By Corinne Sundar Rao, MD

The Kentucky Derby is an annual horse race held in Louisville, Kentucky, on the first Saturday in May. It is considered one of the most prestigious horse races in the world and is the first leg of the Triple Crown of thoroughbred racing, followed by Preakness Stakes and the Belmont stakes. At the time of this writing, Mage won the famous race in the 149th Kentucky Derby.

The Kentucky Derby has been held annually since 1875 and is run over a distance of 1 1/4 miles or 2.01 km on a dirt track at Churchill Downs. The race is open to three-year-old thoroughbreds, and horses from around the world compete for a purse of over $ 2 million. The Kentucky Derby is also known for its traditions, including playing “My Old Kentucky Home” by the University of Louisville marching band, the mint julep drink, and the wearing of flamboyant hats by the spectators. Secretariat, the most successful horse in the Kentucky Derby history, won the race in 1973 with a record-breaking time.

Several factors can contribute to a horse winning the Kentucky Derby, one of the world’s most prestigious and high-profile horse races. Here are some key factors.

1. Speed. One of the most important factors in horse racing is speed. The Kentucky Derby is no exception. Horses that can run fast and maintain speed for the entire 1 1/4 mile race have a better chance of winning.

2. Stamina. The Kentucky Derby is a long race, and horses that have the stamina to maintain their speed over the entire distance have an advantage. Horses that have experience running longer races, such as the 1 1/8 mile races leading up to the Kentucky Derby, may have an advantage.

3. Jockey skill. The jockey plays an important role in the success of a horse in the Kentucky Derby. Jockeys need to be skilled at maneuvering their horse through traffic, considering the horse’s energy for the final stretch, and making strategic decisions during the race.

4. Training. The training and conditioning of the horse leading up to the Kentucky Derby can also play a key role in its success. Well-trained and well-conditioned horses are less likely to experience fatigue or injury during the race.

5. Post position. The position of the horse at the starting gate, or the “post position,” can also impact its chances of winning. Horses that are closer to the inside of the track may have an advantage, as they have a shorter distance to travel. Overall winning the Kentucky Derby requires a combination of speed, stamina, jockey skill, training, and luck. It is considered one of the most challenging and prestigious horse races in the world, and winning it is a major accomplishment for any horse and its team.

What does this have to do with medical training, you may think?

Let’s look at the factors:

1. Speed. Medical training to become a doctor never slows down. You don’t have a chance to catch your breath or take a break. If you take any time off, it’s to your detriment, as the gaps are not in your favor and must be explained in every application for the rest of your professional career.

2. Stamina. It goes without saying that getting through medical school and residency requires stamina with a capital S. In the words of my favorite hand surgeon, Dr. Jean Paul Brutus, “If you get through medical training, you are a tough cookie.”

3. Skill. It takes speed, stamina, but also skill. Somewhere during those long hours of studying in medical school and relentless training, we all figured out where our skills were. Are you great at fixing broken bones, calming a baby/child, caring for geriatric patients, or caring for critically ill patients in ICU? Whatever your skills, you find your path, a.k.a. residency.

4. Training. The hours are long and often brutal. The human body is complex, and there is a reason medical school and residency are as long and arduous as it is. Because training matters- always has and always will. The most highly trained person in the room will always be the ship’s captain.

5. Post position. This is a tough one because even after all the above, positioning yourself in the cutthroat medical world is never easy. It requires constant pivots and being on your toes to adapt to any situation, as the landscape is constantly shifting like quicksand beneath your feet, especially in the post-COVID world.

Back to this year’s race: The 149th year of the famed Kentucky Derby saw the end of a sad and tumultuous week in which seven horses died in the week leading up to Churchill Downs. The deaths renewed concerns about the sports’ safety record and the horses’ treatment. Perhaps this is timely, as the physician burnout epidemic is raging, with renewed concern from many physician organizations and physicians themselves. A record number of 64 percent of ED doctors, 60 percent of internal medicine doctors, and 59 percent of family medicine and pediatric doctors are now reporting one or more symptoms of burnout and moral injury. In this country, up to 400 U.S. physicians are taking their lives by suicide yearly. Those are staggering numbers, as are the numbers of fatalities in the week leading up to the Kentucky Derby. The horses at the Triple Crown are trained and groomed to win the coveted races but are euthanized when suffering an injury they are very prone to suffer.

Are we physicians, the healers trained to save lives and heal others, able to save and heal ourselves? Or is it too late?

Corinne Sundar Rao is a board-certified internal medicine physician.