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Editorial

Sport and Exercise Medicine: A Timely Specialty Development

Batt, Mark E MBBChir, DM; Maryon-Davis, Alan MBBChir

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Clinical Journal of Sport Medicine: March 2007 - Volume 17 - Issue 2 - p 85-86
doi: 10.1097/JSM.0b013e318031c1a5
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The new UK Faculty of Sport and Exercise Medicine could not have been established at a better time. Not only does it come close on the heels of London's successful bid for the 2012 Olympics, with all the interest in sport and exercise that this great event is bound to generate, but it also coincides with widespread recognition that everyday physical activity can play a crucial part in the promotion of health, prevention of disease, and management of patients with long-term conditions.

Physical activity in its many forms-from active housework and gardening, walking, cycling, running, and swimming, to the rigors of competitive sports-have been shown to confer a range of benefits on the human frame-mind as well as body. In the short term, improving or maintaining strength, flexibility, endurance, and psychosocial well-being helps to maintain functional health and independence. In the longer term, an active lifestyle is associated with reduced risk of a range of diseases and disorders, from hypertension, coronary heart disease, and obesity to diabetes, stroke, osteoporosis, and various forms of cancer. In short, physical activity is increasingly recognized as a crucial element in the primary and secondary prevention of a number of long-term conditions and in the rehabilitation of recent episodes.1

The preventive and therapeutic role of physical activity is now a cornerstone of health policy throughout the developed world, and in countries such as the United Kingdom, it forms an important element of national programs for health improvement and health care development. In England, for example, it features strongly in the government's public health white paper, Choosing Health: Making Healthier Choices Easier,2 and it is explicitly referred to in a number of National Health Service frameworks.3-6 It has been given similar prominence in the health-improvement strategies for other parts of the United Kingdom. And, going beyond health and health care, the government's broad strategy, Game Plan, seeks to increase levels of participation in physical activity and sport so that 70% of individuals will undertake 30 minutes of physical activity, 5 days a week, by 2020.7 The results are a burgeoning of awareness of the role of physical activity, exercise, and sport in health and well-being, and the development of national and local multiagency delivery plans.

As part of the health service response, it is recognized that expert medical knowledge and skills will be required to promote physical activity, exercise, and sport; to clinically assess people's readiness to participate; and to manage the problems and injuries that may result.

Consistent and symbiotic with this change in health policy has been the timely evolution of the specialty of sport and exercise medicine. An editorial in the British Medical Journal in 1997 spoke of the emerging specialty of sport and exercise medicine.8 It has now fledged. In February 2005, the Department of Health formally recognized the new specialty, and in September 2005, the Specialist Order Act was amended accordingly.

Sport and exercise medicine embraces the health needs of physically active people of all ages and abilities. On completion of higher specialist training, doctors are expected to have broad-based knowledge and competencies reflecting the breadth of practice, from advising on suitable forms of exercise or managing soft-tissue injuries to team doctoring or care of active people with disabilities. Sport and exercise medicine doctors will work in a wide range of settings across primary and secondary care, typically as members of multidisciplinary teams providing preventive and therapeutic services, and acting as advocates of physical activity in the wider population.

To facilitate this specialty development in the United Kingdom, the preexisting Intercollegiate Academic Board for Sport and Exercise Medicine has recently become The Faculty of Sport and Exercise Medicine (www.rcsed.ac.uk/site/375/default.aspx). The faculty has now started to admit its own members and fellows, producing the constituency of the new faculty. Together with the specialist society (the British Association of Sport and Exercise Medicine; www.basem.co.uk), the faculty will support and nurture not only specialists (fellows of the faculty) but all doctors with a subspecialty interest (members of the faculty). Fellows of the faculty will be primarily those on the specialist register as specialists in sport and exercise medicine; in the future, fellows will also include those doctors completing training in sport and exercise medicine, which comprises 4 years of sport and exercise medicine training after 4 years of medical training. Members are expected to declare their subspecialty interest in sport and exercise medicine by having a masters degree or a diploma in sport and exercise medicine. Funding for the new faculty will come primarily from enrollment, appraisal, and examination fees. The faculty will develop a research arm that will sit alongside standing committees overseeing the activities of credentialing, training, and appraisal.

Given appropriate funding and support, these timely developments mean that the specialty of sport and exercise medicine will be well placed to play its full part in a sustained, broadly based effort to promote active living, sport, and exercise and, ultimately, to achieve the lasting legacy of improved health and reduced health care costs. Broadly similar developments have already taken place to good effect in Finland and The Netherlands. Both of these countries have acknowledged and embraced the importance of physical activity as a lever for healthy living and have set up specialist medical training programs to support this approach. Hopefully, others may soon follow.

REFERENCES

1. Chief Medical Officer. At Least Five a Week. Evidence on the Impact of Physical Activity and Its Relationship to Health: A Report from the Chief Medical Officer. London, UK: Department of Health; 2004.
2. Department of Health. Choosing Health: Making Healthier Choices Easier. London, UK: Department of Health; 2004.
3. Department of Health. National Service Framework for Mental Health. London, UK: Department of Health; 1999.
4. Department of Health. National Service Framework for Coronary Heart Disease. London, UK: Department of Health; 2000.
5. Department of Health. National Service Framework for Older People. London, UK: Department of Health; 2001.
6. Department of Health. National Service Framework for Children, Young People and Maternity Services. London, UK: Department of Health; 2004.
7. Department for Culture, Media and Sport, Prime Minister's Strategy Unit. Game Plan: A strategy for Delivering the Government's Sport and Physical Activity Objectives. London, UK: Cabinet Office; 2002.
8. Batt ME, Macleod DAD. The coming age of sports medicine (editorial). BMJ. 1997;314:621.
© 2007 Lippincott Williams & Wilkins, Inc.