“It all comes down to today. Either we heal as a team … The inches we need are everywhere around us”
I include this quote from Al Pacino’s famous speech to the American Football Team in the movie “Any Given Sunday” because it echoes the importance of the Sports and Exercise (SEM) doctor. For it the SEM doctor that help the athlete (along with the rest of their multi-disciplinary, MDT, team) get those inches – often the different between winning and losing.
So here I am, on the four day course for doctors who have an interest in SEM. Some have extensive experience in medicine – we had A&E consultants, GPs with 30 years under their belt, Foundation Year 2 doctors who were sharpening their skills and deciding where their future will take them.
..And then we had me – still yet to even know if I had passed Finals!
To say I was nervous and feeling slightly out of my depth was an understatement. However, if you read my last blog, you’ll understand when I say, I went for Option B.
The course was held at the Lilleshall National Sports Centre in Shropshire. What an utterly beautiful venue, deep-set in an old country estate with state of the art facilities for our national teams. It was hard not to be inspired. Likewise it was hard not to be inspired by the staff on the course and the other amazing course attendees. Every time I go on a course, I worry about who I’ll meet, will I be on my own etc, but I should have learned by now that these people are all here for similar reasons to me and more often than not I meet some great people and make great friends. This course was no different. Whether it be as we examined a knee, argued the merits of the straight leg raise for diagnosing true sciatica or playing five a side footy and celebrating with a pint afterwards – I enjoyed all the course attendees company.
The course itself covered a vast about of material but I’ll try and summarise what we did for you all…
Day 1: SEM history taking, the risks of inactivity, being an events doctor
Day 2: Tendonopathy; human sports and exercise physiology; knee anatomy and pathology
Day 3: Nutrition and supplementation; shoulder, foot and ankle anatomy and pathology
Day 4: Doping in sport; back problems in sport; components of the athlete MDT
Every day allowed us to review some theory and then crack on with getting hands on with each other. For me, I felt a particular desire to show that I could do these examinations well…afterall I had only just completed my Finals Observed Structured Clinical Examinations, or OSCEs, whereby I have 19 stations or scenarios where I have 5 mins to examine and diagnose a patient (while being marked by a scary Consultant standing the corner of the room!….As an addendum I surprisingly got a “A” grade for m OSCE in Finals which I was thrilled about as I though I had failed that part!). So yes, we digress, back to the course. Around the well stocked tea and coffee there was plenty of discussion and debate about what we had seen, learned and discussed – it was such a wonderful 4 days in this respect – I left inspired and wanting more.
As a not even yet experienced junior doctor there was certainly times when I was out of depth or left dumbly smiling and nodding (when others nodded) as I lost the thread of the conversation…taking me back to the days as a medical student…especially in neurology! I did however come away with better joint examination skills for the knee, shoulder, foot and ankle, and back that will directly impact on my new junior doctor years for the better.
It too is great to have a better sports-specific list of differentials in my head. For example,
Cardiac Hypertrophy: heart failure; hypertrophic cardiomyopathy; athletic heart
Shin splints: medical tibial syndrome; compartment syndrome (from muscle hypertrophy often seen in field hockey players); stress fractures of tibia
As I sit here, looking at the endless notes I have made I think you guys probably don’t want to be bored to death my medical facts but let’s just summarise by saying that the BASEM SEM Foundation Course has provided me with a great insight into being a Sports and Exercise Medicine Professional and I am left with a certainty that this is the specialty in medicine that I wish to pursue.
What leaves me more excited is that with a degree in sports and exercise science, PhD in performance physiology and now degree in medicine that it ‘fit’s. By that I mean that this specialty feels right – and in medicine, to balance work and life, staying happy and inspired, I think this is crucial.
I feel lucky to have found mine so early.
Some interesting papers for you all if you wanted:
Blair et al., 1995 JAMA: Cardiopulmonary Fitness and All Cause Mortality
Mora et al., 2005 CIRCULATION: A re-analysis of the Framingham Study
MSSE 2007; 39; pages 1423-1434: ACSM Position Stand (advice on exercise for public)
Australian Institute of Sport: online website with excellent nutrition advice for different sports