Frequently asked questions for doctors and paramedics that want to get involved.
1.1 Can any Doctor or Paramedic work on the TT Course?
Doctors: In order to work on the TT Course, or the Billown Course, a doctor needs to hold FULL registration with the General Medical Council (GMC). This also applies to UK mainland motorsport events.
In addition to full registration, a doctor needs to have a licence to practice issued by the GMC. In order to get and maintain a licence to practice, a doctor has to have a Designated Body and be subject to revalidation.
Doctors that work outside the UK (and therefore do not hold full GMC registration) but within the EU, should contact the GMC as there are certain circumstances where they can be permitted to work for short times within the UK.
Because FY1 doctors hold a provisional registration rather than a full registration, they are only permitted to work within approved Foundation Year 1 posts, and are therefore not permitted to work on the TT or Billown Courses.
The GMC regulations concerning FY2 doctors has changed, so that even though they are required to work within an Approved Practice Setting (APS), provided that their Educational Supervisor is happy, they are allowed to work outside their Designated Body. It is quite possible that your Educational Supervisor might want further information about the nature of the work and the level of supervision before allowing you to work on the TT Course. We are happy to provide such information for you to pass to your Educational Supervisor. You can read more about Approved Practice Settings here.
Paramedics: In order to work as a Paramedic on the TT Course, or the Billown Course, you need to be a State Registered Paramedic with the Health & Care Professions Council (HCPC).
Do I require Medical Malpractice Insurance?
We are pleased to say that we have been able to organise Medical Malpractice cover for all of the Doctors and Paramedics that work for us during the TT and the Manx Grand Prix as well as during the road races on the Billown Course (Pre-TT Classic races, Post-TT races and the International Southern 100 races). In order to be covered medics need to be Statutorily Regulated. For doctors this means that they have to be registered with the GMC and have a licence to practice. For Paramedics this means that they have to be registered with the HCPC (Health and Care Professions Council) and hold a current licence.
Our Medical Malpractice Insurance will only provide cover whilst you are working for us during one of the events that we provide medical services for. Should you choose to carry out other work whilst on the Isle of Man (such as working alongside the Isle of Man Police) our Medical Malpractice Insurance will not provide cover for that work, and you should make sure that alternative malpractice cover is in place for those activities.
Do I need any specific qualifications?
As a doctor or paramedic, your “Duty of Care” requires you to be competent at dealing with the type of casualties you might expect to encounter when volunteering to work on the TT course. That means that you need to have knowledge of basic first aid and resuscitation/life support as a minimum. Alyhough not essential, there are other skills that would be very valuable, and we would always recommend that you try to attend an appropriate course such as ATLS (Advanced Trauma Life Support), PHEC (Pre-hospital Emergency Care) or PHTLS (pre-hospital Trauma Life Support). More information about these can be found on our Educational Resources page.
Currently, it is not an absolute requirement that you have any of these qualifications, although it is your responsibility to make sure that you are working within your own level of competence.
We would also recommend that you read the BMA guidance for Doctors providing medical care at sporting events here.
Having said all of that, it is important to remember that you will be supported by an experienced team of Marshals, as well as by the very experienced crews in the Air Ambulances and/or Medical cars in use around the TT and Billown Courses, so you will not be on your own!
If this is your first experience of road racing on the Isle of Man, we would also suggest that you try to attend one of the Incident Management Courses that are run by the TT Marshals Association (TTMA). Further details can be found at the Marshals website here.
1.2 Do I get paid for working as a Doctor or Paramedic?
All of the Doctors and Paramedics that work for us on the Mountain Course or the Billown Course are classed as volunteers. However we are able to make a contribution towards your expenses.
The amount that we will be able to pay depends upon the number of medics we have in total, and the number of Practice Sessions and Race Days that each individual covers. We have a fixed pot of money to pay expenses out of and we will pay it all out each year! The payments made to Doctors and Paramedics per Practice or Race is the same.
