The Welsh tradition of picking medics in their rugby team will continue on Friday when the 19-year-old Hallam Amos follows the likes of JPR Williams and, more recently, Jamie Roberts by making his debut against Tonga.
Amos is studying at Roberts' old hospital in Cardiff and can play at centre as well as full-back. But he gets his first cap on the wing alongside two of Warren Gatland's Lions from the summer in a team showing 11 changes and more than a whiff of experimentation after Saturday's victory over Argentina.
Only Leigh Halfpenny and George North – Amos's back-three partners – the prop Rhodri Jones and flanker Justin Tipuric survive from that starting XV. James Hook gets his first start in two years – and in his favourite position of fly-half – with Ashley Beck and Owen Williams filling the holes left at centre by injury, and Luke Charteris is named at lock for the first time since his right knee was reconstructed.
Charteris, one of the standouts in Wales' successful 2011 World Cup campaign, has played only 120 minutes with Perpignan and 23 minutes with Wales since the injury, but he has 42 caps and that kind of experience which will come in handy against a team whose physicality sometimes borders on the reckless.
The aggression was evident against France in Le Havre at the weekend when the prop Sona Taumalolo was sent off with the France lock Yoann Maestri after a flurry of punches, and Taumalolo will miss Friday's match after being banned for four weeks on Tuesday. The scrum-half Taniela Moa went to the sin-bin for elbowing the hooker Dimitri Szarzewski.
All of which could make an interesting evening for a wing who has played only 26 games for Newport Gwent Dragons and joined Gatland's squad 10 days ago after a rash of injuries in the game against South Africa.
"My first cap, under the high ball with 15 Tongans running down on me, will be an experience," said Amos, who was born in Stockport of English parents and moved to Wales at the age of four. He will become the 53rd player selected by Wales in 2013. "It has been a whirlwind couple of weeks. I'm not sure if it's sunk in yet."
He has spoken to Roberts, who is sidelined with a damaged shoulder, about juggling two careers – rugby with the Dragons plus medical studies at Cardiff University. "It can be pretty hectic. One day last month I was nine to five in hospital, doing CPR, learning resuscitation, and then I was straight down to Rodney Parade for the game against Zebre. It's good having Jamie, who has already been through it."
Paul James, who had expected to be with Bath this weekend, will instead be winning his 48th cap after the understanding that Wales believed they had with the club fell down. They had been hoping to save the loosehead for the final Test of the autumn series, against Australia. However, that falls outside the IRB international window, when Premiership Rugby says players should not be released, raising issues over whether North will be available.
Wales: Halfpenny; North, O Williams, Beck, Amos; Hook, L Williams; James, Owens, Rhodri Jones, Charteris, Evans, Coombs, Tipuric, Ryan Jones (capt).
Replacements: Phillips, Bevington, Lee, Lydiate, Warburton, R Williams, Priestland, J Williams.
