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Sports medicine education in Australia
  1. Peter Fricker
  1. Acting Coordinator Sports Science and Sports Medicine AIS, Chair of Sports Medicine, University of Canberra, Canberra, Australia

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    Fellowship of the Australian College of Sports Physicians (FACSP)

    This is recognised as the specialist training programme in sports medicine in both New Zealand and Australia, although government recognition as a medical specialty in Australia is still awaited. In New Zealand, sports medicine has been recognised as a special discipline.

    The term “sports physician” is reserved for Fellows of the Australian College of Sports Physicians (ACSP) and “sports medicine practitioner” is used for all other doctors with a qualification—for example, Master of Sports Medicine, Diploma of Sports Medicine—and/or interest in sports medicine.

    Fellowship of the ACSP is obtained after a minimum of seven years approved postgraduate medical experience and training. Trainees must be registered to practise in Australia.

    An initial three years of internship or hospital residency and perhaps primary care experience is prescribed before a prospective trainee can sit the part 1 fellowship examination of the college. This consists of two three hour multiple choice examination papers which cover physiology, anatomy, pharmacology, and pathology. It is a college specific examination but equivalence has been granted for part 1 examinations of the Royal Australasian College of Physicians and the Royal Australian College of Surgeons.

    Successful completion of these papers confers eligibility to apply for a training position with the Advanced Training Program of the ACSP. At the time of writing, there are 11 training posts in Australia and New Zealand. All teaching is carried out by Fellows of the ACSP and fellows of other specialist colleges appointed by the ACSP, and advanced training takes at least four years. The requirements of each trainee (registrar in sports medicine) are demanding and meticulous. At the completion of advanced training, each trainee must have demonstrated satisfaction from each of her/his supervisors, kept a log of medical experience, undertaken an original research project, and published as first author in an international refereed journal, undertaken formal face to face teaching at least two hours a week, provided team coverage at high level competition, and presented original work (which is reviewed) at each annual registrars conference. A curriculum outlined by the ACSP must be adhered to.

    Advanced training allows for a one year “elective” in sports medicine, however, which can be taken as the fourth year of advanced training, but all requirements as listed must be met before fellowship can be granted.

    In the third year of advanced training, the fellowship examination may be undertaken. This comprises two three hour written papers, which are composed of multiple choice questions and short answer essay questions, and, if passed, an oral examination. This consists of one long case presentation and a number of short case presentations, which use real patients (not role playing), and a viva voce examination using x rays, bone scans, magnetic resonance imaging scans, blood tests, pulmonary function tests, ECGs, and equipment such as orthoses, prostheses, bicycles, tennis racquets, and footwear. Candidates must pass all sections of these examinations for fellowship and must complete their fourth elective year before fellowship is conferred. The post-nominals FACSP are used to indicate Fellowship of the College and expertise as a sports physician.

    Master of Sports Medicine (University of Canberra/Australian Institute of Sport)

    This degree is offered to medical graduates from around the world as a fee paying course. No medical registration in Australia is required. The course is conducted over one calendar year at the University of Canberra and the Australian Institute of Sport.

    Four nine week terms (900 hours of teaching) cover the basic sciences (physiology, biomechanics, etc), traumatic and overuse injuries in sport and exercise, internal medicine, and special considerations in sport such as doping, medicolegal aspects, special groups, and team coverage. Teaching is face to face in the classroom and at the bedside in sports medicine clinics, and a component of the course includes laboratory experience in cardiology, chest medicine, rheumatology, and podiatry. There is also a compulsory research element which necessitates a comprehensive literature review and research proposal.

    Examinations are conducted at the end of each term by written papers (short essays) and by a final clinical examination with real patients, and a viva voce examination (with a range of medical imaging, pathology tests, ECG, and lung function tests, etc).

    The masters degree is accredited by the ACSP towards advanced training by its registrars.

    Master of Medicine (Sports Medicine) (Edith Cowan University)

    This degree is offered by course work as a distance education programme to medical graduates around the world. It is operated by Edith Cowan University (in Perth, Western Australia), and is serviced by the Australian Institute of Sport. It is a fee paying course and can be completed in a minimum of two years. A number of modules have been prepared which cover the basic sciences (anatomy, physiology, nutrition, psychology, etc.), research methodology and statistics, trauma and overuse injury, aspects of internal medicine, and special topics such as doping in sport. Each module comes as prepared text and supporting references, together with recommended reading and core texts.

    A Diploma in Medicine (Sports Medicine) has been offered to those who have completed the first half of the course.

    Examination is by “closed book” short essay questions at the end of each module, and a component of practical teaching (and assessment) is specified before either a diploma or masters degree is conferred.

    Certificate of Advanced Sports Medicine (Sports Medicine Australia South Australian branch)

    This course is being proposed for CME accreditation by the Royal Australian College of General Practitioners (RACGP) and is intended for the development of skills in sports medicine by general practitioners. Sports Medicine Australia is a national body comprising clinicians, scientists, educators, and administrators with an interest in sports medicine. It is essentially multidisciplinary and aims to serve its own members by the provision of education services and to serve the community.

    The Certificate is a fee paying course which is conducted as a set of three compulsory unit modules. The modules cover the scientific basis of clinical sports medicine—for example, anatomy, physiology, nutrition—special considerations in sports medicine—for example, soft tissue injury, drugs in sport, screening, dental problems—and clinical sports injury management (including diagnosis and management of injury, data acquisition, and research).

    The time commitment over the three units totals 74 contact hours of teaching plus 80 hours practical experience. Teaching is carried out in small groups, using formal lectures, case studies, videotapes, and clinical software. Teachers are drawn from general practice, orthopaedics, musculoskeletal medicine, and sports medicine. Candidates spend time in sports medical clinics, operating theatres, and rehabilitation centres.

    Assessment is by take home examination papers, practical assessments, review of research activity, and self evaluation.

    University of New South Wales courses in sports medicine

    The University of New South Wales (UNSW) in Sydney offers three fee paying distance education courses in sports medicine. These are available to medical graduates around the world.

    The Graduate Certificate in Sports Medicine comprises four subjects (sports injuries 1 and 2, medical applications of exercise 1 and 2) which are delivered over one to two years.

    The Graduate Diploma in Sports Medicine covers the content of the Graduate Certificate and adds four modules on applied sports medicine, sports science, nutrition, pharmacology, psychology, and clinical biomechanics. This is presented over two to three years.

    The Masters Degree in Sports Medicine is offered over two to three years and adds research methods and a research project to the content of the Graduate Diploma.

    Teaching uses videotape, CD-ROM, email, and web-based teaching and standard texts and reference papers. Face to face teaching is arranged, and progress is monitored with log books and a case history. Examination is by supervised written examinations at the end of each 14 week teaching period (which covers one “subject”). A final clinical examination is structured on the objective structured clinical examination (OSCE) model.

    Teaching staff at UNSW comprise sports physicians and researchers.

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