As a rough guide we would expect to pay something in the region of £50 per Practice Session and a similar amount per Race (bearing in mind that most Race Days have 2 races). This would mean that a Doctor or Paramedic who covered all of the practices and all of the races might expect to receive somewhere in the region of £600-£700. Obviously, for those that covered fewer sessions the total paid would be lower.
We appreciate that coming to the Isle of Man is a huge commitment both in time and financially, and we know that the actual cost is often higher than we are able to pay. We are enormously thankful for the dedication of all of the Doctors and Paramedics who are so generous with their time. For most, the motivation seems to be the chance to be involved in a unique event that could not be replicated anywhere else in the world!
1.3 Can other healthcare professionals work on the TT course?
The Auto Cycle Union (ACU) governs all aspects of road racing on the Mountain Course and the Billown Course, including the requirements for the medical services. Currently, they specify the use of Doctors and Paramedics and as a result we are not able to use other healthcare professionals. However, we are looking at ways of changing that, particularly with regard to the role of suitably qualified and experienced nurses. There are a number of issues to deal with, but check back here regularly because the situation may change.
In the meantime, if you are not a Doctor or Paramedic but are keen to be a part of the medical services on the Mountain Course or the Billown Course, there are other ways you can get involved. We have a number of First Aiders, Advanced First Aiders etc. who work as a part of the team. We do not recruit them directly, but they are provided for us by our Partner organisations, St.John Ambulance and Hogg Motorsport. If you think you might be interested in joining on of these organisations you should contact them directly.
Alternatively, you could consider signing on as a marshal with the TT Marshals Association. All of the marshals within each team on the course have a specific role. One of those is to look after the casualty. As an individual with a healthcare background it is highly likely that you would take on that role.
1.4 How does the registration process work?
If you have read through the requirements about acting as a Doctor or Paramedic and you are sure that there is nothing to stop you, you can register with us by filling in the registration form on the website.
If it is your first time working with us, we also ask you to send us your CV, which can also be uploaded via the registration form. When you have registered we will send you an information pack through the post, which will contain a lot of important information about the events we cover, and the services we provide.
If you have worked with us before (or with or predecessors Motorsport Medical Services) there is no need for you to send us your CV but we still ask you to fill out the registration form each year so that we know which events you are available for and also to make sure that we have up to date contact details.
Each year, around December, we will put the new registration form for the following year on the website. At that time we will contact all of the people on our database by e-mail and invite them to go to the website to fill out the form. We will do this each year for all of the people on our database (until you tell us to stop, which you can do as one of the options on the form). We appreciate that it can be difficult for people to know very far in advance what their availability might be, and that not everyone will be able to tell us straight away. We will, however, remind you occasionally by e-mail, if we haven’t heard anything (if we accidently send you a reminder when you have already completed the form, please forgive us! It’s a new system!)
If, on your registration form, you have indicated that you are able to work during TT, we will contact you, by e-mail, in January/February and ask you to complete a more detailed availability form, telling us which sessions you can work. We will also ask you at that time whether you are able to provide cover during the Pre TT and Post TT races on the Billown Course. Again, if we don’t hear from you we will send an occasional e-mail reminder.
This process will be repeated slightly later in the year for those people that have indicated they can provide cover during the Southern 100 races and, finally it will be repeated again for those people that have indicated they can provide cover during the Manx Grand Prix. On each occasion you will be sent, by e-mail, a link to follow in order to fill in your availability form and submit it to us.
Many thanks for your interest, and we look forward to working with you.
2.1 How do I get to the Isle of Man?
The Isle of Man Steam Packet Company has regular sailings to Douglas from Heysham. The crossing takes about 4 hours. There are also regular sailings from Liverpool which takes about 2 and a half hours, as well as sailings from Dublin. Information and booking is available on their website. You can also phone them on +441624 661661. If you tell them that you are a medic working at the event, the booking staff will do their best to meet your requirements.
