"What's It Like To…" is a series that looks inside careers in athletics, and the worlds of professional and extreme sports.

Dr. Thomas Trojian is the lead physician for Drexel Athletics and the Chief of the Division of Sports Medicine at Drexel University College of medicine.

Q:  What teams have you worked with?
I have had the pleasure to work with a number of teams, from youth soccer to professional sports. Currently I work with Drexel Athletics. During my fellowship training, I worked with Dr. Jim Bradley and the Pittsburgh Steelers. That was a wonderful experience, especially learning to deal with elite athletes and the pressures they experience. I have also covered men's soccer and rugby at the national team level, and World Team Tennis.

Q. What training does a doctor need to do sports medicine?
A doctor needs to finish med school, then a residency training program. In my case, I did a residency program in Family Medicine. It thoroughly prepared me to become a team physician. Then you need to do a sports medicine fellowship. If a person chooses to go into orthopedic sports, then you need to complete medical school, an orthopedic residency, and a one year orthopedic sports fellowship.

My own sports background involved going to Penn and playing freshman football. After an injury, I decided that I would stop playing further football. I did return to another collision sport – rugby - which I had played in high school and then also after college. I was fortunate enough to play rugby at the national and international level. Throughout my life, I enjoyed many sports, and have also coached basketball, rugby and soccer. I come from a cycling family and hike often. Athletics has always played a large part in my life.

Q:  Best thing about being a sports medicine doctor?
Working with the athletes. Also, I like the need to stay very current with treatment options in order to return people back to athletics safely and quickly.

Q:  Most difficult thing about being a sports medicine doctor?
Dealing with the team/coaches' wants and needs versus the athletes' wants and needs. I expect myself to be an advocate for the athlete, and I try my best to keep the athletes' interests first and foremost. This at times puts me in difficult situations. You learn to negotiate them.

Q:  What's it like to be on the sidelines of a game?  What do you do exactly when you're at a game as a team doctor?
Being on the sidelines can be very exciting, but it can also be boring. Remember, the team physician is working, not in the stands partying. You need to be paying attention for injuries, not just enjoying the game. That said, it's pretty amazing to be on the sidelines of a US soccer game, NFL football game, or professional tennis game to see up close and personal how fast and skilled humans are.

You do a lot different things during a game, mostly waiting for somebody to get hurt. At times, it's similar to the delivery of a baby - everything is quiet, there's not much for you to do, while everyone else is doing things. Then all of sudden, you're needed and it's important and urgent. You need to stay alert and pay attention to the game. I've had to stabilize cervical spine fractures, cool down people delirious from heat illness, care for scratched corneas, place IV's, deal with compound fractures (bones sticking out), evaluate concussions, and comfort seniors who lost their last college game.

Q:  What are the top 3 skills you think are most important to being successful as a sports medicine doctor?
1.  Availability, affability and medical ability. Most teams want easy access and a nice doctor.
2.  Being the best doctor you can be. Keep learning.
3.  Listening to the athlete. As humans, we get rushed and we forget to listen.

Q:  Especially at elite sports levels, how do you balance the pressure of getting athletes back in the game with your ethical obligation as a doctor to do the best thing for them medically?
Balancing the pressure is difficult. Doctors have lost their jobs doing what is best for the player and not the coach. As well, there are times when an athlete wants to play but the optimal treatment would be for them to not play. You have a discussion with the athlete of the pros and cons of playing with an injury. At times, you need to say 'no', no matter what. With head injuries or life threatening injuries, I need to protect athletes from themselves. That said, I believe minors (youth and high school) are different. You need to take a very conservative approach to kids and overzealous parents.

Coaches are another story. Many, many coaches understand that injuries occur and will ask about shaving time off recovery, but understand if you say its not possible. Others are more challenging, and well, that is another story for another time.

Thanks to Dr. Trojian for sharing his experiences. If you do ultra sports or have a sports-related career and would like to be interviewed, contact Dr. Whitman at sarah.whitman@drexelmed.edu.

Read more Sports Doc for Sports Medicine and Fitness.