**4. Essential competencies**

#### **4.1 Patient care and medical knowledge**

The primary care sports and exercise medicine fellow/resident must be trained inpatient care to be able to diagnose and provide treatment of medical illnesses and injuries related to sports and exercise and proficiently perform all procedures essential to the practice of sports medicine. Medical development must include also biomedical, epidemiological, and social/behavioral sciences and its application to patient care [3, 5, 12].

The training doctor must be exposed to a different setting and clinical situations, with broad clinical experience, high patient load, and follow-ups, including different age groups, sports, genders, socioeconomic levels, types of sports, and levels of participation.

*Sports, Health and Exercise Medicine*

and eliminating the need for further consultation.

sports medicine in the integral care of patients [1, 6].

significant financial and political influence.

at various stages of his/her training [1, 9, 12].

**2.1 Undergraduate training**

exercise medicine [7–11].

in sports medicine [7, 9].

**2.2 Postgraduate training**

As consultants, they can be of great help in evaluating and treating active patients by efficiently connecting the different medical fields. Primary care sports medicine physicians can facilitate early diagnosis and management, thus accelerating recovery and avoiding long-term disability, providing adequate management,

Patients can be seen quickly and cost-effectively. Therefore, sports doctors can reduce long waiting lists, solve the shortage of other specialists, and reduce the rising costs of healthcare. There is clearly an important role for the knowledge of

However, the specialist physician in sports medicine is not always well understood by fellow doctors, health workers, team managers, and politicians. It is very challenging to change the current paradigms based on existing diseases in the health systems and the beliefs of the population, where the pharmaceutical industry has

A consistent, sustained, and coordinated effort by the wider medical community, aligned with a bold political vision to change health systems and society's

**2. A general overview of the SEMP training and medical background**

As a general overview, medical students usually do not have many learning opportunities in sports medicine during regular medical programs. Previous publications evidenced that medical students would favor having more exposure to sports and exercise medicine and even suggest compulsory sports medicine education. Similarly, general practitioners feel inadequately trained to practice sports and

Besides this hidden barrier, sports medicine is being more recognized as a potentially attractive career to be pursued by a growing number of young doctors all over the world. Sports and exercise medicine is a multidisciplinary specialty, which has the potential to provide a medical student with valuable learning opportunities

An increase in demand for sports medicine training would facilitate on under-

The profession is moving firmly from the previous concept of "athlete's medicine" toward a vision where the main concern of specialists is physical activity promotion. The current definition of sports and exercise medicine can be extended to public health, presenting greater impact on improving the overall health of the

A high-quality structured education in the field of sports and exercise medicine should be the critical goal for practicing physicians. Primary care sports medicine fellowship programs are designed to provide comprehensive training in preventing

population and assisting the expansion of the specialty [1, 4, 12–14].

standing the specific field, its demands, and possible career pathways for the graduating physician. Program directors of the universities and medical schools should include sports and exercise medicine in their curricula and use the expertise of sports medicine physicians in their community. Lectures and clinical skill workshops on sports-related illness, injuries, and musculoskeletal examination should be included in the undergraduate years, complemented later by electives and rotations

culture to promote and support physical activity, is a crucial requirement.

**20**

#### **4.2 Event coverage**

Fellows/residents should be exposed to event coverage in a variety of settings during their training year(s). These include covering youth or senior/professional sports teams; participating in elite-level Olympic sports, such as athletics, swimming, and gymnastics; and coverage of mass events, such as marathon or triathlon major events.

It is extremely important to participate in a variety of sports to become accustomed to the athletic environment and potential injuries that could be sustained during the events, possibly including coverage to contact sports to be exposed to concussion and other contact injuries.

### **4.3 Pre-participation examination (PPE)**

Programs of excellence will have training doctors to perform pre-participation examinations for a variety of athletes and disciplines, including team sports, individual sports, elite, and young athletes.

### **4.4 Specialty and orthopedics rotations**

Residents/fellows rotate with subspecialists; including sports cardiology; musculoskeletal radiology; rehabilitation; physical/occupational therapy; exercise physiology and performance; neurology; rheumatology; nutrition; psychology; orthopedic surgeons of shoulder, elbow, wrist/hand, hip, knee, and foot/ankle; and pediatric surgeons.

#### **4.5 Acute injury and fracture management**

This provides exposure to acute fracture and dislocation management including assessment and diagnosis, splinting and casting.

#### **4.6 ECG interpretation and exercise testing**

These include training about the specific adaptations in the athlete's heart, normal changes and pathological abnormalities. These perform and interpret the exams, provide proper care, and identify the need for continued investigations and referrals as needed.

#### **4.7 Exercise prescription**

Training on exercise prescription in the different population, their requirements, and specific needs.

#### **4.8 Sports medicine procedures and sports ultrasound**

Regarding this specific topic, there might be differences between programs and learning experiences, according to the country and expected field of work. In our understanding, these procedures are an integral component of most sports medicine practices and will be mentioned here.

Injections and other procedures to consider for general exposure include dry needling, autologous blood injections, platelet-rich plasma injections, and prolotherapy. Procedural training should include education in didactic theoretical and practical sessions, including mentored clinical experience and continuing education options to determine proficiency for all procedures.

**23**

to-play decision [17, 18].