However, you can imagine that during TT, it can be difficult to get a sailing that fits exactly with your availability. We recommend that if you plan to come over for TT or for the Festival of Motorcycling that you don’t delay, and that make your booking as early as possible and pay a deposit. If the exact dates that you want are not available, book the sailings as close to those dates as possible. Once you have done that, email your booking form, along with your preferred sailing dates, to us. We have an agreement with The Steam Packet Company that changes to bookings can be made nearer the time, but only if arranged through us. If, for whatever reason, you are not able to attend the event, your booking deposit will be refunded in full. Our contact details are available on our contact page.
Alternatively, in early March, when the payment deadline for TT bookings arrives, extra spaces on the ferries become available as people relinquish provisional bookings that they have made but no longer require. At the time that those sailings become available you can change your provisional booking to a more suitable date (or make a new booking if you don’t have a provisional one).There is no waiting list for these sailings, so you have to take your chance when they become available on the Steam Packet website.
If you book with the Steam Packet Company for both the TT and Festival of Motorcycling in the same year you will be eligible for a discount on your sailings. This is organized through the TT Marshals Association so you would need to register with them in order to claim the discount. More information is available on their website.
A number of regional airlines fly to and from the Isle of Man, information about flights can be found here.
2.2 Where can I stay on the Isle of Man?
During TT the Isle of Man gets very busy and accommodation can be difficult to find, but there are a number of options.
A lot of people in the Isle of Man open up their homes to visitors during TT, in effect turning them into temporary B+B’s. More information about the TT Homestay scheme can be found at IoM TT Homestay.
General enquiries about travel to the Isle of Man during TT can be made at the official TT website.
More information about visiting and staying in the Isle of Man is available from the Isle of Man Tourist Board.
2.3 Will I need personal transport during my stay?
The Mountain Course is over 37 miles long. It is much easier to get to your location if you have transport. If you have travelled over with a colleague and are both working on the course we can ensure that you are located at adjacent posts in order to simplify your travelling. Let us now in good time if this is the case as it will have an effect on the duty rota that we draw up.
Public transport around The Mountain Course just prior to the roads closing is erratic at best, so if you do not have transport we will have to locate you at a point within walking distance of where you are staying. Again, if you let us know in good time this can be arranged.
2.4 Can my friend come with me to watch?
When they are on duty, Marshals and Medical staff stand in areas that are restricted. The general public is not allowed in those areas, so it goes without saying that your friend will not be able to stand with you whilst you are on duty.
Of course, it is quite possible for your friend to sign on as a Marshal and the TT Marshals Association are generally very accommodating at placing people at locations of their choice. More information is available on their website.
3. RACE DAY
3.1 How does the road closing system work?
In order to allow racing on the Mountain Course the roads have to be closed to the public. Once closed, the roads can be set up to make the suitable for racing. Since most of the locations around the course are only accessible by going on the course, this means that Marshals and Medics generally have to be in position before the roads close. We suggest you allow plenty of time to get to your location before the roads close since traffic can be heavy. There are some locations that can be accessed when the roads are closed, but these are in the minority.
The roads in the mountain section of the course (from Ramsey to Creg-ny-Baa) close earlier than the rest of the course. During TT the mountain section is one way from Ramsey to Creg-ny-Baa and there are cones and signage to control the traffic when the road is open. Before racing can start all of these need to be removed. Hence the earlier closing over the mountain. As a result, if you are stationed on the mountain and you want to get to your location on open roads you will have to get there quite a bit earlier. During TT you would also have to do so via Ramsey. There is no one way system in operation during the Manx Grand Prix, but if you do go up the mountain from the Creg-ny-Baa end whilst the roads are still open we would recommend extreme caution as many of the other users appear to assume that it is one way!
The other alternative to get to your post on the mountain is to wait at either Creg-ny-Baa or Ramsey (depending upon where exactly you are stationed on the mountain), and then to join one of the two Marshals’ convoys that leave approximately 15mins after the road has closed. The convoy from Ramsey and the one from Creg-ny-Baa both end at the Bungalow (from opposite directions).
