Sport and exercise medicine

This page provides useful information on the nature of the work, the common procedures/interventions, sub-specialties and other roles that may interest you.

Nature of the work

A consultant in sport and exercise medicine possesses excellent clinical history-taking and examination skills, enabling accurate diagnosis. They take a holistic [1] approach to patient care and understand the specific physical attributes required to participate in a variety of sports.

 A multidisciplinary approach and a broad-based specialty, SEM practitioners work in a variety of settings across primary, secondary and tertiary care [2].

Sport and exercise medicine became a recognised medical specialty in 2005. Alongside treating sport and physical activity related injuries and common conditions, it aims to increase physical activity both to reduce and treat many non-communicable diseases. The role includes:

• providing accurate diagnosis for individuals with musculoskeletal injuries or illness who would like to exercise, or for whom exercise would be beneficial
• overseeing and implementing rehabilitation programmes
• workplace wellness and vocational outputs
• making their clinical expertise available to other clinicians and allied healthcare professionals in the wider multi-disciplinary team
• providing support to  sportsmen and women to assist them in maximising performance (within international rules), reducing injury time and minimising the co-morbidity associated with sporting participation
• promoting the highest level of ethical standards within sport by contributing to sporting organisations and teams
• promoting improvements in public health through encouraging physical activity and exercise in the general population
• developing and implementing public health policy for physical activity programmes
• liaising with and supporting the work of health authorities, sporting organisations and other community agencies involved in the promotion of healthy lifestyles and safety standards in sport
• participating in audits, research and training to contribute to development of SEM as a speciality.

Doctors in sport and exercise medicine treat and are involved in treating a variety of conditions including:

• soft-tissue injuries  of muscles and ligaments, including sprains (partial tears) and ruptures (complete tears)
• stress fractures
• tendinopathies
• medical conditions related to the musculoskeletal system MSK disorders and conditions
• osteoarthritis and other degenerative conditions
• female athlete triad
• obesity
• osteoporosis
• diabetes
• cancer
• heart disease
• hypertension [3]
• stress and mental illness
• obesity
• exercise-induced asthma

Common procedures and interventions

These include:

• clinical history and physical examination
• musculoskeletal injections (often Ultrasound [4]-guided)
• biomechanics and gait assessment
• musculoskeletal ultrasound [4]
• compartment pressure measurements
• spinal injection skills
• cardio-pulmonary exercise testing
• physical fitness and arthropometric assessment
• physical activity programmes and exercise referral
• ture

Want to learn more?

Find out more about:

• the working life [5]of someone in sports and exercise medicine
• the entry requirements [6]and training and development [7]

• Pay and Conditions

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  This section provides useful information about the pay for junior doctors (doctors in training), SAS doctors (specialty doctors and associate specialists) and consultants.

  Find out more about the current pay scales for doctors [8], and there's more information on the BMA website [9].

  NHS Employers [10] provides useful advice and guidance on all NHS pay, contracts terms and conditions.

  Medical staff working in private sector hospitals, the armed services or abroad will be paid on different scales.

• Where the role can lead

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  Read about consultant and non-consultant roles in sports and exercise medicine, flexible working and about wider opportunities.

  Consultant roles

  You can apply for consultant roles six months prior to achieving your Certificate of Completion of Training [11] (CCT [12]). You will receive your CCT [12] at the end of your sports and exercise medicine training.

  Managerial opportunities for consultants include:

  • clinical lead - lead NHS consultant for the team
  • clinical director - lead NHS consultant for the department
  • medical director - lead NHS consultant for the Trust

  Most NHS consultants will be involved with clinical and educational supervision of junior doctors.

  Here are some examples of education and training opportunities:

  • director of medical education - the NHS consultant appointed to the hospital board who is responsible for the postgraduate medical training in a hospital. They work with the postgraduate dean to make sure training meets GMC standards
  • training programme director - the NHS consultant overseeing the education of the local cohort of trainee doctors eg foundation training [13] programme director. This role will be working within the HEE local office/deanery
  • associate dean - the NHS consultant responsible for management of the entirety of a training programme. This role will be also be working within the HEE local office/deanery

  SAS doctor roles

  SAS doctors (Staff, Associate Specialists and Specialty Doctors) work as career grade specialty doctors who are not in training or in consultant posts. You will need at least four postgraduate years training (two of those being in a relevant specialty) before you can apply for SAS roles.

  Find out more about being an SAS doctor [14].

  Other non-training grade roles

  These roles include:

  • trust grade
  • clinical fellows

  Academic pathways

  If you have trained on an academic sports and exercise medicine pathway or are interested in research there are opportunities in academic medicine.

  For those with a particular interest in research, you may wish to consider an academic career in sports and exercise medicine. Whilst not essential, some doctors start their career with an Academic Foundation post. This enables them to develop skills in research and teaching alongside the basic competences in the foundation curriculum.

  Entry into an academic career would usually start with an Academic Clinical Fellowship (ACF) and may progress to a Clinical Lectureship (CL). Alternatively some trainees that begin with an ACF post then continue as an ST trainee on the clinical programme post-ST4.

  Applications for entry into Academic Clinical Fellow posts are coordinated by the National Institute for Health Research Trainees Coordinating Centre (NIHRTCC). [15]

  There are also numerous opportunities for trainees to undertake research outside of the ACF/CL route, as part of planned time out of their training programme. Find out more about academic medicine. [16]

  The Clinical Research Network [17](CRN) actively encourages all doctors to take part in clinical research.

  Other opportunities

  There are opportunities to be employed by the NHS, academic institutions, private sector, universities, the armed forces, sporting teams, organisations and national governing bodies. A portfolio career – working for several employers – is possible.

• Job market and vacancies

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  This section provides useful information about the availability of jobs, finding vacancies and where to find out more.

  Job market information

  Sport and exercise medicine is one of the smallest specialties in the UK with a range of opportunities for securing employment. Opportunities are currently limited within the NHS therefore it is common for SEM doctors to work in a variety of settings.

  NHS Digital regularly publish workforce statistics which show the number of full time equivalent consultants and doctors in training for each specialty: NHS Digital workforce statistics [18]. 

  Competition ratios for medical specialty training places are published on Health Education England's specialty training webpage [19].  

  For information regarding Scotland, Wales and Northern Ireland please click on the links below.

  NHS Scotland medical and dental workforce data [20]
  NHS Wales medical and dental workforce data [21]
  Department of Health, Social Services and Public Safety workforce information for Northern Ireland [22]

  Where to look for vacancies

  All candidates apply through the online application system Oriel [23].

  HEE local offices/deaneries will have details of training vacancies. Not all HEE local offices/deaneries will offer new training posts in all specialties in all years.

  All jobs will be advertised on the NHS Jobs website [24].

  Northern Ireland has its own recruitment process. For further details please visit the Northern Ireland Medical and Dental Training Agency [25] website.

  Job vacancies are also advertised on the Faculty of Sport and Exercise Medicine [26] website.

• Further information

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  Organisations

  Faculty of Sport and Exercise Medicine (UK) [26]

  The Royal College of Surgeons of Edinburgh [27]

  Royal College of Physicians [28]

  Royal College of Physicians of Edinburgh [29]

  Royal College of Physicians and Surgeons of Glasgow [30]

  British Association of Sport and Exercise Medicine- The specialty association [31]

  General Medical Council – SEM section [32]

  Joint Royal Colleges Physicians Training Board [33]