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ACSM and the Emergence of the Profession of Exercise Physiologist

FOSTER, CARL Ph.D., FACSM

Medicine & Science in Sports & Exercise: August 2003 - Volume 35 - Issue 8 - p 1247
doi: 10.1249/01.MSS.0000078922.45634.C1
ACSM 50Th Anniversary Historical Perspective

Department of Exercise and Sport Science, University of Wisconsin-La Crosse, La Crosse, WI

To commemorate a year of celebration for its 50th Annual Meeting in May 2003 and its 50th anniversary as an organization in 2004, the American College of Sports Medicine and Medicine & Science in Sports & Exercise® are pleased to publish personal historical perspectives from leading sports medicine and exercise science professionals. This article is one in a series of articles based on the impact ACSM and MSSE ® has had on the fields and categories covered in this ACSM’s flagship journal.

When I was a student at the University of Texas in the 1970s, exercise physiology was an interesting and diverse academic discipline. The academic benchmark at the time was Bengt Saltin’s bed rest study. The main academic arguments were George Brooks’ challenges, first of “oxygen debt” and later of the “anaerobic threshold.” Physiologic regulatory mechanisms were largely considered to be feedback in nature. The concept of feed-forward regulation was perhaps already formed in Jere Mitchell’s mind, but nowhere else. John Holloszy was just beginning to transform Charlie Tipton’s doctoral students into the scientific leaders of a generation.

The problem was what to do with the mass of data in the academic discipline of exercise physiology. Although we knew that exercise was a part of the solution to the epidemic of cardiovascular disease that gripped the western world, we did not have a sense of how to use it. Leaders including Bruno Balke, Ken Cooper, T. C. Cureton, Jeremy Morris, Herman Hellerstein, John Naughton, and Ralph Paffenbarger had launched the exercise revolution (or had begun to produce the students who would direct the revolution), but how did we integrate exercise into a health care system that was just discovering coronary artery bypass graft surgery? To borrow a phrase from Stanley P. Brown, Ph.D., FACSM, exercise physiology was an academic discipline but not a profession (2). At the time I graduated in 1976 the question “what is an exercise physiologist?” elicited from the American College of Sports Medicine (ACSM) a statement about “a doctoral-level research scientist.” But what were we to call these folks with master’s degrees who were beginning to emerge from places like La Crosse, Wake Forest, and East Stroudsburg?—Folks who would become the main players in the emergence of the cardiac rehabilitation in the late 1970s.

Fortunately, a farsighted group of individuals, who represented the very soul of the postfounders’ generation of ACSM, Karl Stoedefalke, John Faulkner, Sam Fox, Henry Miller, and Bruno Balke, had recognized that appropriately trained physical educators could use the information within the academic discipline of exercise physiology to create the profession of exercise physiologist. Collectively they codified this critical body of knowledge into the Guidelines for Graded Exercise Testing and Prescription (1), first published in 1975. I still remember my first reading of the Guidelines, on a Greyhound Bus between Austin and San Antonio, Texas, and my awe and wonder at how this marvelous document showed how exercise testing and training could be a useable tool to a) help persons with cardiovascular disease; b) work cooperatively with a variety of folks who would eventually be called health care professionals; and c) create a logical plan for the academic development of practitioners. With the first publication of the Guidelines the profession of exercise physiologist was born. In my reply to Stanley Brown’s opinion piece in Clinical Exercise Physiology (3), I (together with Jeff Roitman and Carol Harnett) challenged his assertion that exercise physiologists could not be professionals because they had no “unique body of knowledge.” I asserted that the Guidelines represented just that “unique body of knowledge.” Some of Dr. Brown’s arguments about professionalism that a) we still do not have a tightly defined academic preparation program, b) we still do not adequately limit the right to sit for certification/registry examinations, and c) we still do not (and may never) have the “sanction of law to practice” are still valuable challenges. However, regardless of his important arguments, I believe that on the day of publication of the first edition of Guidelines we crossed the threshold from academic discipline to profession. That this profession will evolve as some of the challenges raised by Dr. Brown are met is certain. The first step toward the profession of exercise physiologist occurred, thanks to the foresight of a Karl and John and Sam and Henry and Bruno, who probably would not together have produced this document except for the presence and focus provided by the American College of Sports Medicine.

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REFERENCES

1. American College of Sports Medicine. Guidelines for Graded Exercise Testing and Prescription, Philadelphia: Lippincott Williams & Wilkins, 1975.
2. Brown, SP. Profession or discipline: the role of exercise physiology in allied health. Clin. Exerc. Physiol. 2: 168, 2000.
3. Foster, C., J. Roitman, and C. Harnett. Profession or discipline: asking the right questions or turf protection? Clin. Exerc. Physiol. 2: 169, 2000.
©2003The American College of Sports Medicine