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UKsem

7 key attributes of Sports Doctors and Physiotherapists at The Commonwealth Games

24 Jul, 14 | by Karim Khan

PhotobombHow can young doctors and physiotherapists get involved?

Paul Dijkstra (@DrPaulDijkstra)

I’m passionate about high performance medical teams and how they work. I used the lead-up to yesterday’s opening ceremony of the 20th Commonwealth Games in Glasgow, Scotland, to chat with participants from different countries here with me in the Village. The excellent sports clinicians are very busy, running around and working long hours to plan and deliver world class medical services to thousands of elite athletes and officials (6500 from 71 nations competing in 17 sports over 11 days!).

I asked “What are the key attributes of Sports Doctors and Physiotherapists working at a major event?”. I asked clinicians and also asked the coaches and management what they expect from good medical teams. Here are top attributes:

  1. Be comfortable to work in an open and collaborative clinical environment (a flat hierarchy) amongst a group of medical, science and coaching professionals where good people do what they’re good at’: Dr Mike Loosemore, Chief Medical Officer of Team England. (@DoctorLoosemore)
  1. Make sure you’re well qualified and experienced for the job’. Easier said than done… It takes 10-12 years of hard work and study to become a specialist Sport and Exercise Medicine Physician and good jobs don’t fall into your lap! Medical students and young doctors in training should not hesitate to get out there and volunteer. ‘Chase knowledge’ said one coach. ‘Build relations with colleagues, physiotherapists, teams, coaches, athletes and sporting officials’. Angela George, Team England physiotherapist agrees: ‘Be prepared to volunteer for every opportunity, get your name known and gain experience in lots of different sports. We all started out in community sport and now have the opportunity to work at the pinnacle of elite sport.’ Really good advice – offer to shadow and assist senior clinicians in the policlinics or next to the fields in smaller local clubs or school events. Be willing to work hard for little or no pay. (@PhysioAnge)

Kudos to Mike Loosemore and Team England management who’ve allowed British marathon runner and Specialty Registrar in Sport and Exercise Medicine (ST5 SEM), Rebecca Robinson to work as part of the Team England medical staff. Market yourself: ‘Blog, write and tweet…’ watch this space: Rebecca will share her experience in a BJSM blog soon! (rjpRobinson)

 

  1. Connect with the athlete’ says Paul Treu, Head Coach to the Kenyan Rugby Sevens team. ‘It is so important for the Team Physician to be able to really understand and appreciate the expectations of each individual athlete’.Dr Stephen Chew, Team England doctor agrees: ‘Attention to detail is important – know the athlete, know the venue and know the sport’. (@paultreu)

 

  1. Be able to adapt to the different environments without compromising on your standards of clinical care’ says Dr Karen Schwabe, here with the South African Team. She added: ‘Be ready to give energy – know how to pace yourself, do some exercise and get down time’. Karen has vast experience in rugby and endurance sport having just published three landmark papers in the BJSM – the SAFER studies.

 

  1. Know your place – the athletes are here to perform. When you’ve seen an injured athlete, don’t keep focusing on that injury or illness by constantly asking the athlete how he / she is doing. They will tell you!’ A valuable lesson I think; our instinct as doctors is to be caring, empathetic and protective. These are all good attributes but should be applied in a sensitive way in a performance focused environment.

 

  1. Laura Hanna is a very experienced physiotherapist and leading Team England’s physiotherapy team: ‘Experience, sound clinical knowledge, flexibility and ability to deal with whatever comes through the door gives physiotherapists working in a multi-sport an advantage. Long hours and putting your hand to anything will help and importantly having a great sense of humor and fun makes anything seem possible.’li>

 

  1. You have to be able to enjoy working in a complex and challenging environment and be passionate about working in sport’, wise words to end this short blog from Dr Bruce Hamilton, leading the New Zealand medical team here.

 

Enjoy the Commonwealth Games!

PS: BJSM Editor’s comment – Follow @DrPaulDijkstra and when he get clearances he’ll keep us informed. Health professionals are part of the TEAM at the Commonwealth Games so they need media clearance of course. He’ll be contributing to the @weRengland twitter feed (Who comes up with those nAmes?)

