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Sports medicine is now recognised as a specialty in some European countries. As an emerging discipline, sports and exercise medicine needs to develop a solid academic footing if it is to gain acceptance by the Royal Colleges in Great Britain and Ireland. A higher professional university degree is a requirement for work in sports and exercise medicine clinics abroad, especially schemes associated with the Fellowship of the Australian College of Sports Medicine. Health insurance companies, professional athletes, and teams now demand a much higher standard of care from their sports physicians, and this makes the higher status of further postgraduate university qualifications even more important.
In Great Britain and Ireland, practitioners engaged in masters programmes develop an understanding of training methods from a wide variety of sports and the prerequisite knowledge to monitor and optimise the health and performance of athletes whether recreational or elite.
The standard postgraduate training schemes are usually hospital based and offer little direct exposure to elite and recreational athletes for practitioners with an interest in sports and exercise medicine. The teaching of musculoskeletal history taking and examination is generally poor even within most hospital orthopaedic departments. Sports medicine relies on a broad based knowledge and is better suited to the general medical training found in the disciplines of accident and emergency and family medicine.
The educational attractions of a masters course are that it provides a multidisciplinary approach to the teaching of functional and applied anatomy, exercise and applied physiology including laboratory based practical fitness testing, and emergency medicine. A knowledge of the techniques and expertise of other practitioners, including physiotherapists, nutritionists, podiatrists, biomechanists, psychologists, coaches, and athletic trainers, is also provided. The teaching of functional clinical anatomy, especially in some universities, has a low priority; however, this knowledge is the key to an understanding of the possible differential diagnoses of most sports related injuries.
The athletes themselves appreciate practitioners with a knowledge of the demands of training and competition for their particular sport. A university based taught masters incorporates sports specific lectures and workshops given by coaches, team medical officers and physiotherapists, and athletes from different sports. Even the best part time, weekend, or distance based course will never be able to address all these areas or pull together the various disciplines that encompass the many facets of sports medicine.
Programmes incorporating research and evidence based medicine are also essential if sports and exercise medicine is to develop. The research thesis required by a masters programme, which is either laboratory or field based and is examined by an external examiner, gives the practitioner an opportunity to develop research skills and a scientific basis for the study of all aspects of sports medicine.
A masters course gives the participants an opportunity to familiarise themselves with the theory, practice, and guidelines for the scientific monitoring and training of athletes from a wide range of sports. The university based masters course here at Trinity College also gives the doctor an opportunity to work with various college sports teams and gain practical experience in how to deal with coaches, athletes, and managers before they act as fully fledged team doctors. It is also essential that they have participated and passed a cardiopulmonary resuscitation course and be able to cope with on field emergencies, particularly potential spinal injuries. A pre hospital trauma/side line care course is a vital element in sports medicine training. It is compulsory to pass both these elements in examinations for the Trinity College, Dublin masters course and the diploma in sports and exercise medicine at Bath University.
A full time degree taught partly by research, with academic standards upheld by university external examiners, allows the clinician to develop skills that would be impossible to develop in full or part time clinical practice. The new Intercollegiate Academic Board of Sport and Exercise Medicine plans to develop a curriculum and a four year higher specialty training in sport and exercise medicine. A unified well structured and coordinated masters programme organised by the universities in Great Britain and Ireland should be an integral part of this scheme.
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