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Editor,—Can I begin by expressing my appreciation for the introductory free access to the journal since its launch on the web earlier this year.
This year I have undertaken an intercalated degree in clinical medicine which has been offered by the Department of Medicine and Therapeutics at Glasgow University for the past four years. Over 60 of my fellow students opted to do the same. We each, however, opt to do a specialist module in addition to a common core course. The options include cardiovascular studies, clinical neuroscience, and cancer studies, among others. I chose to do sports medicine, largely because of my own interest and participation in sport. Indeed participation in sport was a common factor among the 10 students opting for this module.
Admittedly many of us felt that this, compared with some of the other modules, would not be a particularly taxing option. Our reputation as “slackers” among the rest of the year group was evident. As far as they were concerned, we were lectured in fun things while they grappled with the serious issues at the cutting edge of medical research! However, although I have thoroughly enjoyed the lectures, this was by no means the easy option, and I agree wholeheartedly with Paul McCrory that it is about time attitudes changed.
Who says there are no serious issues in this field? Consider the dilemma of the physician who has been pleaded with to give a pain killing injection to a young player, with the risk of more serious damage, because an international scout will be at this match and this may be his only chance to make an impression. Consider also the responsibility, swift judgment, and strength of character required when faced with the head injured player who knows he will be out for a whole season if he comes off, and then of course there's his coach . . .
The elite athlete has emerged as someone with specialist medical needs, and we need specialist sports medicine physicians to respond.
But then the field of sports medicine goes far beyond these more traditional roles into a wide range of other specialties: cardiology, respiratory medicine, gynaecology, rheumatology, neurology, to name but a few of the areas our lecturers have explored. We need specialists who can advise in each of these areas, but to enable them to do so we need to provide them with the necessary evidence base.
What has been most evident throughout is the requirement for more well conducted research and clinical guidelines based in this field. We are a generation of medical students for whom the term evidence based medicine (EBM) is used as commonly as coronary heart disease (CHD). My fellow students this year are involved in researching areas as diverse as the thrombolytic response and contrasting platelet activity during exercise (surprisingly there are still no definitive answers here), the role of strength training in rheumatoid arthritis, the relation between knee injuries in female footballers and the menstrual cycle, the barriers to exercise in cardiac rehabilitation patients, to name but a few.
I may only be at the beginning of my medical career but I feel I have had a valuable insight into the challenge and diversity presented by this field and the great potential it holds, and I look forward to changed attitudes and a more formal recognition of this specialty.
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