*The Primary Care Sports and Exercise Medicine Physician: A Key Role in a Continuum…*

Sports ultrasound might also be included in the training programs and is seen as an important skill to be performed. Current endorsements for recommended sports ultrasound curriculum for sports and exercise medicine physicians can be found in

Ability to work in a multidisciplinary team and to communicate efficiently are extremely important for the proper patient care not only in a team environment as a team doctor but also for best of care in the outpatient care directing proper multi-

**5. The sports and exercise medicine physician medical role: from elite** 

The broad and specific knowledge of SEMP, when following a proper training program, allows him/her to provide comprehensive care of patients, being able to handle most of the illnesses and injuries, from the pre-participation assessment to

The primary care sports medicine physicians can facilitate early diagnosis and management, thereby speeding recovery and preventing long-term disability. The appropriate case management, either with physiotherapy, bracing, and orthotics, injections, can optimize treatment pathways, eliminate the need for further consul-

The role of the specialist sports medicine physician is not always well-understood by medical colleagues, team managers, healthcare directors, and politicians. We here describe some of the characteristics of the sports doctor in the elite athlete care approach, event coverage, and healthy lifestyle promotion, including some interprofessional relationships needed in this field, which are usually different from regular working relations and organization found in the more traditional medical

The team physician's education, training, and experience uniquely qualify to provide the best medical care for the athlete. Team physicians have the leadership role in the organization, management, and provision of care of athletes in indi-

The team physician should possess, be responsible for, and/or understand not only clinical illness and injuries, but also medical and administrative duties, ethical matters, medicolegal problems. This role must be developed to provide a foundation for best practices in the medical care of athletes and teams. The most important responsibility is the medical care of athletes at all ages and all levels of participation [17].

The team physician should be proficient in the prevention and care of musculoskeletal injuries and medical conditions encountered in sports. The team physician integrates medical expertise with medical consultants, strength and conditioning coaches, and other allied healthcare professionals. The team physician also is responsible for educating athletes, coaches, parents, and administrators. The team physician is ultimately responsible for the clearance to participate and the return-

Expected requirements for the team physician are clinical training and experience including medical specialty board certification, residency/fellowship training

*DOI: http://dx.doi.org/10.5772/intechopen.88443*

**4.9 Interpersonal skills and communication**

professional and teamwork for the patients.

tation, and save time and healthcare costs.

**5.1 Sports and exercise medicine in the elite level**

vidual, team, and mass participation sporting events.

the return-to-play decision.

specialties.

published journals and sports medicine associations [16].

**sports and events to healthy lifestyle promoter**

*The Primary Care Sports and Exercise Medicine Physician: A Key Role in a Continuum… DOI: http://dx.doi.org/10.5772/intechopen.88443*

Sports ultrasound might also be included in the training programs and is seen as an important skill to be performed. Current endorsements for recommended sports ultrasound curriculum for sports and exercise medicine physicians can be found in published journals and sports medicine associations [16].

#### **4.9 Interpersonal skills and communication**

*Sports, Health and Exercise Medicine*

concussion and other contact injuries.

**4.3 Pre-participation examination (PPE)**

individual sports, elite, and young athletes.

**4.4 Specialty and orthopedics rotations**

**4.5 Acute injury and fracture management**

assessment and diagnosis, splinting and casting.

**4.8 Sports medicine procedures and sports ultrasound**

cine practices and will be mentioned here.

options to determine proficiency for all procedures.

**4.6 ECG interpretation and exercise testing**

Fellows/residents should be exposed to event coverage in a variety of settings during their training year(s). These include covering youth or senior/professional sports teams; participating in elite-level Olympic sports, such as athletics, swimming, and gymnastics; and coverage of mass events, such as marathon or triathlon major events. It is extremely important to participate in a variety of sports to become accustomed to the athletic environment and potential injuries that could be sustained during the events, possibly including coverage to contact sports to be exposed to

Programs of excellence will have training doctors to perform pre-participation

examinations for a variety of athletes and disciplines, including team sports,

Residents/fellows rotate with subspecialists; including sports cardiology; musculoskeletal radiology; rehabilitation; physical/occupational therapy; exercise physiology and performance; neurology; rheumatology; nutrition; psychology; orthopedic surgeons of shoulder, elbow, wrist/hand, hip, knee, and foot/ankle; and

This provides exposure to acute fracture and dislocation management including

These include training about the specific adaptations in the athlete's heart, normal changes and pathological abnormalities. These perform and interpret the exams, provide proper care, and identify the need for continued investigations and

Training on exercise prescription in the different population, their requirements,

Regarding this specific topic, there might be differences between programs and learning experiences, according to the country and expected field of work. In our understanding, these procedures are an integral component of most sports medi-

Injections and other procedures to consider for general exposure include dry needling, autologous blood injections, platelet-rich plasma injections, and prolotherapy. Procedural training should include education in didactic theoretical and practical sessions, including mentored clinical experience and continuing education

**4.2 Event coverage**

pediatric surgeons.

referrals as needed.

and specific needs.

**4.7 Exercise prescription**

**22**

Ability to work in a multidisciplinary team and to communicate efficiently are extremely important for the proper patient care not only in a team environment as a team doctor but also for best of care in the outpatient care directing proper multiprofessional and teamwork for the patients.
