As sports and exercise medicine (SEM) develops as a postgraduate specialty, training curricula are increasingly becoming sophisticated and developing along the principles of current educational theory. We have a problem, however, that at the present time the majority of sports physicians are graduates of “traditional” didactic medical courses, whereas the future generation of trainees will come from a more progressive learning environment with self-directed “problem-based learning” (PBL) principles in their undergraduate courses. The usefulness of this approach in postgraduate SEM education remains both problematic and unproven.

TRADITIONAL LEARNING MODELS

Medical schools as we know them began in the early Renaissance period in southern Europe and were under the jurisdiction of the Roman Catholic Church. In later centuries, medicine was taught by a lengthy apprenticeship system with various medical colleges arising in order to provide primitive training (eg, anatomical dissection) and a form of licensure.

Sir William Osler (1849–1919) was a Canadian-born physician who is largely responsible for many of the things that we take for granted in medicine today: university-based medical education, a strong underpinning of basic science for clinicians and an emphasis on bedside learning. Perhaps his greatest contribution to medicine was to insist that students learned from seeing and talking to patients, and this approach led to the establishment of the medical residency programme within hospitals. He himself liked to say, “He who studies medicine without books sails an uncharted sea, whereas he who studies medicine without patients does not go to sea at all.”1

Osler’s textbook, The Principles and Practice of Medicine,2 became the standard text of internal medicine following its publication in 1892 and the basis of most medical education. He stressed that the derivation of the word diagnosis comes from the Greek words dia, which …