The Role of the Covering Doctor in Elite Sport – Lessons for aspiring SEM doctors

By Dr Jo Larkin

Sport and Exercise Medicine: The UK trainee perspective (A semi-monthly series on the BJSM blog)

Experience in a variety of sports settings may be considered essential to a Sports and Exercise Medicine (SEM) trainee’s development. In doing this I have gained significant insights into the role of the ‘covering’ Sports and Exercise Medicine physician. The challenges are many as are the benefits to one’s clinical practice.

Learning from physiotherapists

These situations provide one with a great opportunity to gain experience from other medical practitioners and the wider coaching staff. In particular, the role of the physiotherapist.  The physiotherapist often has a wealth of knowledge that is vital when it comes to understanding the risks involved for an athlete and decision making. Here, our role as an SEM clinician is completely different to the one we experience within the hospital environment. It is essential that a strong relationship is built with the physiotherapist, working together as a team.  Hierarchy does not have a place on the pitch.

Working with coaching staff

My experiences to date have been particularly varied when it comes to working with the coaching staff across different sports.  Head coaches can have very different and distinct views on how to approach training camps, which may oppose the ideas of the medical staff e.g. early pre-season “beasting” sessions to toughen players up after a summer break.  At the same time it is essential that everyone understands that the final decision regarding an athlete’s medical fitness and position in camp rests with the medical team. Of course, based on decisions involving consultation with the athlete.

The key to establishing yourself is to ‘fit in’, meet the players and staff, and make yourself approachable.  In order to integrate best with teams I have also spent time preparing for camps, learning about the sport, including the rules and regulations.


Documentation is key and even more so when you are the covering doctor. This may be the only piece of evidence upon which you are judged by colleagues when handing over medical information. It is therefore essential to document everything including all working differential diagnoses, as the acute setting will offer the perfect opportunity to fully assess the injury. In a Sports Medicine setting the old adage “If you don’t document it then you haven’t done it!” rings truer than ever.  Failure to adequately document a medical incident will leave you little leeway in a court of law.

Enjoy the experience!

Travelling with a team while attempting to fit in your normal commitments can be extremely difficult.  Effective time-management skills and an understanding social circle will offer you the best hope.  It is essential to enjoy the experience and appreciate the passion and determination of the athlete as it all makes for great learning.


Dr Jo Larkin. Sport and Exercise Medicine trainee, ST5 in the London Deanery.

Dr James Thing co-ordinates “Sport and Exercise Medicine: The UK trainee perspective” semi-monthly blog series.


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