September In Medicine: Scouting Season For Future Doctors

In medicine, September marks scouting season. Like professional baseball clubs, residency programs meticulously generate and analyze scouting reports for prospective interns, aimed toward building an ideal lineup of future doctors that functions seamlessly as a team while augmenting everyone’s individual strengths.

From an applicant’s perspective, the focus on experience, exam scores, and class rankings reflects the layout of a player’s statistics on the back of a baseball card. With more objective data transitioning to Pass/Fail, subjective data is anticipated to carry more weight on residency applications. This raises the importance of the often-overlooked “player attributes” section of baseball cards, i.e., distinguishing characteristics beyond statistics that add value to the team.

From ex-baseball player to medical student, I noticed a fundamental translation of abilities from the baseball diamond to the hospital wards. Hopefully, my player attributes will be defined by the versatility and composure acquired through being “called up” in both settings, as they will extend through all roles and stages in my medical career.

For medical students starting clinical rotations, the phrase “scrub in,” received as instruction or invitation, can elicit anxiety or excitement; apprehension or ambition. Those who answer the call may be transformed by the experience of being pulled from the sidelines to don a surgeon’s uniform and participate in removing tumors, replacing arthritic joints, amputating limbs, or fixing broken hearts.

Hearing “scrub in” for the first time transported me back to a pivotal little league baseball playoff game. I’m alone in right field, and after not having a single ball hit in my direction, I surely thought both teams had forgotten about me. Unexpectedly, our coach pulled me aside to give me the “scrub in” baseball equivalent: “Get loose.” The message was clear; it’s my turn to pitch, and the outcome of the game was in my hands.

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At a young age, baseball players discover the value of flexibility and adaptability to various field positions. Medical students similarly acquire versatility as they rapidly rotate through diverse specialties and health care settings. For baseball players, practice and preparation are essential to building composure in high-stakes scenarios, like being elevated to the pitcher’s mound with the game on the line. Medical students commiserate with the intense, time-consuming studying required to pass exams, but the knowledge and confidence gained in the process cultivate a sense of comfort and poise when “called up” to manage complex, challenging cases.

Surprisingly, there is harmony between the medical hierarchy and the baseball diamond, and the roles within each are defined by various levels of vision, control, connection, and proximity.

With their proficient knowledge, experience, and direction, the attending physicians are ascribed the coach archetype. However, coaches are not physically involved in making plays on the field and, instead, indirectly manage the game by designing a lineup that optimizes everyone’s individual strengths and minimizes the potential for errors. Conversely, attendings are in the game.

Physicians are excellent leaders and coordinators of multidisciplinary care. They more accurately resemble the catchers who control the game through vision and efficient communication with all players on the field. As with a physician and their patient list, catchers extensively study lineups of hitters, anticipate many situations that could transpire during a game, and prepare responses to every scenario. Like their white-coated counterparts, catchers wear the most gear and are the most protected players on the field.

Fellows and chief residents have the strongest connection to attending physicians, mirroring that of pitchers and catchers. Like pitchers who thrive on the mound, fellows and chiefs radiate steadfast stamina, control, and composure in high-stakes situations. While true inspirations to the rest of the team, pitchers, fellows, and chiefs trust their teammates to have their back.

The infield is home to interns and residents. The hard dirt produces an unpredictable surface that’s more challenging for making clean plays and acts as a crucible for unseasoned players to sharpen their skills and coordination. As a unit, infielders handle the most plays and develop tight relationships, while bridging the gap between the pitcher, catcher, and outfielders.

Comfortably positioned on grassy turf, the outfield can feel isolated and uneventful. While expected to cover a large area, outfielders see limited plays and frequently back up infielders. Comparably, medical students are expected to deeply understand a small volume of patients while shadowing behind residents. For medical students, the praise from identifying a rare disease or recommending unique clinical judgment parallels outfielders making diving catches or heroic throws to home plate. Nonetheless, outfielders and medical students are farthest away from the action and have brief highlight reels. Therefore, both groups function with intense impatience for opportunities to prove their fitness and value to the team.

Throughout clinical rotations, I often felt like an outfielder, disconnected from the treatment team and making little impact on the outcome of my few patients. I craved chances to earn my place in “the infield” and join the big leagues with residents, fellows, and attendings who were practicing hands-on medicine to heal patients.

Evidently, awareness as a medical student is equally as important as adaptability and composure. Though still a “right fielder” at this stage, my responsibility is nevertheless to learn and not yet to lead. The point is not simply to be close to the action but to understand your potential role and unique contributions to the game, then recognize your moment to make a play. My time will come, but, for now, I’m relishing just playing the game.

In the end, all players run onto the field together, united by a shared mission, and run off the field together, hopefully having accomplished it. Our patients deserve a unified medical team composed of individuals who understand their respective responsibilities and are eager to use their unique talents to deliver excellent patient care.

Assuming the relationship between the medical team and patients truthfully reflects that of fielders and batters, the identity of the umpire – the one with the authority to call hitters safe or out – is a story for another day.

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