Written by Sugandhat Bharti

Most of the sports scientists and strength & conditioning coaches reading this might have started with a bachelor’s degree in kinesiology, then perhaps moved on to a higher education in the same area.  Perhaps some even transitioned to an allied health, or even medicine for a career.  I did the opposite.

I was a medical doctor. I completed my degree in medicine from India, however, while practicing I had an urge to do more and interact with patients differently.  I had the urge to meet patients where they were rather than just having them see me in my office for a couple of minutes as they were likely uncomfortable describing their health concerns to someone who didn’t know them.

The above example is an oversimplified reason why I eventually transitioned from medicine to strength & conditioning. I had a desire to help people focus on their health and fitness improvements as opposed to focusing on the management of their illnesses.

All the individuals I met early in my S&C career appreciated my knowledge of science. However, my medical degree did not prepare me to be an effective coach, in fact, it did the opposite. As I began my new career, I had to be really analytical about my strengths and weaknesses, and spend a significant amount of time learning and unlearning at the same time.  Furthermore, in 2018 I decided to move to Canada. The change of my career, and moving to a new country forced me to grow in ways in never expected.

I will reflect on skills that are important for a physician that translates to being an S&C coach before sharing items I had to unlearn.  Unlearning relates to the skills I had to unlearn from medicine and the extremely difficult journey that I am still experiencing.

 

DOCTOR TO S&C COACH CARRY OVER

1)   Meticulousness: As a physician, I dealt with serious issues, not to say an S&C coach doesn’t, but the scope of practice is different. Many times, I had to choose between life and death in a matter of hours or minutes. When working with a patient, the decision process involves medical tests, screening, re-screening, and making the best decision at that time with the available information. For an S&C coach, the requirement to be prepared is the same.  An S&C coach needs to be evidence-based, needs to perform testing, needs to perform a gap analysis, and at times needs to be cautious. An S&C coach at times has a responsibility that can make or break someone’s career in the weight room (1).

2) Confidentiality: How to handle sensitive data was ingrained into my mind during my medical school training and clinical practice. For example, never share patient data with anyone including my family, other doctors, or a patient’s family members unless permission is explicitly granted. This has led me to believe that I do not need to shout out or post an athlete’s performance test scores in front of a group, to other coaches, and certainly not via social media unless overtly asked to do so by the individual.

3) Adaptability and Working Under Pressure: I remember walking through an empty emergency room (ER) at 11 am one morning and by 1 pm the room was full of patients suffering from a multitude of different injuries because of a transit accident. I have encountered similar situations in the strength and conditioning world, at times programs and plans have to change quickly. At times athletes suffer injuries in the weight room or the field of play. S&C coaches need to be prepared, and at times perform duties that may not be initially expected, such as providing immediate initial care for an injury.

 

 UNLEARNINGS

1) Communication and Intake: I worked in an ER, and most days I would see patients move in and out and in many cases without the ability to communicate. When I worked in the outpatient department, I would usually see a patient for 1-3 minutes on average.  Looking back at it I realize I was taught to treat the disease (or the chart), not the patient,… Why?  Because that was the premise of my medical school training. Most physicians working in a similar scenario might not have the time to communicate with their patients (2). As S&C coaches: Think about how things would progress if we just focused on the needs of the sport and not the athlete. The communication I learned through my previous career led me to overlook the individual and focus only on the outcome at the expense of the process.

2) Selling Myself: If you are an MD, you have an advantage, I am guessing in most countries. In my case, I never had to sell myself as a doctor. Everything came easy for me. From my family of physicians to my friends in medicine. This was a significant unlearning; doctors don’t have to sell themselves, as patients typically overflow doctor’s offices (3). Fast forward a couple of years, and I am trying to learn the difficult process of how to sell myself as an S&C coach in a new country.  Something I am not comfortable doing.

3) Public Speaking: The power dynamics of a doctor-patient relationship typically favours the doctor (3). As such, it usually didn’t matter how I said something or conveyed a message as long as the patient was getting better. A dozen times I was the one to provide information that a loved one had passed away, reflecting on it, I wish I had known back then about empathy what I know now from working as an S&C coach. In medical school, we were taught to simply deal with facts and be objective. To give a message, not how to give a message. Moving into S&C, it is clear that how we give a message is just as important as the message itself, regardless of whether the situation is one-on-one or to a large group of people (e.g., athletes, coaches, teams or fellow S&C coaches at a conference).

4) Relationships: “Understand their pain but remember to be emotionally unavailable.” This was the first sentence I heard from the primary ER physician and my professors who are pioneers in their field. Meaning, that I had to treat the patients but ensure that I didn’t get carried away by their health concerns. From a physician’s point of view, perhaps connecting emotionally is not ideal. As an S&C coach, I desire to connect with athletes. I desire to understand their sleeping patterns, recovery practices, game schedules, past injuries, performance goals, health goals, and physiological capabilities.  Rather than being single-minded in helping athletes, a transdisciplinary approach is most effective and likely leads to a stronger relationship (4,5).

5) “The answer is 17 years, what is the question?”   It takes approximately 17 years for new advances in medicine to come into practice (6). The evidence in medicine is very unlike the evidence in sports science. This could be a possible reason I was not expected to stay on top of evidence as a physician. The bottom line is that you can’t just try a new treatment that was tested because it worked on a similar population. Clinical trials go through a significant and robust evaluation phase (7). As an S&C coach, I am not bound to one training method.  “Coach, can I try running between those gates, I think I will zoom past it.” These were the words from a U12 athlete I worked with at the Ontario Cricket Club. Obviously, I allowed them to run through the timing gates during the testing session not only because they asked to but also because I wanted to understand how the results would compare to previous testing (see title picture). Research in strength and conditioning is booming (8), hence I have to be on top of new advances and training technologies. I am more inclined to read the latest research as an S&C coach than I ever was as a doctor.

