By Professor Mutsuo Yamada M.D., Ph.D.
The International Rugby Board (IRB; World Rugby from 19th November 2014) awarded the 2019 Rugby World Cup (RWC) to Japan on the 28th of July in 2009. We, the medical professionals for Japan Rugby Football Union, realized there was much to do over the next 10 years to ensure the medical provision for the tournament was of the highest quality. Below is a list of key steps we took to prepare for the Cup:
1 Meeting the World Rugby (WR) Medical Standards
With the intention to have our pitch-side medical care mimic those of Tier One nations, we cross-learned from a medical officer in a Tier One Union and also gathered information on the minimum medical standards from the Japanese Rugby Football Union (JRFU) (although information prior to 2011 was limited).
2 Training medical personnel
We then devised a training pathway, and trained JRFU medical staff with WR and Asia Rugby colleagues. This process initially required Japanese doctors to attend Immediate Care in Rugby (ICIR) and Prehospital Immediate Care in Sports (PHICIS) courses in a foreign country, but it was imperative to start running these courses in Japan too. With a lot of hard work and collaboration, we held our own advanced ICIR courses in Japan by 2018, and had educated 291 medical staff by the start of RWC 2019 (Figure 2).
3 Requiring medical personnel to gain experience at the elite level Rugby in Japan.
The Japan Top League (JTL) mandated qualified match-day doctors (MDDs) and those MDDs worked together on a regular basis in 2016. From 2016 to 2018 (with the introduction of Super Rugby to Japan), MDDs had practiced in 254 games, gaining a wide range of experience.
4 Nominating Match Day Doctors (MDDs) and Immediate Care Leads (ICLs)
At the end of the 2018 season, 40 MDDs and 16 ICLs were nominated to work at RWC 2019 and accredited by a Medical Advisory Group. In addition to this, four foreign MDDs were nominated from Asia Rugby to provide an independent group of medical professionals at the Cup.
5 Practicing at the international elite level Rugby
Nominated doctors have been practicing in international Rugby since the 2018-2019 season, and gained experience in Super Rugby and Asia Rugby Championship matches.
Some MDDs traveled to Malaysia, Hong Kong, and South Korea as MDDs of AR to gain further practice, and some also worked at the Hong Kong Sevens.
6 Building the legacy plan for JRFU Medical and Asia Rugby Medical.
We are keen for this process to have a tangible effect on how Sport & Exercise Medicine is practiced in Japan beyond RWC 2019. Our Legacy Plan (with AR) has three main aims:
- Extending Immediate Pitch Side Care courses and cover to community rugby and other sports.
- Continuously training and developing of the Extrication Team.
- Sharing the knowledge and experience with AR.
It has been very challenging for the JRFU to build a high standard medical system for RWC, but by following the above step-by-step strategy and utilizing trained Japanese and AR medical personnel, Japanese Rugby can now meet WR minimum medical standards. This would not have been possible without the encouragement and support of the Japanese Rugby Football Union, Asia Rugby,World Rugby, and the likes of Ichiro Kono, Akihiko Nakamura, Lucy Clark, Martin Raftery, Andy Smith, Mark Harrington and others from the WR Immediate Pitch Side Care working group. Without each and everyone’s help and contribution, we wouldn’t have come this far. Thank you so much for the bottom of my heart, and enjoy RWC 2019!
Professor Mutsuo Yamada M.D., Ph.D.
Japan Rugby Football Union, Medical Officer, Injury Prevention and Research Unit, High-performance section, Asia Rugby, Chief Medical Officer, World Rugby, Medicine, Science and Research Working Group, Immediate Pitch Side Care Management Working Group, JR2019 Medical Advisory Group Medical Officer