For all future F1 docs

I’m constantly contacted by medical students and young doctors who wish to devote their lives and careers to Formula 1. They seek advice as to what the best path to follow to actualise that desire. Here in a nutshell is my answer.

First of all, I know almost no one in motorsports medicine for whom it is a full-time job.This includes some of the most well-known and important guys doing this. There are a number of reasons for this, including the weekend nature of the sport, the fact that to maintain any level of competency one needs constant clinical exposure, and the fact that very few (non corrupt) motorsport associations can afford to pay doctors a full-time salary for what is basically a hobby. A time-consuming, passionately engaging, and extremely serious and rewarding hobby to be sure, but a hobby nonetheless.

DO NOT ENTER THE FIELD OF MEDICINE BECAUSE YOU WANT TO BE A “F1 DOC”. Become a doctor because you want, need, cannot BUT, be a doctor. If what keeps you going, through the long grueling years of studying, through the 100 hour weeks, the emotional and physical hardships of training, is the ultimate goal of being in the front seat of the medical car, GET OUT NOW. Not just because of the extreme statistical unlikelihood that it will happen, but because the motivation needs to come from the day to day practice of medicine, not from what or where you want to be . . . years later.

In terms of the skill set you need to work in motorsports, pick the field of medicine you love. The one that fulfils you. The specialty that fits your personality. It doesnt matter if it’s dermatology, ob/gyn, anesthesia, emergency medicine, or endocrinology. Remember, you need to wake up every day and go to work. And if your first thought is “shit, another day in the clinic seeing diabetics” or some such negativity, you’re going to be miserable.

To be effective at a circuit, at a rally, drag strip, etc, you of course will need total mastery of the basics of trauma care. Taking and passing courses such as PHTLS, ATLS (or perhaps more usefully the European Trauma Course) is obligatory. And only then can you start to take these certificates and turn them into real, reflexively available, psychomotor skills. I know psychiatrists, dermatologists, etc, who are marvellous motosports docs – because they’ve taken the time to learn what they need.

Get involved with the sport you love early. Start hanging out at your local venue, whether it be a hill climb, rally, circuit … Get exposed to the work, the environment, the organisation. Start to meet and know the people, and to let them know you. It’s a pretty small world, and by the time you’re ready to get out there, you’ll have built up a circle of friends, mentors, and colleagues.

Work as much as you can. I remember when i first met Sid. I’d been a consultant anesthesiologist for years, but had been doing motorsports for only a few months. I remember he turned to me on the Sunday and said “you know old boy, in five or ten years, you’re going to have figured this thing out, and you might be pretty good”.  I was, of course, shocked. But, of course, he was right. It takes a long time to figure things out. In every way. Be patient, keep your eyes and ears open. Find a mentor, and engrave everything he or she says in your memory. And be safe, right from the get-go. It’s a dangerous environment, and mistakes get paid for in cash. Protect your ears from the beginning. Thresholds are such that ANY exposure will immediately start killing your sensory cells. They don’t grow back, and you won’t notice it until it’s too late. I’ve been extremely careful since the beginning, and I’m the only person I know in any position with fully intact, audiogram-proven, hearing. Everybody else is well on their way to becoming functionally deaf.

If your personality, your medical orientation, and your needs point you to a more “acute” specialty, then the obvious constitute fantastic preparation for prehospital trauma care. Emergency Medicine and Anesthesiology – nothing like them to give you the knowledge, technical skills and reflexes necessary for immediate, life-saving decision making. Then go on and learn the principles of mass casualty management.

Hope this helps. Post your questions to the comments, and I’ll get to them as I can.

24 thoughts on “For all future F1 docs

  1. As a side bar here……Mick Schumacher was involved in a crash in a F4 race. He broke his hand. If any of you have seen the video please explain to me why he was high on the race track when all the other cars, with the exception of the guy who ran into him, were down low. Pit?

    • No, pit entrance on that track is in the middle of the last turn, can’t be even seen on the video and pit exit is after that turn. You really need to be on the outside for that turn 1 so he was probably just moving off line to prevent giving guys behind a tow, maybe to be in clear air and would tuck in again if the guy hadn’t hit him. Probably didn’t have enough time to take his hands off the steering wheel as it was really unexpected. Would have been a good finishing position P5.

