Introduction
Sports and exercise medicine (SEM) encompasses two different but related topics, namely sports medicine and exercise medicine.1 ‘Sports medicine is involved with prevention, diagnosis and management of musculoskeletal disorders and medical issues related to physical activity (PA), while exercise medicine aims to use PA to prevent and treat chronic diseases’.1 2 SEM is now a recognised medical specialty in 26 countries worldwide.3 4 Nevertheless, SEM is still scarcely taught at the undergraduate level even in the above-mentioned countries.5 6
Musculoskeletal conditions are highly prevalent within the general population and greatly limit daily activities and productivity within developed and developing countries.7–9 Sports injuries are frequent, with an annual prevalence around 20% in a representative sample of the general Danish population.10 Furthermore, with rising rates of non-communicable disease (NCDs) the search for cost-effective measures of prevention and treatment has become a priority worldwide.4 11 12 PA is one of the means to combat NCDs.13–15 Physical inactivity has been recognised as the fourth leading cause of death worldwide, and is described as a pandemic by the WHO.13 16 In 2018, the WHO published the ‘global action plan on PA 2018–2030 which aims towards a ‘15% reduction in the prevalence of physical inactivity by 2030’.17 To reach this aim, one of the principle points in these guidelines is to educate health professionals about PA promotion and prescription.17
Since 2000, several studies have highlighted that medical doctors, particularly general physicians, are not knowledgeable enough about PA benefits and prescription and thus neither confident to prescribe it nor to refer patients to an SEM specialist.18–21 Similarly, a British study showed that ‘medical students underestimate the risk of physical inactivity, do not know the PA guidelines and feel unconfident about giving PA advice’.22 This systemic lack of knowledge and teaching at medical school markedly contrasts with the evidence that PA plays a major role in preventing and treating almost all the NCDs.13–15 Yet, some data suggest that medical students are keen to learn more about SEM.23 Moreover, examples of successful sports and/or exercise medicine implementation in the undergraduate curriculum have been shown in Nottingham (UK), South Carolina (USA) and in Tehran (Iran).24–26
The ‘Principal Relevant Objectives and Framework for Integrative Learning and Education in Switzerland’ (PROFILES), written by Swiss experts under a mandate of the Joint Commission of the Swiss Medical schools, sets out the skills and knowledge Swiss medical students have to acquire during the 6 years of study.27 ‘PROFILES displays three different chapters: a first chapter listing general objectives related to the different roles of doctors, a second chapter presenting entrustable professional activities reflecting the main medical tasks that a physician must be able to perform autonomously on the first day of his residency and a third chapter listing 265 common clinical situations that a doctor is expected to deal with after passing the Swiss Federal Licensing Examination’.27 Each university then has the autonomy to organise its own undergraduate curriculum to fit with the objectives of PROFILES.
This study had four aims. First, to determine whether Swiss medical students are expected to acquire SEM-related skills and knowledge according to PROFILES. Second, to systematically review SEM teaching in the Swiss undergraduate medical curricula. Third, to determine if Swiss medical students are aware of SEM, and fourth whether they want it included in their curricula.