I have 18 years of SAR in CO, 6 years as medical officer. My original instructors are now the director for DMM and the director for CMC's WEMS program.
WEMT FAQ:
Will it get you on a SAR team, nah.
Will it provide a good mindset and techniques as well as enough CE to refresh your EMT? Yea.
Is the WEMT upgrade a similar curriculum to WFR? Yes.
Does the "industry" regard an EMT with a WFR as a WEMT? Yep!
Do we preferentially train our rescuers as WFRs over EMT? Yes (unless they want to practice as an EMT outside of the team).
Is there a difference between austere, wilderness, and rescue medicine? Yes... kinda... sometimes...
Will a SAR team sponsored class taught by SAR providers have more focus on organized rescue medicine? Yes.
Is WEMT worth your time any money? Up to you!
8 years ago a physician on this forum, Veneficus, asked me about WEMT courses and this was my response::
WEMT as an initial certification is a combo of EMT course with another 48-80 hours of wilderness focus added on. That is what I did. I found it a little confusing to simultaneously learn wilderness and urban protocols. On that note, virtually no EMS agency outside of those who teach WEMT utilize the expanded Wilderness protocols.
I do think WEMT is a great CE course for EMTs and is great for SAR, ski patrol, guides/usps/usfs/blm and other EMTs who recreate in the wilderness. Its good practice for packaging and improvisation. I do like it when my back country partners have a WFR. Incidently, when a WFR takes an EMT, their WFR issuer will often grant them a WEMT card.
You ask: are they actually worthwhile? The answer is: for whom? I'm sure for many students, they are merely "playing in the woods." There are plenty of players in the market: SOLO, NOLS/WMI, WMA, DMM, CMC, ASHI, etc following curriculum based off of WMS's practice guidelines. Recently, most of these players did get together to streamline their curriculum.
What can you get out of it? Primarily mindset and improvisation practice/techniques.
For most providers: the courses are really good at teaching improvised care, making some care decisions with limited resources and extended extrication, and some best practices that are different in the wilderness setting. For a physician who has familiarity with austere care, they'll see little benefit in that regard.
For EMS providers specifically, I think courses like WEMT Upgrade etc also help enforce the idea of preventing problems and thinking beyond 5, 10, 15, 30 minutes, thinking about limited resources and wilderness extrication, etc when making care decisions and plans.
I will agree with you that the courses are rife with gee-whiz improvisations that nobody (besides the instructor) would remember how to do, much less implement, in the real world. My favorite example is the rope litter. It looks neat, requires practice, and sucks when done correctly. But I can surely go grab a book, Dr. Aurebach's giant wilderness cornucopia or ASHI's Wilderness manual and see an example of how to make your very own rope litter. Sure, I learned how to improvise a traction splint from ski poles or paddles and webbing... they were even timed drills. I could still make one relatively easily, but I doubt I ever would, and the evidence on traction splints in the wilderness is questionable!
I think that almost everyone charges too much (at least CMC you can do your WEMT upgrade for $300 or a WFR for $500 while NOLS wants $500-950 for the same).