Paul was too humble to put this in his Blog but his BJSM paper “Managing the Health of the Elite Athlete” has taken off – it’s gone viral as far as journal articles go.  You can read it free tonight here once you turn the TV off.

Benefits and barriers: Sport & Exercise Medicine (SEM) conferences through the eyes of a student

19 Dec, 12 | by Karim Khan

Undergraduate perspective on Sports & Exercise Medicine – a BJSM blog series

By Holly Weaver

lecture hallThe consensus amongst my peers was that being a team doctor in the Olympics would make a ‘Top 5 jobs in the world’ list. You may therefore be surprised to hear then that it is relatively easy to progress through undergraduate studies without encountering Sports & Exercise Medicine (SEM). Keen to remedy this, I set up a SEM society in my clinical school last year with the aim of encouraging interest in the speciality. Since then, to keep my finger on the pulse, I have made it my mission to attend as many conferences as allowed by my schedule (and bank account). So here is my level 5 evidence for SEM conferences –  through the eyes of a medical student.

The Student-orientated Conferences (aka ‘cheap as chips’):

  • Imperial Sports Medicine Conference – 14th May 2011 – Cost: £7

At a price even a student finds cheap, this was a great introduction to the world of SEM. It taught me the value of ‘networking’ as I made contact with other student societies which got the ball rolling.

  • ECOSEP SEM Student Congress – 18th-19th August 2012 – Cost £10

The excitement in the wake of the Olympics ensured a strong group of delegates at this inaugural ECOSEP conference aimed at students. My verdict? Definitely a success – I would recommend attending its next instalment. Integrating delegates from a variety of backgrounds demonstrated the importance of a multi-disciplinary team approach to SEM. My highlight was the seminar on exercise prescription; in my opinion this should be covered in all medical school curriculums.

  • Cardiff SEMS Olympic Conference – 15th December 2012 – Cost £10

After the hugely successful first conference held by the Cardiff Sports & Exercise Medicine Society (CSEMS), I made sure I took full advantage of the impressive programme on offer at the Cardiff SEMS Olympic conference. The opportunity to attend different workshops, in addition to inspiring key note lectures, enabled me tailor the programme to my personal preference.

The Professional Approach (aka ‘big names, big money’):

  • UKSEM International Conference 2011 – 23rd-26th November 2011

I attended UKSEM for free as an undergraduate representative for the Manchester SEM Society. It was a grand affair at the Excel centre in London, attracting an international roster of leading SEM professionals. Many expressed interest in the student society, however the scale of the conference venue and the lecture programme precluded people from spending much time in the exhibition hall.

  • World Sports Trauma Congress – 17th-20th October 2012 – Cost: £150 for 2 days

Thanks go out to my college for providing the financial support for this conference; the price, even with the ‘early bird’ price discounted for training grade, would have stopped me from going otherwise. I was keen to go as the emphasis was on sports orthopaedics. This combined with the ticket price meant that I had high expectations. The scope was huge, and in terms of organisation, venue and sponsors they ticked every box. All of the speakers were fascinating and I learnt a lot about a subject matter I was never exposed to previously. However, I didn’t leave buzzing with excitement. I realised that this was because it was pitched at people at the stage in their careers where the cutting-edge topics weren’t just cool, it was what they needed to keep their skills up to date. This conference simply wasn’t aimed at me. In fact, few conferences are aimed at individuals in the early stages of their career.  However, students should still attempt to attend conferences, placing a higher priority on networking & getting a foot into the ‘SEM door.’

Taken together, my experiences and conversations with peers suggest that medical students must use their initiative to fill our current ‘SEM knowledge gap.’ There is little benefit from just waiting for SEM to feature in the undergraduate curriculum!!

