Guest blog By Dr Matthew Stride

The UK trainee perspective (A monthly BJSM blog feature)*

The year 2012 represents a pivotal time for the speciality of Sport and Exercise Medicine. Time will tell whether the Olympic and Paralympic Games will leave any significant lasting ‘legacy’ on the health of our nation.¹ However there is no doubt that the subsequent months after the Games will represent the strongest test for the integrity and future of the speciality.

Consultant SEM Physicians were envisaged, when the training program was inaugurated in 2007, to be instrumental in delivering the legacy. Now five years on, if this is going to come to fruition, there has to be a greater shift towards health promotion and a greater acceptance of exercise medicine than there is currently. As it is primarily through this role that SEM consultants are likely to be (and arguably should be) employed in the not too distant future.²

The SEM curriculum has a greater emphasis on the role of regular exercise for health and chronic disease management than in other countries.³ This includes public health training, knowledge and experience of exercise physiology, exercise testing and exercise prescription in health and disease states, in both the primary and secondary care setting. It is this training and expertise in exercise medicine that is unique to the SEM curriculum and separates us from any other speciality. Musculoskeletal medicine and sport injuries are a comparatively smaller part of the curriculum, yet continue to be by far the largest focus of interest and expertise (the ‘traditional’ Sports physician.) There seems to be a marked, noticeable disparity between curriculum content and SEM physicians who currently specialise in exercise medicine. This imbalance may be largely driven by the historical context of the speciality development. However if this continues then deliverance of the post games legacy may not happen and the speciality training program may not last for much longer.

Exercise medicine needs greater emphasis and acceptance if more SEM Consultants are to be employed in the NHS.⁴ Exercise medicine is an integral part of the training and cannot be dismissed. After all, its inclusion helped the speciality to gain recognition and led to the supposed governmental promise that SEM physicians will be trained to ensure the games leaves a lasting legacy on the health of our nation.

References

1. London 2012: Legacy. A Position Paper from the Faculty of Sport and Exercise Medicine. Available at
2. Sport and Exercise Medicine. A Fresh Approach.
3. Cullen M.  Crossroads or threshold? Sport and exercise medicine as a specialty in the UK. Br J Sports Med 2009;43:1083-1084.
4. O’Halloran P, Tzortziou Brown V, Morgan K et al.The role of the sports and exercise medicine physician in the National Health Service: a questionnaire-based survey. Br J Sports Med. 2009;43(14):1143-8.

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Dr Matthew Stride is a Specialist Registrar in Sport and Exercise Medicine. He is now in the final year of the training program in the London Deanery. He is currently based at Homerton University hospital and has been made an honorary research fellow at Imperial College. He is also a football club doctor.