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The German situation
  1. Ralph Beneke
  1. Berlin, Germany

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    Over the past century, education in sports medicine and exercise physiology in Germany has undergone various modifications. Furthermore, the reunification of the country over the last decade has caused political and economic changes resulting in fundamental and continuing changes in education and in the professions of general doctors, clinically orientated specialists, and basic and applied scientists in the field of sports medicine and exercise physiology. Currently, doctors in Germany do not have the opportunity to specialise in sports medicine. However, the introduction of such professional training is continuously being discussed. Every fully trained doctor can acquire additional certification in sports medicine. This consists of a course of 120 lessons on theory and practice in sports medicine, including basics and special aspects such as children, top level sports, prevention of injury and rehabilitation, psychology, movement science, biomechanics, and pedagogics, plus 120 lessons on the theory and practice of sports and exercise, covering areas such as prevention of injury and rehabilitation, recreational and elite sports, and also lifestyle, fun, and extreme events. This professional training is completed during a one year appointment as a part time team doctor or a comparable post. Alternatively, the certification in sports medicine can be attained during tenure of a one year full time position in a specially licenced medical unit, such as one of the very few state institutes of sports medicine, Olympic centres, and several university departments. Two years of training on the job as a clinician are a further prerequisite for the certificate.

    Academic education in sports medicine and exercise physiology is also of interest to a broad spectrum of non-physicians. German universities provide numerous different courses in the field of physical education. This is also changing for the following reasons. The physical education system is still mainly focused on training to become a teacher specialised for selected school types, and jobs not associated with school teaching are rare. Up until now, there has been no other accepted field of professional activity that requires a highly qualified academic or scientific background. In addition, our educational system is not compatible with the internationally favoured Anglo-American system. This has encouraged us to reorganise our long standing diploma qualification and implement internationally accepted undergraduate and postgraduate opportunities. At selected universities, the European Network of Sport Science in higher Education using existing concepts such as the European Master in Health and Fitness is under discussion and construction.

    German sports medicine and exercise physiology research units, like university institutes, do not exclusively focus on science. They also serve as clinical departments with a particular place in the healthcare system. Consequently, the head of such an institution not only is responsible for scientific guidance but also has clinical duties which require him/her to be a licenced doctor. In spite of the fact that this combination of clinical duties and basic science has in the past proved to be an effective generator of relevant ideas for integrative research projects, nowadays internationalisation and top standards in basic and applied science demand sufficient career opportunities for non-physicians as highly qualified and competitive specialists in exercise physiology and related disciplines. Corresponding requirements on organisation and infrastructure of scientific departments but also new career pitfalls have been identified, but so far only very few consequences have been anticipated, generating continuing controversy.

    Another possibly related problem is that neither sports medicine nor exercise physiology are obligatory subjects in medical schools. Thus, only very few medical schools offer facultative lessons in sports medicine or exercise physiology, a matter that has been under discussion for decades. This discussion is fuelled by the realisation that a knowledge of sports medicine and exercise physiology is of interdisciplinary relevance to many areas, not only in the field of physical education but also in the prevention and treatment of many chronic diseases in particular.

    Unfortunately, over the last two decades, this has been complicated by a shortage of money in the university system, healthcare system, and various areas of non-professional sport. The economic situation is somewhat inhomogeneous throughout the regions, and integrative and applied research has lost out on resources because of the competitive funding. There is a great risk that the ideas and solutions favoured in the end will be dictated by the budget without sufficient account being taken of the fundamental academic problems, questions, and ideas. However, the multifactorially changing sports medicine and exercise physiology education system in Germany offers huge and exciting opportunities.

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