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Sport and exercise medicine (SEM) in the UK is gaining the recognition of medical students as a potentially attractive career. The London 2012 Olympic health based legacy, together with the media spotlight on sports injuries, has served to further increase this interest in SEM at an undergraduate level. In this editorial, I address three barriers that students who are interested in SEM need to overcome to enter specialty training.
No SEM in the curriculum
The undergraduate curricula at most medical schools in the UK do not include any formal SEM education, either in a sports medicine or exercise medicine format. We are taught about disease rather than health. Many students feel disappointed that their education is failing to mirror NHS, and global priorities,1 of using physical activity as a modality for prevention and treatment of non-communicable diseases. Weiler et al 2 in the UK and Edward Phillips3 in the USA have highlighted this dearth of physical activity teaching and Joy et al 4 has stated a call to action to develop programmes to provide this education to students and physicians.
Few role models
Medical students do not encounter SEM professionals during their normal clinical attachments. We are shielded from role models, yet the guidance from positive role models strongly impact student decisions regarding future careers.5 ,6 In the elite sporting environment, frequently complicated insurance and trust issues with administrators or coaches can make shadowing virtually impossible anyway.
Which specialist career path leads to SEM?
Even if a student is able to source informal SEM education and gain clinical experience in the specialty, there still remains the uncertainty of which pathway into SEM is appropriate. Should students follow the more traditional routes of general practice, orthopaedic surgery or rheumatology pursuing SEM as a specialist interest or should they gamble upon the new SEM training pathway? If a student embarks upon the SEM training pathway, there is no guarantee that there will be registrar posts. Will there be a central role for SEM in the NHS? To achieve this, SEM must demonstrate that it can cost effectively improve patient care and have political clout.
Overcoming these barriers: tips for medical students
Despite the lack of undergraduate experience opportunities described above, SEM has the ingredients to potentially be an immensely enjoyable and rewarding vocation. Once medical students identify these barriers, they may be proactive and overcome them using their initiative.
At several universities across the UK, student SEM societies have been formed to formally bridge the gap between the lack of SEM education at the undergraduate level and the expectations of postgraduate courses in the field. They run regular evening talks and often help to arrange shadowing experience or involvement with SEM related research. Students should strive to become active members of one of these groups!
Students should be encouraged to use their own initiative to try to arrange their student selected modules and elective placements to incorporate SEM or musculoskeletal sciences. Students can undertake intercalated degrees in SEM or sports science to further their interest. This can help students to contact those few existing role models in SEM.
Students should not get intimidated by their lack of knowledge in SEM as there is much out there that is applicable. The NHS Information Document ‘SEM—A Fresh Approach’ can be used by students to learn what an SEM specialist offers the NHS and NHS patients.7 Listening to podcasts, such as the entries from Mike Loosemore8 and Steven Blair,9 not only provides much food for thought but also gives a simple insight into the future pathway SEM will be treading. Watching SEM media, such as the 23.5 h video from Mike Evans, can be hugely inspirational and introduce students to ‘Exercise Medicine’. Reading the BJSM and blog will help them to keep up to date on critical and emerging research areas in the field, many of which students can get involved in. Through such initiatives as the Move. Eat. Treat. Campaign,10 students have shown that SEM provides them a chance to become educationalists themselves!
A crucial step is to create opportunities to network with SEM professionals who can then adopt the mentor role as previously discussed. Attending conferences, such as the annual BASEM conference every November or a specific undergraduate SEM conference, is a great way of achieving this. Making use of platforms such as the ‘Undergraduate Perspective on Sports and Exercise Medicine’ BJSM blog series can help students get their name recognised and forge opportunities in SEM. SEM work will not land in the doctors’ laps—we are still not in a ‘routine’ phase of career development as is the case in established priorities. Thus, the budding SEM doctor will need to be proactive, risk-loving and prepared to work hard over and above his or her clinical load.
Does this reflect the state of SEM at the undergraduate level in other countries too? Can the UK learn from BJSM member societies (eg, the USA, Australia, the Netherlands, Norway, South Africa and Switzerland)? Will the career path be easier for the next generation of SEM doctors?
Competing interests None.
Provenance and peer review Not commissioned; externally peer reviewed.
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