In 1978 he met Bernie Ecclestone, at the time chief executive of the Formula One Constructors Association, who offered Watkins the position of official Formula One race doctor. Ecclestone had checked in for a medical problem and offered Watkins $35,000 a year for the entire season. Watkins had to pay airfares, hotel bills, rental cars and all incidental expenses. Watkins accepted, and attended his first race at the 1978 Swedish Grand Prix. Outside of the Grand Prix weekends, he remained in his position as a neurosurgeon in London. His first day as the Safety and Medical Delegate, was at Brands Hatch to introduce himself to the drivers. Watkins did not attend private test day sessions due to the large number of sessions held over the course of the year.