Already during her studies at the University of Latvia, her classmates called Veronika Puiša ‘the girl who wants to work in space’—this was her answer to a professor’s question about the students’ future dreams. Now, it’s no longer just a dream: she is a member of the European Space Agency’s (ESA) Medical Board, representing Latvia.
Although Veronika Puiša represents Latvia in this position, currently she works in a small hospital in northern Scotland, where the nearest the nearest full-service hospital is two and a half hours away. She took on this challenge of a family doctor because the working conditions resemble the most those on a space station—limited equipment and the necessity to deal with crises on their own.
What does it mean to be a member of the ESA Medical Board, representing Latvia?
The ESA Medical Board ensures the safety and health of astronauts and participants in ESA-funded or hosted research projects, reviewing all studies involving ESA personnel. Member We are not astronauts’ doctors per se, but rather an external team that reviews all processes.
How did you get this position?
I knew about the position because I saw a British Space Agency announcement. Because all ESA Member and Associate Member States participate in these processes, if the UK could apply, then so could Latvia.
I contacted the Latvian Space Industry association and the Ministry of Education and Science, sent my resume, and asked if they would be willing to nominate me. I had no real hope that ESA would approve my application, knowing that other candidates were more experienced. My goal was to apply, hoping that in 10 years, if I applied again, I could demonstrate my long-standing interest in the position. To my surprise, they already accepted my candidacy, and I’m Latvia’s representative on ESA’s Medical Board.
How long have you been working in this position?
Just recently—my candidacy was confirmed at the end of January, but we started working in April. This is an unpaid position, which each board member takes on in their free time. That is why we review research remotely, so we don’t have to go anywhere because we each have our own schedules. We only meet in person once a year; the rest of the time, we work independently.
What advice would you give to others who want to apply for a similar position?
First, you must apply, even if you think you don’t have a chance. If you don’t apply, you can be certain you won’t get the job. Secondly, I’d suggest studying the field and trying to learn as much as possible from every available source. Attend conferences and events related to the field to meet people working in it. Also, write emails. Even if only two out of ten people respond, that’s still a good result. One must understand that for every door that opens, there will be ten that don’t. That’s normal. Sometimes it will feel like you’re banging your head against a wall and nothing’s happening. That’s okay. Sometimes, being in the right place at the right time matters, but you also need to be prepared. You need the right education and qualification—there are no shortcuts in this aspect.
My higher tolerance for risk has helped me; after finishing residency, while my colleagues took the traditional path and became family doctors. Although I was afraid to go down a less conventional path, I took a chance and dared to do things differently. In the UK, younger doctors often choose a work model where they can sign up for shifts at various hospitals on a specific database. I must admit that for quite a while I didn’t know how many shifts I’d have in a month. It was scary, but I was willing to take the risk. Of course, that’s not for everyone.
You must know what you want from life and where you want to get. Once that’s clear, you need to know what you’re willing to sacrifice to get there. We all have our dreams. Even if they’re as unusual as space medicine, don’t let yourself believe they’re unrealistic. The path may be long and challenging. For example, some people tend to think that ‘nothing ever happens in Latvia’. In the spring, I attended the ‘Deeptech Atelier’ conference and saw how much is happening in space science in Latvia. There’s a strong and inspiring foundation here. There is much more happening than I could ever imagine a few years ago. And being from Latvia was what gave me the opportunity to join the ESA Medical Board.
Is this your first experience with space research?
No, I worked on space-related projects when I studied at King’s College London, and for the last two years I’ve been involved in the Aerospace Medicine and Physiology Research Laboratory. One of the projects I worked on was an ESA project to develop a medical kit for the lunar orbit station Gateway, planned to launch into lunar orbit soon. This is part of the ‘Artemis’ project, a multinational effort that includes human missions to the Moon, create a lunar base, and launching an orbiting lunar station for landing and return. Another project involves creating a laboratory for spacesuit physiology research. ESA is interested in having an independent capability to send people into space. Part of this project could be its own spacesuits for using both inside the spacecraft and on the lunar surface.
How did a family doctor get into space-related projects?
I had thought about space already a long time ago when I studied medicine at the University of Latvia. In a paediatric surgery class, our lecturer asked what each of us wanted to become, and I said I wanted to work in space medicine. I heard that after that I was called the girl that wants to work in space. With time I forgot about this dream and, after my studies, left Latvia to continue learning and exploring the world. My first job was at Luton Hospital, where I started in internal medicine.
I returned to my dream of space after I started skydiving. The more I skydived, the more I became interested in piloting airplanes. Over time, I began flying as a pilot. Meeting people in aviation and space engineering, I started to think about how I could make my dream a reality. When I heard about the ESA astronaut selection process, I decided to try.
