Junior doctor contracts and SEM within the NHS: Looking to the future

Undergraduate perspective on Sports & Exercise Medicine – a BJSM blog

By Jonathan Shurlock

With significant advice and assistance from Dr Daniel Broman

Sport and Exercise Medicine (SEM) remains a relatively young specialty within the National Health Service (NHS). During my short time as a medical student, I have witnessed its development into the specialty we see today. SEM, as a specialty, continues to adapt and overcome challenges and become more integrated into NHS services. As of 1st August 2016, a new contract will be imposed upon all junior doctors working within the NHS. How will that impact SEM trainees?

Impact on SEM trainees

futureFrom a financial standpoint, the new contract benefits SEM trainees. Most, but not all, SEM NHS contracts are unbanded, with no unsocial or weekend work. This reflects the role SEM currently plays within the NHS, with most trainees working in non-emergency services. However, it does not reflect the out of hour commitments trainees have to academia, teaching and work in sport. Based on this, SEM trainees are one of the specialist groups to benefit financially from the proposed basic pay rise of 13.5%, without losing any enhanced hours pay.

The outcome of the Shape of Training Review1 may change this however, as SEM doctors may be required to assist in acute care settings, taking more time away from their SEM specific training. At the recent BASEM/FSEM annual meeting, the future of SEM in the UK and the NHS was a key topic of discussion. Dr Justin Hughes outlined the potential future of SEM training; a transition to dual specialty training, combining SEM with an acute medical specialty.

With the uncertainty currently surrounding contracts and the NHS training structure as a whole, it remains unclear what the exact impact will be on SEM trainees.

Impact on recruitment

The Association of Surgeons in Training (ASiT) shared data that suggest there has been a 10-15% fall in recruitment to acute specialties including Emergency Medicine, over the past year.1 If one takes the vigorous responses and protests to contract imposition at face value, these numbers may well continue to fall.  Encouragingly this trend is not evident with SEM – competition rates for training places have remained relatively constant over the past 3 years.2

Looking to the future

In the spring FSEM edition of BASEM today, Dr Natasha Jones explained that ‘To influence the NHS at a strategic level, SEM will need to continue to build an evidence base both in research environments and in pragmatic interventions’.3 However, as we know, SEM does not exist in a vacuum, and the broader medical community is sure to have impact on this vision.

From a trainee perspective, we simply seek to make sense of the situation and understand the future of SEM within the NHS. To achieve this, it is important to consider the broader impact of changes within the NHS, beyond the aforementioned financial factors. In closing, rather than arguing for one specific path forward, our aim of this blog is to promote discussion, as we view continued conversation as integral to a positive outcome for both general medical practitioners, and SEM specialists.


  1. The Association of Surgeons in Training. Online. Available at: https://twitter.com/ASiTofficial/status/695945762199498752 [Accessed 11/02/16]
  2. Joint Royal colleges of Physicians Training Board. Sport and Exercise Medicine. Online. Available at: http://www.st3recruitment.org.uk/specialties/sport-exercise-medicine [Accessed 11/02/16]
  3. The Faculty of Sport and Exercise Medicine (UK). BASEM Today. 2015; Issue 30:p13


Jonathan Shurlock is a medical student, currently based in Brighton. He is a research assistant at the FIMS Reference Collaborating Centre of Sports Medicine in Eastbourne, working on a series of anti-doping projects. @J_Shurlock




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