 

Theory into Practice

The previous section of this article lays a foundation of how I was juggling between learning and unlearning. The next challenge,… putting things into practice. Something I am still working on, a transition that does not occur overnight.  

1) Canadian Sport Institute Ontario (CSIO): My role with CSIO started as a summer intern in 2023.  I am grateful to have learned from a giant in the industry during my internship. Until my internship, I never knew how much a mentor could mean, or that I needed one.

My Mentorship: Why do I need to bother someone to learn? I have the education behind me and some experience, so I will be fine. This is what I said to myself early in my S&C career. A few years later I was being mentored by one of the best S&C coaches that I have ever met, i.e. Sheldon Persad, a person with close to 40 years of coaching experience. I was not only guided towards using the latest evidence and sports science equipment, but Sheldon also pointed out areas of potential growth. For example, how I communicated with others.  From learning how to communicate coaching cues to athletes using powerful words, to appropriate ways of greeting athletes and coaches coming into the facility.  Previously, I was handling things from a physician’s perspective. I remember taking these learnings and applying the communication skills even outside of the weight room in order to gain confidence. If not for Sheldon, it would have not been possible for me to analyze myself as an S&C coach and move forward in the field. I am grateful to still be working with the CSIO and still have the opportunity to interact with Sheldon regularly.

The Not so Loud S&C Coach: My perception of an S&C coach was that they had to be loud i.e. the loudest person in the room. This might work in some cases but a genuine question for all of us strength coaches: Do we always have to be loud and carry this into other aspects of life? I can remember interviewing for an S&C position and the head of S&C almost shouting at me while I was sitting next to them.  It was only after I met Sheldon that I realized that not all great strength coaches are the loudest people in the room, at least not always.

2) Presenting at the NSCA Conference: Presenting at the NSCA clinic in Nova Scotia was a major achievement for me since I applied three of my unlearnings into my presentation, including communication, public speaking, and evidence-based practice. Additionally, it also made me realize the importance and value of paying it forward.

3) Strength & Conditioning at a Competitive Sport Club: During my time with an organization, I realized that athletes care if I care. I remember genuinely consulting a young athlete with regards to putting on more muscle mass during my second week in the role. “Coach I feel like I am very thin and have no muscle mass when compared with other guys on the team, I feel like I do not belong here and have started to dislike the sport, maybe I won’t be here next month. ” On the outside, I did everything I could do to help that athlete, on the inside it took me by surprise and made me realize that this is what I was missing when I wore the hat of a medical student and a physician, getting to have a deep understanding of an individual’s needs.

4) Learning never ends: One important aspect that I have taken away from almost all of my roles is that learning never ends. This does not mean learning only about programming or periodization but also about identifying what you need to learn or unlearn, especially when it comes to human behaviour. I would not have been half of the coach I am today if I didn’t receive guidance on how to focus on my communication and relationship-building methods.

I have dropped my physician’s hat and I am mindful of my learnings and unlearnings in the role I play today. It is important to look at what to learn but I believe that it is more important to take time to reflect and understand what not to carry forward.

 

Author Bio

Sugandhat (Sugi) Bharti, BPH, MBBS, CSCS, MS(C)  teaches the Health & Wellness diploma at Bryan College, Toronto. He also works as a S&C coach contractor with the Canadian Sport Institute Ontario.

References

1. Faigenbaum, A. D., & Myer, G. D. (2010). Resistance training among young athletes: safety, efficacy and injury prevention effects. British Journal of Sports Medicine, 44(1), 56–63. https://doi.org/10.1136/bjsm.2009.068098
2. Ha, J. F., & Longnecker, N. (2010). Doctor-patient communication: a review. Ochsner Journal, 10(1), 38–43.
3. Goodyear-Smith, F., & Buetow, S. (2001). Power issues in the doctor-patient relationship. Health care Analysis: Journal of Health Philosophy and Policy, 9(4), 449–462. https://doi.org/10.1023/A:1013812802937
4. Foulds, S. J., Hoffmann, S. M., Hinck, K., & Carson, F. (2019). The coach-athlete relationship in strength and conditioning: High performance athletes’ perceptions. Sports, 7(12), 244. https://doi.org/10.3390/sports7120244
5. John, J. M., Haug, V., & Thiel, A. (2020). Physical activity behavior from a transdisciplinary biopsychosocial Perspective: A Scoping Review. Sports Medicine, 6(1), 49. https://doi.org/10.1186/s40798-020-00279-2
6. Morris, Z. S., Wooding, S., & Grant, J. (2011). The answer is 17 years, what is the question: understanding time lags in translational research. Journal of the Royal Society of Medicine, 104(12), 510–520. https://doi.org/10.1258/jrsm.2011.110180
7. Hopewell, S., Clarke, M., Stewart, L., & Tierney, J. (2007). Time to publication for results of clinical trials. The Cochrane            Database of Systematic Reviews, 2007(2), MR000011. https://doi.org/10.1002/14651858.MR000011.pub2
8. Shurley, J. P., Todd, J. S., & Todd, T. C. (2017). The Science of Strength: Reflections on the national strength and conditioning association and the emergence of research based strength and conditioning. Journal of Strength and Conditioning Research, 31(2), 517–530. https://doi.org/10.1519/JSC.0000000000001676