  2. “the most valuable skill needed to work with someone who is hierarchically superior but not even on the same scale in terms of know-how, interpersonal qualities, and “truthiness” ”

    I really doubt I could remain working as a doctor If I wouldnt be able to do that…..hehehehe. A little joke for you all fellas😉

    With all due respect, Gary, I really DO keep my mouth shut. Think about why I am writing to one of my idols (Yeah!) using a ridiculous nickname. Yes, I consider you and the other guys like Mathew and Sean the way to go. Childish? Maybe. But helps me to get into the car…

    But I was just making some sound about a very common way of motorsport doctoring wich many of you used to Big circuits arent used to. We really experience tough conditions, not to give ourselves too much credit, but I could really make all the kids run away from this world with a couple of histories. But I Dont want that.

    My illusion was never to become one of you, as close as one feet to the world motorsport medicine chiefs seing a nice moulage using a fancy F1 simulator for extrication (very nice pics and great job by the way Mathew😉, but I try to keep my level as high as I can.

    And as I said, you are my mentors, my inspiration. Perhaps one of the bunch of motivations that get me in my overalls weekend after weekend.

    All my apologies to all the people that felt hurt by my previous comment. I didnt meant to be agressive…

    Love and peace for all motorsport lovers.

    Best Regards

    • I completely understand all your points! I think everything you’ve said is extremely useful for anyone thinking about working in this field.

      My references to hierarchies had to do with an extremely competent skilled doctor (Ian R) having as a “boss” someone who has absolutely no idea at all about what he’s doing (JC Piette).

      I’m quite sure no one was hurt or insulted. Your perspective was totally realistic, just phrased in a rather . . . concrete way.

      • Haven’t seen any video. And no details about the injury either. Fractures of the scaphoid bone or other parts of the thumb are relatively common when the hands are still on the wheel (hooked around the spokes) when the car impacts the wall. This is why you’ll see most drivers taking their hands off the wheel soon after accepting loss of control. At that point, only the brakes might influence outcome, and they’re usually standing on them by this point.

  3. Dear Sir,
    I would not question your perspective on this Mr Hartstein but I’m a Psychiatrist working for the FIA Management and my appointment book is booked solid.
    Regards
    Bigg Ears

  4. Thank you for the great blog and the sound advice! Ever since I was a little boy I want to be a doctor and I’ve always been a motorsports fan. It makes sense you connect the dots at some point in your mind and think about a career in motorsport medicine. However, as I’m heading towards my clinical rotations, I discovered during my studies, extracurricular activities and job in the hospital that there are so many great disciplines within the field of medicine.

    At the moment I still pursue a career in emergency medicine and/or anesthesiology. Not because it might help getting a job (hobby;-)) in motorsports medicine, but because I simply find the challenges in that specific field fascinating.

    • I specialized in anesthesia because it fit perfectly with my personality, and have never, not for one day, regretted it! Best of luck in what I hope will be a long and totally satisfying career. Inch’allah!

  5. Before we completely take a blowtorch to aspiring motorsport medics, I’d like to take a more sanguine view. After all, many areas are struggling with medic recruitment for motorsport events.

    First off, I agree with the core of Gary’s post:
    -Do medicine because you WANT to
    -Do motorsport because you WANT to, but don’t EXPECT a glorious career.

    To flesh it out a bit, it is certainly true that providing medical cover at motorsport:
    – Will not make you a lot of money. At very least it eats in to your time to put towards lucrative locum jobs. Not infrequently it will cost you money between travel, accomodation and food.
    – Will not make you a celebrity. It may however make you quite unpopular at home if you abrogate family responsibilities in pursuit of fame and glory.
    – Can be very boring. For car races at least, getting stuck into a meaty trauma is getting less commonplace. This is overall a good thing as it is a reflection of how far safety features have come in narrowing the injury gap between intact survival and death. However, the gap is still there and more so for the less monetized forms of motorsport. It is also certainly there for motorbike events.
    – Can seem quite thankless. Over the years, simple things like officials’ packs have been stripped right back, to the point where the medical team members sometimes don’t even get an event cap or t-shirt (It’s not the item, it’s the recognition of effort). Don’t be surprised that everyone else at the event thinks you are being paid big bucks to be there. That said, an injured competitor moreoften than not will at least say thanks to the team.
    – Will not guarantee a doorway to fame and glory. You might get to rub shoulders with a few famours racers or personalities when picking them up from a track incident or at the medical centre, but don’t expect an invitation to their boat for the after party. At the end of the day, these guys are doing their job and while you may become involved, you are but one of many they will meet at any given race event. Most of the lower tier guys are just normal people who are happy to chat if the situation allows.

