The Olympics kick off today for doctors, too—and some have been waiting 15 years

Olympic athletes aren't the only ones who spend years preparing for the games: Doctors and other health care providers caring for Team USA at this year's winter Olympics had to undergo "a grueling selection process of their own"—a process that can take some applicants up to 15 years, Leah Samuel writes for STAT News.

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Every two years, the U.S. Olympic Committee's (USOC) Sports Medicine Division selects a crew of volunteer doctors, nurses, chiropractors, orthopedists, sports therapists, and other health care providers to care for Team USA. Providers who make the cut will work with the athletes through practices, training, and eventually at the Olympic Games themselves.

An arduous selection process

According to Samuel, the selection process begins with an application—but not every provider can apply. Eligible providers must be licensed or certified with a minimum of three years of experience, no felonies, no disciplinary actions, and no sanctions, Samuel reports. In addition, physicians need up-to-date DEA registration, a minimum of $1 million in malpractice insurance, and current CPR and defibrillator certification. Applicants also must be certified in sports medicine, a requirement that can add additional coursework for certain providers before they may apply for a spot.

If the applicants meet all those requirements (and pay a $90 application fee for a background check), they go to a U.S. Olympic Training Center for training, interviews, and to care for athletes in-training. According to Scott Rodeo—an orthopedic surgeon who worked with the U.S. Olympic swim team in the 2004, 2008, and 2012 Olympics—it's like an "internship type of thing, where you get to know their system, [and] they get to know you, basically."

After that, the doctors start going to smaller competitions as a form of tryouts, Samuel writes. USOC will notify doctor applicants about Olympic qualifiers or other relevant competitions, and the applicants volunteer for each event on a first-come, first-serve basis. If selected for an event, the providers are responsible for their travel costs.

At the events, doctors are part of a team effort: They help evaluate and treat athletes, coaches, and guests; remain on-call for any emergencies; and assist with the on-site medicine clinic. They also attend every team practice, help set up and take down equipment—and even pitch in with the laundry. "You need to be ready to work and check your ego at the door," said Rodeo. "It's a little bit like residency."

And a doctor could be dismissed at any point in the process. "At any time, you can be told, 'Thank you for your service,' then you're done there and sent home," Mark Hutchinson, an orthopedist in Chicago who worked at the 2016 Summer Olympics, said. "Some people didn't make it because they got bad comments from athletes or the coaches didn't like them."

Ultimately, a doctor can do these lower-level events for two to 15 years before he or she is selected to work at the Olympics, if they are selected at all. To help boost their chances, doctors can try a variety of tactics, such as sending updated CVs or asking an athlete to write a letter of recommendation.

Those who do make the cut typically learn about it one year beforehand—but the ultimate reasons for selection often remain mysterious, Samuel reports. "You get an email saying you've been selected," Kim Tee, a podiatrist from Chicago who worked at the 2016 Summer Olympics, said. "After you meet all the criteria. But the criteria, that is something only the committee knows."

A demanding job, but worth it

Once they're at the Olympic Games, the doctors mostly deal with "travel medicine," Rodeo said. "We'll get a lot of stomachaches and everything that comes with eating different food or drinking different water or switching to a different time zone." But the demands can change quickly, Tee noted—anything from a ruptured ligament during a game to a bee sting to concerns about contracting Zika.

And the volunteer position places demands not only on doctors' time, but also on their finances. "Over the time I was trying out, I was away from my practice for six months, and lost about a quarter of a million dollars," said Hutchinson.

But Rodeo said the experience is worth it. "It's volunteerism at its best," he said. "You do it because you want to give back. You have to love it to do it." David Pascal, a chiropractor from North Carolina who has been to five Olympic Games, agreed. "The hours are long but the memories last a lifetime," he said. "And you get some really cool USA clothes" (Samuel, STAT News, 2/8).

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