Tom | Event Medic
Tom is a dual GP-ED trainee, event medic and the co-founder of Ascent Medical Support. Ascent provides medical cover at endurance and extreme sporting events around New Zealand including ultramarathons, long-distance triathlons and the legendary slopestyle mountain biking event, Crankworx. An experienced athlete himself, he spoke to us about his journey to becoming an event medic.
My story
At medical school, I thought I wanted to be a sports physician. After PGY2 I wanted more experience and did a variety of SHO jobs in provincial hospitals before starting GP training.
During that time, I completed a post grad diploma in sports medicine and went on a few tours with sports team. I realised working 9-5 in a clinic wasn’t for me, and missed acute medicine. I returned back to the hospital and Emergency Medicine. I like the episodic nature - it is very much like Event Medicine actually. You are there, you have your team, you work, you finish.
I started working in Rotorua and met Ascent co-founder Ben. He had already started doing some work with an outdoor emergency management company, Peak Safety, working with them at endurance events. These events often require a specialist level of care, people can get really sick; it helps having doctors on site. Especially in the remote environments where they often take place.
I started to work with Ben and, as things grew, it was getting a bit messy working through another company. Along with a super experienced RN, Ange Guy, we decided that it made a lot of sense to make it our own business. We could focus more on doctor and nurse led events and operate in a more clearly defined way. We could also appear more professional, rather than just using our personal email addresses and bank details, especially for invoicing equipment. We can now be clear about what we offer, what we will deliver on the day and offer clear feedback to events.
We still work closely with Peak Safety which is so refreshing. It is super motivating to work with people from outside the hospital/medical bubble. They are a real mix; ski-patrollers, outdoor guides – people who have a huge amount of life experience. They know their limits, they communicate well and use initiative. It makes us lift our game.
It is super motivating to work with people from outside the hospital/medical bubble.
My role
Ben and I do a lot of background work for the business – paperwork, scoping events, set-up etc. I still work full-time so that can be a bit full on sometimes!
My ‘average’ day
I will tell you about a typical day for a doctor working with us.
With Ascent, you won’t be stuck as an observer or in a muddled first-responder role. You are a doctor at an event – you are going to practice the way you do day-to-day and use the skills you already have. Come to an ultra, you are going to see sick people. Come to a mountain bike event, you will see trauma.
We scope every event in advance and assess the resources needed as well as any potential risks. We have a set of medical protocols that we have refined over the years which provide context-specific information and we review them after every event. We can still do quality improvement in the bush!
Our smallest events would have one doctor and a nurse. Bigger ones might have several doctors on site.
Come to an ultra, you are going to see sick people. Come to a mountain bike event, you will see trauma.
If someone is coming to work for us for the first time it will generally be at a bigger event. You would usually show up around mid-morning (coffee in hand!). We discuss what is happening that day, what we are expecting to see, available resources, emergency contacts and back up arrangements.
We have some doctors who come and work for us who are in their element immediately. Others are more cautious and run a lot of things by us. We are happy with both – we acknowledge differences in approaches and want to support that.
The day usually starts with a trickle of patients before things ramp up in the afternoon. It can get pretty busy, but you lose track of time! Every patient gets a record – even though you are in a tent, you are still a doctor and we expect you to make decent notes.
At some events, if we have enough doctors, you might get to spend some time watching out on the course. But we are generally based in our tent – we are not putting people back together on the side of a hill. You won’t have to run 10km with an oxygen cylinder! Even though our setting is a bit different, it is quite like working in a hospital, except there is grass on the ground instead of lino.
At the end of the day, the first-responders come in from the field and often everyone goes for a beer and something to eat. It is usually a 10-12 hour day.
Is it paid or volunteer work?
Most of our roles are paid, there is a bit of variation depending on event location, hours worked and the number of staff present. At the very least we have a paid lead doctor at every event. High standards of competitor medical care are an important piece of competitor experience; people who get hurt shouldn’t have to worry about getting appropriate care. . Increasingly services delivered at events are paid; timing, catering, commentary, why should medical care be any different. We enjoy what we’re doing but we also have specialist knowledge and serve a real purpose for the events we work with.
My experience of ‘going beyond’
In terms of taking the leap to start the business, it helped that there were two of us. I think if you’re doing anything outside the realm of the norm, having that collegiate support is really important.
What were the reactions from others when you decided to do something a bit different?
I think the initial perception is that we are like medics dragging people off the ground out in the field. I don’t think many people realise exactly what we do until they come and work for us. The idea is that when you see Ascent the experience is like seeing a doctor in any other setting. The care, from history taking to documentation, should be high standard. We are really clear about not being cowboys in a tent out in the forest. Personally, I have previously been super conscious of how we are practicing a little differently, I think for a lot of people trying to try different things in medicine, this is probably a common barrier. We just make sure we strive for high standards and keep up to date with evidence.
Our colleagues have been super supportive
Actually, our colleagues have been super supportive – partly because we have kept literally hundreds of people out of the ED on event weekends! One of our SMO colleagues would come to the same event each year and just refuse to be paid. We have also been invited to give teachings and a grand round around ultramarathon medical issues.
Is there anything you wish you had known before taking on the role?
In terms of the business - get help! Initially we muddled along doing our own finances, then we just got an accountant. It is 100% worth it.
Practical Stuff
In terms of being an event medic, I would advise working with an existing company if possible. If you wanted to set up on your own, like we did, you would probably have to work for free for a while.
It is a great addition to a career and there are so many opportunities - policy or guidance for a sports organisation for example.
It is a great addition to a career
Skills & Experience
I would recommend that you are up to date with ACLS and ideally ATLS for mountain biking events. Having some minors experience is also very useful as is having done an ED run. Another tip would be to go to a couple of events as a competitor and get used to the environment - we are usually based at the finish line where there can sometimes be thousands of people around, it can be overwhelming. This also helps you to relate better to your future patients!
Indemnity
Just speak with your provider. We are both members of MPS and their cover extends to any environment where you are working within your scope, which we are. We generally only take doctors at Ascent who are PGY3 or above to make sure there are no restrictions on general-scope and they have a solid medical grounding.
If you could go back to your medical school graduation day and give yourself one piece of advice, what would it be?
No experience is a bad experience. If you see a good opportunity, just do it. Worry less about where it’s going to take you and more about what it involves.
No experience is a bad experience