7 tips for students attending SEM conferences:

  1. Sign up early as many have early bird ticket prices (and buy train tickets early too)
  2. Get sponsorship, some of them are overpriced for a student budget – ask about funds at your university or relevant student society
  3. On the same note…take advantage of the cheap ones! Don’t assume because a conference costs a tenner it will be inferior to the pricey one with all the big sponsors
  4. Plan the sessions you will attend and research the speakers; it enables you to pinpoint which topics interest you so that you can read a relevant paper or two
  5. If you achieve No. 4, remember that if you’ve got a good question, ask it!
  6. Get stuck in at practical workshops, it’s easier to chat over a model knee than at formal ‘networking breaks’; at least it’s an ice breaker if you can’t tell your PCL from your ACL!
  7. Choose a conference that is happening now and put it in your calendar for next year; plan to enter the poster competition or submit an abstract and keep your eyes peeled for the submission deadline! Voila, extra CV points!

**********************************************************

Holly Weaver is a final year medical student at the University of Cambridge Clinical School. She is the founder and president of the Cambridge Sports and Exercise Medicine Society (Cambridge SEMS).

Liam West BSc (Hons) is a final year medical undergraduate student at Cardiff University, Wales. He coordinates the “Undergraduate Perspective on Sports & Exercise Medicine” Blog Series for BJSM.

Final Round! – BJSM’s Best Cover of 2011 Competition

21 May, 12 | by Karim Khan

 

Thanks to everyone who voted in rounds 1 & 2. Here are the finalists:

A. South African Sports Medicine Association (SASMA) Congress issue (June 2011)

vs.

B. BASEM’s Sport and Exercise Medicine Conference issue (July 2011)

Who will be the champion?

While you can only vote once – get your friends to vote too (maybe they will even split the prize with you!). You get bonus notoriety points if you vote for the winner AND win the prize.

Remember: Voters (from all rounds) will be entered into a draw for PRIZE of $133 gift certificate to amazon.com. Takes 20 seconds to complete! Your email address is just for us to contact you if you win – we delete them all after the competition.

Click here to vote NOW!  (until May 28th)

Don’t miss Richard Budgett’s Olympics podcast…

20 Dec, 11 | by Karim Khan

Just a quick alert that Richard Budgett, the Chief Medical Office for the London Olympics, shares his very special insights.

He was an Olympic Gold medal winner in Los Angeles before serving the UK and now the world!

Click here for the podcast

And remember, the IOC, through its Medical Commission, supports the 4 of the 16 issues of British Journal of Sports Medicine (BJSM) annually. See recent editorial about Youth Olympic Games here. The BJSM is the leading clinical source of sports and exercise medicine.

Fit is not actually ‘vs.’ Fat – Guest Blog by Professor Timothy Noakes

30 Nov, 11 | by Karim Khan

On Monday the Guardian published It’s not obesity that’s killing us – it’s the lack of exercise. Inspired by research presented at UKSEM (see also Blair Physical inactivity: the biggest public health problem of the 21st century, and BJSM Warmup 2011; 45), the Guardian exhorted us to focus less on obesity and more on physical activity. With 191 comments, 1000 Facebook likes, and 71 tweets (in 48 hours) it doesn’t take a social media expert to figure that this topic is hot.

A critical question is whether exercise is THE primary tool for weight loss (rather than just as part of a healthy lifestyle).

Does exercise promote weight loss?

King, Horner et. al’s have a great article – Exercise, appetite and weight managementin BJSM Online first.

Professor Timothy Noakes (and @GaryTaubes) add these insights to the discussion in this guest blog:

Photo courtesy of Gavin Clarke, Flickr cc

What astonishes me is the continuing failure of so many people, my medical colleagues included, to realize that the solution to personal obesity is so simple. The cause for most people is exactly as Gary Taubes described it – a diet too low in fat and protein and too high in carbohydrate especially sugar. If you are over forty, overweight, personally motivated, and not eating a high fat/high protein/low carbohydrate diet, then you are missing out – your life is passing you by.

The second key is also as Taubes describes it – obesity begets inactivity whereas leanness promotes activity. Trying to get lean by exercising whilst continuing to eat the “healthy” high carbohydrate diet will be unhelpful for most with an elevated BMI (and who are are therefore by definition, carbohydrate intolerant/resistant). You need first to lose the weight by changing to a high fat/high protein/low carbohydrate diet. As the weight falls of (as it does very dramatically at rates that most will not believe), the desire to exercise becomes increasingly overwhelming. In time the desire to exercise becomes addictive.

