Dr Charlotte Durand
I am a MIPS member and junior doctor currently living and working on the Sunshine Coast. When I started as a junior doctor, I noticed many similarities between the challenges of my new job in the hospital, and the training I was doing outside of it. I found myself drawing on techniques I’d learned in the pool or on the bike to navigate the day-to-day life of an intern.
Triathlon is an endurance sport that involves a combination of swimming, cycling and running over a range of distances. It can be a daunting concept at first, but with the right amount of training and perseverance, can be one of the most enjoyable and rewarding experiences of your life. Ok, I know many of you don’t completely believe that last part, but you can take my word for it for now…
Here I share some of those important lessons from triathlon, with some hope that it provides a new perspective, but mostly to convince you to join in for a pre-dawn swim, bike or run!
Lesson 1: Leave your ego at the door
In triathlon, ego can easily get in the way, making you vulnerable to equating athletic performance with self-worth. Letting your emotions guide decision making can interfere with your ability to perform well under pressure. Athletes who respond to cues from their ego tend to over-train, continually seek external validation, and isolate themselves through comparison with others.
Anyone is susceptible to this throughout the season, so many of us use a coach or sports psychologist to help develop skills to manage our mindsets. Training sessions are deliberately tough, forcing us to put space between our reflexive emotional response and the conscious decisions required to succeed. These are thoroughly unenjoyable sets until you get it right.
In medicine, understanding how your ego influences your interactions, decisions and sense of self is invaluable. Maybe you can’t help but panic during a procedure if someone is watching over your shoulder, or maybe you find yourself getting flustered during a difficult interaction with a patient or colleague. The good news is that this awareness is a skill that can be learned and practiced, starting with tuning in to where your mind goes when you’re under stress.
Lesson 2: Maintaining form under duress
Endurance performance relies on the maintenance of technique in the face of rising fatigue. In training, every movement is done with purpose, so that good form eventually becomes automatic. Mindset can also be developed in this way by deliberately turning attention away from negative thoughts to those which are more constructive.
In medicine, the ‘duress’ under which we perform comes not from physical exertion, but from time pressure, challenging conversations, expectations from colleagues and mounting workload. This approach to deliberate practice is helpful for procedural tasks, such as putting in a challenging cannula; as well as mental tasks, like delivering bad news or calling a senior for help in an emergency. If you practice your best technique in all situations, on all days, then it will be there reflexively when you need it.
Lesson 3: Visualisation
One of the most powerful ways to prepare for a key event is through visualisation. Like any given shift in the emergency department, almost anything can happen during a race. Getting a flat tyre is a common anxiety-provoking incident that we can prepare for using mental rehearsal. In the lead up to an event we might practice in our minds the stepwise process of replacing the tube whilst remaining calm and methodical. Having done it multiple times in our head, we are then better prepared for when it eventually happens in real life.
Simulation in medicine allows us to do this in a more interactive way, exposing us to new and challenging situations in a controlled environment. But you don’t have to wait until it’s your turn in the sim lab to do so. You can practice visualisation at any time, using your mind to walk yourself through a complex procedure or explore how you would manage a deteriorating patient. As you do this over and over, you can modify how you act and react in the scenario, until it becomes your default response. Now you can be prepared for whatever the day throws at you!
Lesson 4: Run your own race
During a race it can be tempting to try and keep up with a competitor who passes you on the bike. However, if you can’t hold that pace you risk burning out before you even start to run, which makes for a painful and miserable day. Straying from your race plan to keep up with someone else is a classic beginners mistake- both in triathlon and medicine. ‘Control the controllables’ is a well-known phrase we use to redirect our focus back to the actions we can take, independent of what others are doing, to deliver our best performance in the moment.
As a junior doctor it is easy to get caught up in the whirlwind of the ‘CV-arms-race.’ It can be intimidating to see friends and colleagues publishing research, delivering presentations and spearheading committees. The natural reaction is to try to pick up the pace by signing up for similar things. However, you have limited time and finite energy to burn, much of which is used up trying to be a good clinician and have a life outside the hospital. CV-padding is an unfulfilling practice and doing extra work for the sake of it will lead to early fatigue and burnout. If you run your own race and focus on controlling the things you can control, you will not only do well, but more importantly you will enjoy the ride.
These are just some of the lessons from triathlon that I have put to use in my career so far. Many of you bring these same skills to work from other aspects of life, whether you realise it or not. A career in medicine is an endurance event in itself, so if you want to do well: be aware of your ego, work on your form, use visualisation and (most importantly) run your own race.