Once racing has finished the mountain section will stay closed for approximately 30mins longer than the rest of the course to allow replacement of the cones and signage. The Marshal’s convoys, however, will leave whilst the road is still closed so you can join that when it passes your location in order to get off the mountain without undue delay. The general public have to remain on the mountain until the road is opened!
The timing for the road closing operation on the mountain does vary a bit, but generally, on race days, the road from Ramsey to Bungalow closes 1hr 15mins before the main road closure, with the section from Bungalow to Creg-ny-Baa closing 15mins after that (i.e. 1hr before the main road closure). For practice sessions the equivalent times are generally 45mins before general road closure from Ramsey to Bungalow, and 30mins before general road closure from Bungalow to Creg-ny-Baa.
We will post the actual road closure times on the News section of the site once they are published. There can be delays to road closure, often due to weather, but sometimes due to incidents on the course whilst the road is still open. During an event the latest road closure news will be broadcast on Manx Radio TT. We will also try to keep you updated via our group text system.
3.2 What do I need to bring with me?
Do I need to bring any equipment with me?
All of the equipment that you need will be provided for you. At your location you will find an orange Immediate Care Case.
The cases are provided for us by The Rob Vine Fund. There are NO drugs in the cases. At your location there will also be a scoop stretcher for transporting any casualties. In addition to the supplies at each location, the 2 medical helicopters are both fully equipped for resuscitation including a wide range of drugs that may be required in pre-hospital care.
Of course, if you have a favourite stethoscope feel free to bring it with you!
Do I need to bring any drugs with me?
It goes without saying that we are talking about medical drugs for use in treating a casualty! As mentioned above, and in line with MSA guidance, there are no drugs in the Immediate Care Cases, and if you are travelling from the UK we generally advise that people do not bring controlled drugs with them.
If you are dealing with a casualty that requires analgesia, you can rest assured that a Medical Crew will be on their way to you, and they carry a full range of drugs used in Pre-hospital Care.
What should I wear when on duty?
You should appreciate that once you are at your location, and the roads have closed, you will not be able to leave until they open again.You should take warm and waterproof clothing with you. The Isle of Man has not built it’s reputation as the Road Racing Capital of the World because of it’s weather!
You may well end up carrying a casualty over rough terrain so appropriate footwear is essential. You will be provided with a yellow tabard identifying you as a Doctor or Paramedic, and this should be worn on top of your clothes at all times when on duty on the course.
Is there anything I should or shouldn’t take with me?
Although the evening practice sessions are not too long, the race days can last up to twelve hours so you should be prepared. Take food and drink and anything else you feel you might need such as a book!
It is really helpful if you take a mobile phone with you to allow us to contact you should we need to. It will also allow us to keep you updated via our group text system in the event of delays etc. When you are on duty on the course, it is not appropriate for you to be trying to get that close up picture of John McGuiness that you always wanted, so your new Nikon will need to stay at home!
3.3 Is there anything I should do when I arrive at my post?
Before you get to your post, you should make sure that you leave plenty of time get there and locate your post. For the vast majority of locations, you will not be able to get there once the roads have closed. When you arrive you will need to find a safe place to park. There are usually designated parking areas for the marshals and medics. The marshals at your post will be able to advise you.
The team of marshals at your location will be organized and run by the Deputy Sector Marshal (DSM). You should find that person and introduce yourself to him or her. Once at your location you should also inform Medical Control in the control tower that you have arrived. You can do this by texting 07624 365531 or by phoning 01624 644607. The Medical Control is manned from approximately 30mins before roads close for practices and 1hr before roads close for race days and will stay manned until the roads open again. If you haven’t got a phone with you, or if you are unable to get a mobile phone signal, you can ask the DSM to radio in to Control on his or her tetra radio to let us know that you have arrived.
