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The waiting game

A job at the races

Exchanging banter with the likes of Frankie Dettori is all in a day's work, writes Dr Tim Morton

For many doctors the closest they get to horse-racing is watching Channel 4. I have a part-time post as a racecourse medical officers, providing medical support to the staff and jockeys. Exchanging banter and treating the likes of Frankie Dettori is certainly a welcome change to my life as an NHS GP.

Racecourses stage two 'codes' of racing ­ flat and jump. Currently there are 18 flat courses, 24 jump courses and 17 dual-purpose with 5.5 million people attending 7,650 races last year. These races range from Royal Ascot, where you see the world's most valuable thoroughbreds, members of the Royal family and many celebrities, to Yarmouth on a wet blustery afternoon.

But even Yarmouth, where I work as senior RMO, has its attractions ­ the chance to be part of a dedicated team ensuring racing is safe and enjoyable for all involved.

The Horseracing Regulatory Authority

(HRA) sets and enforces the standards of

medical care at the country's 59 racecourses and undertakes unannounced inspections to ensure medical standards are being met. These inspections can be an anxious time as contravening instructions can result in a large fine being imposed on the racecourse.

I first got involved as a GP trainee in 1986 when my then trainer was in charge of the medical team. Some 20 years later I am in his position but with a huge increase in regulatory issues to deal with both on race days and in preparation for the season.

All RMOs have to pass pre-hospital trauma life support (PHTLS) courses every three years (four years for advanced TLS) so they can deal with the injuries that can occur. Horse-racing is one of the country's most dangerous sports with fatalities and serious injuries and it is up to us to help reduce those risks.

The medical department of the HRA is led by Dr Michael Turner, who is always available by telephone to discuss more unusual medical dilemmas. Jockeys are a tough breed who will do virtually anything to ensure they ride ­ and at the lowest weight.

The HRA maintains a database of all jockeys' injuries, including those occurring off the racecourse, and this now forms the basis of a computerised medical record system operated by Wetherbys.

As SRMO I arrive 90 minutes before the start of racing and a second RMO arrives 30 minutes later. On arrival we report to the clerk of the course, who is responsible for everything on race-day, and the clerk of scales, whose job is to weigh the jockeys before every race and check that the correct weight, colours and numbers are carried.

We liaise about which jockeys previously injured need assessing before racing commences. The list known as the 'Red entry' details who is currently not racing and what injuries they have sustained. This can vary from dehydration from too much time in the sauna to multiple fractures. Those with serious injuries will liaise with the chief medical adviser for specialist reports.

Once these formalities have been dealt with I meet the rest of the team in the medical centre for pre-race briefing, checking of kit and radios. The team consists of a nurse, first-aiders and two paramedic ambulance crews. On days when large crowds are expected, there is a third crowd doctor.

Once racing starts it is a constant round of attending the parade ring, stewards' box and weighing room to monitor the safety of the jockeys and staff, co-ordinating the medical response to any incident and helping out assessing sick crowd members who turn up in the medical room. The second doctor is present at each start and follows the race with an ambulance in case of fallers.

There are similarities between my duties as a racecourse doctor and my GP life in that teamwork and communication are essential, however not many consulting rooms have live TV of your actions or a grandstand of racegoers watching your every move.

There was the time a member of the public had a cardiac arrest clutching a wad of money in front of the main grandstand. The screens were drawn around, resuscitation started but unfortunately was unsuccessful and only when we finished did we see everyone watching us from the main balconies, clutching their drinks.

I am employed by Northern Racing, which owns Great Yarmouth Racecourse among others. The remuneration has improved in recent years to reflect the responsibilities, paying £275 per meeting with a meal and members' badges for spouses and friends.

It also reimburses the three-yearly trauma course fees, which can be sizeable. But at the end of the day it is the satisfaction of being part of a team with one goal ­ an enjoyable but safe day at the races.

Tim Morton

is a GP in Beccles, Suffolk

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