    Despite all of this apparent negativity, providing medical cover at motorsport events is still a worthwhile interest.

    – It is fun. Usually more due to the people that you spend your day with than for any champagne you are missing out on.
    – You do get access to parts that others never see beyond the pitlane barrier, whether it’s chatting to a pitlane mechanic before free practice or seeing parts of the country that few others get to during a rally
    – It’s refreshing, a little challenging and keeps you on your toes to get out of your day job environment (a hospital for most of us) and mix with people who have a diverse range of knowledge and skill sets. It stops us getting too comfortable and self assured. And that might take you in directions you hadn’t ever thought about.
    – as Jane A posted above “There must be a tiny, tiny number of driven people prepared to work so hard for so little glory”. Yes, it doesn’t take too long to meet most of the regulars, but on the flip side, you end up with a solid bunch of friends who share a common interest. That’s a reward in itself and worth the effort.

    So don’t do medicine to become a Formula 1 doctor in the medical chase car. Do medicine because you want to do medicine, regardless of which area of it takes your interest. And if motorsports is something you also have an interest in, then it is certainly possible to combine those two interests. Just be honest with yourself as to your expectations of what it will lead to.

    Have fun

    Matthew

    • Thanks for thie Matt! As usual, brilliantly fleshed out. Despite all the “negatives”, we all do/did it for a long time, so there must be some pretty powerful “positives”!

      And for info, for all the young ‘uns out there (current and future motorsport medical personnel) Matthew’s blog is a must follow. He puts a HUGE amount of effort into it, and every time you check it out you’ll learn something. Here’s a link:

      http://rollcagemedic.yolasite.com

  6. Hello Docs my name is Sultan, a spanish med student whose passion by cars started because of my father who was a Senna fan, he showed me this world I am in love with. The more I read the more I know which way I want to take in this carreer that I love, medicine.

    I love motorsport, I love racing and I want to dedicate a part of my life to this sport. However, I know that reality isn’t Monaco and the glamour that we see on Tv. Some days ago I asked by twitter to Dr. Hartstein which specialitys would be useful to me. There are a few of them that I like as Traumatology and I asked you Doc because I didn’t know if I could be a motorsport doc not being a emergency medicine specialized doctor. Reading your post I realized that it is not necessary, the only matter is to do what you like as you say.

    Thank you all for your advices!

    • Hi Sultan. It took a while, but I finally DID write the post. Thanks for catalysing that.

      You’re right – first be a doctor, then be the doctor you want to be. THEN get yourself the skills and knowledge to be able to function in motorsport. None of us would discourage anyone from doing what we’ve spent countless hours doing. We just want things to be clear from the green flag!

  7. I think you definitely are too soft with the “I want to be a F1 Doc” kids…

    The world of motorsport is often hard and not friendly. I am going now to uncover the “real” motorsport medicine to all of you kids. Not glamour, not TV, not first class drivers and stewards….only the real world. Low profile.

    You have to become a doctor….a good one as Dr. Hartstein said. In my case, ED, in Gary’s both Anest. and ED. In this long term career the motivation should be something like “heal”, “help people”, etc….but NOT “I am going to be in the right front seat of the C63 State” coz you know?? That is not going to happen. Period.

    The story of Gary becoming an F1 Doc is inspirating but very VERY unlikely to happen to ANY of you/us. And since the good old times of Prof. Watkins, you better get well “politically” prepared. Rigth Dr. Hartstein (wink wink)??

    Now, its time for another “reality” bolus. I had to pay for my nomex overalls (not retail price, anyway not cheap). I receive NO salary AT ALL most of the weekends due to the economical difficulties everybody is experiencing….

    Whenever I attend to a rallycross or a hill climb I really freak out. There is a kind of Formula “mini F1” competing all over the country, BUT….no security measures at all, no medical warning light, no extricable seats….doing 0-60 in less 3 secs on open roads….
    There is a mad creation called “KartCross”, where the pilot attaches himself to a tubular structure with motorcycle engine…..figure out how an extrication should be…..