Within each team of marshals there will be one marshal whose job it is to look after the casualty, and to assist you in doing the same. You should find that person and check with them that you both know what each of you is going to do in the event of an incident. It isn’t a good idea to run two or three hundred yards down the road to attend a casualty only to find that neither of you remembered to take the Immediate Care Case!
Before racing starts it is a good idea to check the equipment at your location. There will be an orange Immediate Care Case, a scoop stretcher and a red vinyl head support. The contents of the Immediate Care Cases are checked regularly to make sure that they are fit for purpose. The case will be sealed with a yellow plastic tag which snaps off if you need to get into the case. Feel free to look in the case to familiarise yourself with the contents, but if you do please re-seal the case with a new yellow tag. There are spare tags inside the case for this purpose.
After that you should sit back, relax, and enjoy the racing!
3.4 What happens in the event of an incident, and what is expected of me?
Each of the marshals at your location has a specific role that will have been assigned to him or her by the Deputy Sector Marshal (DSM). These roles include clearing the bike and any debris from the track, displaying the appropriate flags and manning the tetra radio handset. Your role is to look after the casualty. In the event of an incident, the marshal manning the tetra radio will press the red emergency button on the top of the handset. This will alert control to the fact that there has been an incident, and to the location.
When that happens a Travelling Marshal (TM) will be dispatched to attend the incident. The Travelling Marshals are not medically trained but do have first aid training. They are also very experienced in the overall management of incidents. One of the Medical Helicopters (Airmed) will also have been put on standby so that they are ready to respond if needed.
One (or more) of the marshals will be waving a yellow flag to alert oncoming riders in order to make it safe for the other marshals, and you, to attend to the incident. It is VITAL that you don’t go onto the course until it is safe to do so. Be alert at all times to the fact that there will probably still be other bikes on the course. LOOK BEFORE YOU LEAP!
If the rider has regained his or her feet, it will be necessary to get him or her to a safe spot where you can assess the situation. If the rider hasn’t regained his or her feet, and is in a dangerous position (in the middle of the road for instance), it will be necessary for you and the marshals to move him or her to a safe location so that you can carry out your assessment.
If there are no injuries, or only minor ones, and you feel it is safe for the rider to remain where he or she is, you should ask the marshal with the radio to inform control in order that Airmed can be stood down. If this is the case, it is important to keep a close eye on the rider for 10 or 15mins, as situations can change, especially when the initial surge of Adrenaline is wearing off. If this happens, and you are unhappy with the rider’s condition, you should contact control on 644607 in order that we can evacuate the casualty.
If the injuries are more serious, or if you are unsure, the casualty will need to be evacuated. You should ask the marshals to contact control and request Airmed. Generally, the response time for the helicopter is in the region of 5 minutes. During that time you will be looking after the casualty and taking appropriate steps such as protecting the airway if necessary, protecting the cervical spine etc. With the help of the marshals and TM, you will also load the casualty onto the scoop stretcher, secure him or her with the straps provided, and start making arrangements to move him or her to the designated helicopter landing site for your location.
Depending upon the nature of the incident and the severity of any injuries, you may not have completed all of these steps before the helicopter arrives. Don’t worry HELP IS ON IT’S WAY!
When the helicopter arrives you should report your findings to the Aircrew and follow their instructions. They will provide a replacement scoop stretcher, Immediate Care Case (if required) and red head support. The red vinyl head supports are intended for use with a casualty that is wearing racing leathers with a ‘hump’ on the back. It goes under the head and allows the neck to stay in a neutral position thus helping to protect the cervical spine. If you are dealing with a casualty who is wearing leathers without a ‘hump’, and you suspect a cervical spine injury, you should not use the red head support as to do so would cause flexion of the cervical spine.
Once the casualty has been evacuated you should check that you have the necessary equipment. Sometimes, in the middle of managing a hectic incident, it is possible to overlook the replacement of equipment. If you let Medical Control know, that can be sorted out. It is also helpful to contact Medical Control once the dust has settled in order to update us about details of the incident.
Finally, sit back, relax, have a cup of tea and enjoy the racing!