Trying to encourage overweight people to exercise without first changing their habitual eating patterns (not diet, please note) will never produce the same outcome as will one in which the initial focus is on changing to a high fat/high protein/low carbohydrate diet.

As Gary Taubes describes, this has been known since 1861 but was written out of the medical and popular literature after 1970 when Dr Ancel Keys essentially single handedly developed the global fear of fatty foods that mislead the world and led directly to the epidemic of obesity and diabetes that began to engulf especially people in the developed world especially after about 1977.

Until we rid ourselves of the ridiculous idea that carbohydrate foods are somehow “healthy” (for all) and fatty foods are unhealthy, and as long as we allow our eating patterns to be dictated by industries that aim remorselessly to increase global consumption of sugar and refined carbohydrates, then we cannot solve the global problem of obesity and diabetes.

But at an individual level we can take control by realizing that obesity is a genetic/nutritional disorder caused by excessive carbohydrate consumption in those who are carbohydrate-resistant (and who are therefore unable to metabolize carbohydrates especially fructose, appropriately but who will store the excess calories in fat, rather than expend them in physical endeavor).

Dr. Timothy Noakes is a Sports Physician, Exercise Physiologist and Discovery Health Professor of Exercise and Sports Science at the University of Cape Town and Sports Science Institute of South Africa.

Moneyball: Rewarding excellent sports medicine care. But check your indemnity limit. You may need more if treating elite professional athletes.

27 Nov, 11 | by Karim Khan

UKsem was the first conference to have a ‘Moneyball’ panel session; attendees voted with their feet that this should happen again. What’s ‘Moneyball’? The unabridged term refers to Michael Lewis’ book of that name. It’s about a baseball team who performed much better than they should have by recruiting cheap players who didn’t have the ‘look’ of top draft picks but whose statistics were impeachable. The implication is that an astute statistician may help to recruit this type of player whereas a ‘sport expert’ might be fooled by intangibles – the style, the charisma, pedigree – but in the end things that don’t predict success as well as the carefully analyzed data. The concept was in the news in Australia just today.

In the sports medicine setting, Dr John Orchard raised raised the concept in 2009. He’d read the book (didn’t wait for the Brad Pitt movie) and figured that team physios and team sports physicians could augment team performance. This appreciation, literally valuing of the sports medicine / fitness team would lead to great salaries for those individuals. At the conference Moneyball session, Liverpool Football Club’s Peter Brukner estimated that many soccer/football clubs in the English Premier League have annual player salaries over 100 million GBP but pay less than 0.5% of that for ‘maintenance’ – the sports medicine team. Seems crazy and I suspect that in Formula 1 the investment in the ‘asset’ would be much higher.

Security sit - ready for action - at Liverpool vs. Chelsea, November 20, 2011

Also in the UKsem session was power lawyer Mary O’Rourke, QC, who is clearly a pre-eminent sports lawyer in the UK. She emphasized the risk that sports physicians are at when taking care of players who might be earning over 100,000 GPB per week. Is your personal liability insurance in place for the 40 million GPB or so you might be sued for?  I didn’t realize that as Dick Steadman operates in Colorado, the legislation in that stats caps any medicolegal claim at $10 million. In the UK, there is no cap. Food for thought for both players, and physicians. Lots of players have value greater than $10 million.

There was also an introduction to the idea of clincians using agents to help them get better deals in this new world. Clinicians valued more = larger contracts = need for help with negotiation and for digging out the good gigs. Makes sense.

A great idea for future conferences in the UK and beyond. I can see it traveling very well at AMSSM in Atlanta 2012, the VSG (Netherlands), Australia, Switzerland, South Africa, and among the ECOSEP member countries.

For a detailed movie review and background to Moneyball click here please.

And on the subject of Liverpool Football Club, it seems like Brad Pitt is a fan!

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