I then shifted to a freelance model, which gives me flexibility and potential to earn enough to support my studies. First, I learned orbital astronautics in the U.S., which allowed me to attend conferences, and then continued with the Space Studies Program at the International Space University in Strasbourg, France. Eventually, I enrolled in the aerospace medicine master’s program at King’s College, where almost all my study colleagues were military doctors and family doctors. They sparked my interest in family medicine. Parallelly to this, I started working in motorsport medicine. I went to an aviation medicine conference and met a doctor who worked in motorsports. I initially worked in the United Arab Emirates and later at ‘Silverstone’.
Photo: Veronika Puiša, Representative of the European Space Agency's Medical Advisory Board in Latvia, Publicity photo
How do you manage all this?
It’s not easy; it’s a fast pace. Now it’s a bit easier, as I’ve completed my residency and am a qualified family doctor with therefore more flexibility.
After my master’s studies, I realized that family medicine could be a good foundation for both space medicine and motorsport and would allow me to work independently within a relatively realistic timeframe. So, I chose to do residency in family medicine. During the residency, it was tougher.
However, to be honest, I haven’t skydived or flown in over two years until I finished my residency. There was neither the time nor financial possibility at that period. Before residency, I had time to invest in my dreams. It was followed by a period where I had to focus on other priorities—residency.
How do family medicine and space medicine fit together in one sentence?
Very good! Space medicine is a broad field, and part of it is astronauts’ doctors. Depending on how it is organized in different space agencies, there are places where doctors work exclusively with astronauts while they are on a mission or in training, while elsewhere, they handle astronauts’ everyday health needs, similar to family medicine. Some of these doctors even tend to astronauts’ families.
Space medicine also has close parallels with emergency medicine, especially during launch and landing when injury risks are high, and it is necessary to ensure the possibility of giving the first aid. This also aligns with my motorsport medicine experience, because it involves a lot of organization and logistics. For example, when I participated at the ‘Extreme E’ motorsport event in Scotland, big part of my work involved ensuring that the right personnel with the right skill set and equipment were in the right places and that the closest hospitals knew about our event and work plan. It all requires a specific system – during the launch and landing processes for astronauts is similar. The risks differ, but the principle is the same.
Planning a medical kit for space missions is also similar. You must think about weight, about how much equipment it is possible to bring (which is not a lot), and what is the most important that can be used in different ways, which will be most useful.
Medicine is the same. The core principles are the same. The different specifics are what needs to be considered. Core principles are the same, however additional training is needed.
And on top of that all, since August I have another new job in northern Scotland, where I’ll work at a rural hospital for a year. Here, there are only two doctors and a few nurses, and the nearest hospital is a two-and-a-half-hour drive away, so the focus is family medicine with a strong emphasis on emergency care. Looking to the future, I considered focusing on either family medicine or emergency medical care. I chose this opportunity because I realized that, as a family doctor, I lack hands-on experience in emergency medicine, and this role in Europe closely resembles the conditions found in space medicine. This small hospital doesn’t have a laboratory—the only blood tests available are those that can be done on small, portable devices. There’s only an X-ray and an ultrasound machine, with no MRI. This setup is quite similar to the conditions on the International Space Station. The only difference is that in Scotland, we can call for emergency evacuation transport. In space, it’s much more complex. There are similar positions in northern Canada and remote areas in the U.S., but in Europe, such places are rare.
Does that mean that you and the other doctor must suture wounds, assist in births, and even handle heart attacks?
There is a midwife here, but otherwise—yes, we must manage everything else. Naturally, I am nervous about such a high level of responsibility, but that’s precisely why I’m doing it—to learn. The positive side is that I have supportive colleagues in this programme who have been working here for several years, but it will still be a fascinating experience.
What will happen to your patients in England?
Unlike doctors who are working only in a specific clinic and have their own patient list—like how it is in Latvia—I work freelance. I work as a family doctor but in various locations, and I don’t have as many shifts. It’s somewhat comparable to being a doctor on duty in Latvia.
I chose this career path, at least for now, because I have so many interests, and it allows me to work both in family, space, and motorsport medicine. I also want to get qualified as an aviation medical examiner to work in a civil aviation medical clinic, so I’m studying for that as well. I have several jobs, none of which are full-time. In each facility, I have a small workload, and I piece my work together like a puzzle made of many parts. There are times when I work more in family medicine, and in other periods, I focus on space, aviation, or motorsport medicine. But the next year will mostly be spent in the northern Scotland.
About European Space Agency
ESA is intergovernmental organization with the mission to shape the development of Europe’s space capability. Latvia joined ESA as an Associate Member State in 2020. Developing and implementing space policy is a priority for the Ministry of Education and Science of the Republic of Latvia. Thanks to Latvia’s status as an ESA Associate Member State, Latvian companies and research institutions can participate in world-class space projects, collaborate with major industry players, and gain expertise for effective integration into the European space sector. Meanwhile, students can apply for internships opportunities and other ESA-organised programmes for young researchers.