunch, we drive three hours to Stanley, arriving between 4-6pm. You can leave your car parked at the MFRE warehouse in Stanley during the trip. After a hot shower at your hotel, enjoy Stanley for a nice dinner on your own at the Sawtooth Hotel or the Casino Club or drive 10 minutes to Redfish Lake Lodge. The next morning drive home or to Boise for flights after 12:30pm.
Dates & Pricing
Prices are based on double occupancy.
Trips include: Ground transportation to and from Stanley, all meals from lunch on day 1 to lunch on day 6, all camping equipment, all rafting equipment, watercrafts (oar boats, paddle raft, inflatable kayaks, inflatable SUPs), all commissary equipment for meals and camp, 3 dry bags, and MFRE mug to use and take home after trip.
Trips do not include: Flights to and from Stanley, flight into Indian Creek, motel in Stanley for nights before and after trip, travel insurance, optional tipping of guides, and additional alcoholic beverages.
September 1 - 6, 2025
$3,850 per person
$789 Optional CME Cost
(16 AMA PRA Category 1 Credits™)
$155 Scenic Flight to Indian Creek
Available - Filling Quickly
Questions? Ready to reserve your spot?
Speak to an expert at Bio Bio Expeditions - the award winning outfitter of this trip
1-800-246-7238
A few of the publications Bio Bio Expeditions has been featured in:

Testimonials From Your Colleagues
"Awesome faculty, very knowledgable, and they communicate well. Friendly and very competent guides. Food was too good! Beautiful location! Activities were a good balance of challenge for our group."
Bill Schroa, MD - Family Practice, Durango, Colo.
"Everyone on the faculty was fabulous. I love them all. Excellent guide staff. Location is beautiful, remote, relaxing, and conducive to joyful learning. This course has enhanced who I am."
Susan Ralston, ARNP, Phoenix, AZ
"Phenomenal guide staff! Top notch! Everyone was eager to make your experience a positive one. Faculty is knowledgable and easy to approach. You Cant beat the itinerary!"
Randi Wagner, MD Family Practice
COURSE CONTENT INCLUDES
- Altitude Illness
- Hypothermia
- Frostbite and Other Cold Injuries
- Environmental Heat Illness
- Traveler's Diarrhea, Giardia & Other Waterborne Wilderness Infections
- Surviving the Unexpected Night Out
- Lightning Injuries
- Improvised Medical and Trauma Care
- Management of Fractures and Dislocations
- Preparing for Foreign Travel
- Backcountry Medical Kits
- Wilderness Wound Management
- Patient Assessment in Wilderness Settings
- Wilderness Dermatology
- Marine Hazards & Envenomations
- Snake Envenomation
CME ACCREDITATION INFORMATION
"This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education through the joint providership of the Center for Emergency Medical Education and Wilderness and Travel Medicine. The Center for Emergency Medical Education is accredited by the ACCME to provide continuing medical education for physicians."
The Center for Emergency Medical Education designates this live activity for a maximum of
16 AMA PRA Category 1 CreditsTM.
Physicians should claim only the credit commensurate with the extent of their participation in the activity.
This trip is planned, outfitted and conducted by Bio Bio Expeditions, or subcontractors arranged by Bio Bio Expeditions. Please note that Wilderness and Travel Medicine, LLC is responsible for the CME Educational content only. Wilderness and Travel Medicine reserves the right to change or substitute the faculty for any CME course without advance or prior notice to participants.
For more information or to register for this trip please call
Bio Bio Expeditions at 1-800-246-7238
UPCOMING CME DESTINATIONS BY DATE
Classic Patagonia - Torres Del Paine
Jan 29 - Feb 9, 2025
Japan Ski & Snowboard Adventure
Feb 2 - 8, 2025
Mar 15 - 22, 2025
Apr 2 - 19, 2025
Apr 20 - 30, 2025
April 23 - May 10, 2025
Apr 25 - May 5, 2025
The National Conference on Wilderness Medicine: Santa Fe, NM
May 28 - June 1, 2025
Skills Course Rafting & Mt. Shasta
June 8 - 13, 2025
The National Conference on Wilderness Medicine: Snowbird Ski & Summer Resort, UT
July 26 - July 30, 2025
Deluxe African Safari: Zimbabwe
Aug 16 - 26, 2025
Aug 31 - Sept 10, 2025
Sept 1 - 6, 2025
Sept 10 -20, 2025
Sept 12 - 22, 2025
Sept 21 - Oct 5, 2025
Sept 28 - Oct 9, 2025
Oct 5 - 15, 2025
Fly Fishing for All Levels - Northern California
Oct 12 - 17, 2025
Oct 25 - Nov 7, 2025
Japan Ski & Snowboard Adventure
Jan 25 -31, 2026
Jan 27 - Feb 4, 2026
Classic Patagonia - Torres Del Paine
Jan 29 - Feb 9, 2026
Jan 31 - Feb 7, 2026
Apr 20 - 30, 2026
April 26 - May 10, 2026
Deluxe African Safari: Zimbabwe
Aug 29 - Sept 8, 2026
Aug 30 - Sept 9, 2026
Sept 17 - 24, 2026
September 19 - 29, 2026