During my medical student training I was lucky enough to be a sports scholarship holder playing Australian rules football (AFL) at the University of Sydney. I played for the NSW representative team and we competed against reserve team professionals from the Sydney Swans, Western Sydney Giants, Gold Coast Suns, Brisbane Lions and other representative teams from the ACT, Queensland and Northern Territory. Our pre-season commenced in October, with time trials starting day one, and the season itself ran for six months, potentially ending in late September. Training and the interstate travel schedule meant that much of my weekends were occupied. In addition, there were late night training and early morning strength and skill sessions as well as additional work such as video reviews, recovery and attendance at club events. I am currently playing in the AFL Sydney first grade competition and have been involved in various positions of leadership and coaching throughout my time in football.
Sport and medicine can seem quite disparate to some with the end goal of team sport a seemingly superficial pursuit of winning and the other directed toward a more impactful and humanitarian purpose. However, sports women and men possess traits that are sought after in medical trainees. Medicine, too, is a high performance environment; an effective doctor, like any high level team sportsperson, is paid to perform at an exceptional level. In my more than ten years playing AFL at a semi-professional level, I identified key attributes transferrable to my role as a medical professional.
As an intern, senior colleagues in positions of leadership performed simple, considered acts to include other team members. Examples included my registrars sending me home on time when possible, or consultants asking about my weekend or taking time out from the round to buy the team coffee. Another instance that particularly resonates with me was when a term supervisor brought me a Casio calculator watch after hearing I was a ‘Back to the Future’ fan. These leaders were inspiring and made you want to join them on their journey. The best leaders I have come across have their own unique style and leave a legacy, wherever they work or play.
During my emergency term I witnessed incredible examples of teamwork on a regular basis. One evening, a high-speed motor vehicle accident came in and the trauma code was activated. The team assembled prior to the patient’s arrival – surgical doctors, emergency doctors and nurses, radiographers, clerks, anaesthetic and intensive care staff were all assigned specific roles. The patient was critically ill, yet within minutes the bleeding was stemmed, intravenous access obtained, fluid resuscitation administered, pelvic and long bone injuries identified, and binders placed to allow the patient to be stabilised for intubation and an emergency laparotomy. It was incredible to observe the teamwork which allowed a methodical and timely response to such a critical situation.
Part of our culture rebuild saw a movement away from winning as the sole marker of success. Instead, the process of training, individual improvement, culture, coaching and physical preparation became additional measured end points. Considerable time and resources were allocated to education, employment, chapel services, mentoring and psychology services for players. This investment made us feel valued and proud of our club, promoting motivation on and off the field. Many people in sport refer to the famed culture of the All Blacks, New Zealand’s national rugby union team. In James Kerr’s book, Legacy1, the author talks with amazement about an All Blacks game where he witnessed a number of senior players sweeping the sheds and cleaning up the rooms after the game. One of these players was a former world player of the year. This scene exemplified the humility of these superstars and their willingness to take on and perform lesser roles that perhaps people in other teams would not feel worthy of their time.
Although culture in the workplace is a topical issue in medical training, my experiences as a JMO have been positive. I have felt comfortable approaching senior clinicians for advice and felt well supported by registrars, medical administration staff and nurses. Issues such as understaffing, unpaid overtime hours and a lack of focus on education and wellness are being addressed, allowing for a much richer learning experience. For example, the initiation of the junior medical officer (JMO) Evening Teams Service at my hospital has allowed for a dedicated evening shift JMO (who has not worked during the day) for each major service in the hospital, allowing the day shift JMOs to leave work on time. In contrast to the blunt and hierarchical approach taken by some of my previous football coaches, the healthcare system has worked hard to remove hierarchical barriers which have previously impeded JMO development. The teaching, learning and experiences I have received from senior colleagues has fast tracked my maturation as a junior clinician.
In football, our standards encompassed performance at training, game day and importantly, general behaviour outside of the playing arena. This behaviour encompassed how players treated support staff, supporters and fellow teammates, as well as their attitude towards university study, and the way they presented themselves at club events. Small details, such as turning up late for your scheduled physiotherapy appointment, or players who started running before the whistle during a set of sprints, were examples of poorly learned behaviours which we would try to coach out of our players.
To avoid player misunderstanding, it is important to clearly outline and communicate the set standards to foster improvement. When starting a new term as an intern, I found that my supervisor’s orientation and mid-term assessments were important milestones which allowed me to understand the requirements of my job and where there was room for improvement. Some of my colleagues who received poor marks at the end of term were confused, having received no orientation and good mid-term reports. When I first started on the wards, it was the interns or residents who had come before me that I turned to to understand the expectations and standards of a junior doctor.
Through my current football club, I was put in contact with a former captain, who allowed me to shadow him in the emergency department as a junior medical student. Often, I would leave those shifts embarrassed at how little I knew, but the staff would always support my learning and invite me back the following week. These mentors have had a profound impact on me personally and on my career in sport and medicine. They would often take time out of their busy lives to simply listen and give a gentle suggestion or nudge in the right direction. I found that support especially helpful when things were not going well. They would help me navigate through the same issues they faced when they were at a similar stage as me. I could ask them anything and they would always come up with a helpful answer if needed, I often found they had made me answer my own question without me realising at the time! I would recommend that every medical student or JMO put some time into seeking out a mentor. There are many people out there are willing to help us.
Having hobbies or pursuits outside of medicine can provide a fledgling doctor with tools, such as the importance of teamwork, meeting standards and the value of a robust workplace culture to navigate training as a student and JMO. Team sport has certainly given me many non-clinical skills that I have taken into medicine and adapted to benefit me. Keeping busy with hobbies or activities can also give a junior doctor joy and motivation in times when he or she may not be getting that at work. Having the support of a team of people or an involved mentor to lean on can also help during these times. As these people become part of your network and as your network becomes bigger and stronger, the less, hopefully, you will feel you are doing this on your own!