    Plus, the enviroment. You couldn’t believe how dangerous this is. No “K” vehicles in regional motorsport. WE have several fire extinguishers in our medical car, and metal cutting tools. So in the event of fire I have become a firefighter, a rescue operator and -of course- an ER doc at the same time. The real danger is multiplied by ten in this kind of motorsport. So get out THAT lovely images of Dr. Hartstein youtube interview of your brain….no fancy circuits and paddocks.

    Last but not least, the confort. Dont expect any luxuries you have in your life be present when attending motorsport. Not having a hot lunch is common. Not having a toilet. Freezing, Starving, Wet, Suffocated….those are feelings you wil have to be familiarized with if you want to be a motorsport doc. BORING?? No matter how much you love motorsport. Everyone of us want to be at monaco spending the time watching the cars…..but when seated in the front right (or back) seat of the car is often quite dificult not to ask to yourself…why I do this??

    But in the end, every one of US sitting in the medical cars worldwide feel that we are helping others to enjoy our common passion. We really have gas instead of blood through your veins. And why I continue spending my weekends this way?? The answer is clear, I cant avoid it.

    Remember kids…If you like motorsport so badly, It would be easier to sit on a cockpit on the starting grid than on the front right seat of the F1 Medical Car. Do the math…22 vs 1.

    Best Wishes for you Dr. Hartstein in your brand new life on UAE!

    • With considerably more “reality” than my post, I thank you. It is indeed only a rewarding activity because it gets us close to a sport we love, and bonds us with people motivated by the same passion. It is indeed usually long, boring, tiring, bladder-filled, hungry, cramped. It is indeed as close to volunteer work as it can get – nay, sometimes beyond, coz it costs us money to get to where we’re going and to eat . . . when we get a chance to eat.

      My story has absolutely nothing to do with any particular talents I have, although my involvement helped me develop skills I would not have had a chance to work on otherwise. It was a question of “right place, right time”.

      Ian, who currently has the position, was no doubt chosen because he has the necessary medical/technical skill set, but mainly (and unlike yours truly) he can both keep his mouth shut, and maintain a low profile. His ability to sit next to Piette while the latter spouted inanities if not outright lies at the “Bianchi press conference” was proof of this, the most valuable skill needed to work with someone who is hierarchically superior but not even on the same scale in terms of know-how, interpersonal qualities, and “truthiness”.

      Does motorsport medicine STILL interest you? Then I daresay, you probably have what it takes!

      Thanks Doc Hybrid, for the totally useful comment as well as the good wishes.

  8. There must be a tiny, tiny number of driven people prepared to work this hard for so little glory. I’ve often thought that Sid’s time at Syracuse in the early 1960s and his experience of American racing must have been a key factor in how well he got on with Gary. All the more frustrating of course to lose such a job to someone with no prior medical racing experience.

    • I’ve no idea what was behind our friendship, but will be eternally grateful that my life was touched by so fascinating, kind and generous a man. I’m sure he’s appalled that the responsibility for terribly injured drivers falls on the “shoulders” of such that be.

  9. This is excellent advice. Watching my sister get through medical school has given me a whole new appreciation for doctors and their expertise. My PhD journey has been almost easy compared to her long, hard slog.

  10. Sound advice from the Sage of Motorsport Medicine. Note that there is a large volunteer component to working in the sport and you may hang around a long time for a few minutes of action and often little thanks. It’s actually a good day for the medical team if nothing much happens.

    Also note that personality is key. Sitting in a car with someone for a long time means you have to be agreeable, and know when to play and when to switch on suddenly and get right on it at the sharp end.

    Sean – CMO Abu Dhabi F1

    • Thanks for that Sean!

      Couldn’t agree more. Over the years, you wind up spending more hours with your crew-members than with family. The common passion is the glue, but the bricks are our personalities, and how we share our knowledge, humor, and diversity with each other. The camaraderie is precious, and it’s what kept me coming back season after season.

      And for those who don’t (yet) know Sean, he’s a key resource in pushing motorsport medicine forward, in the UAE, but also worldwide!

      And, as we say, he’s a real mensch.

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