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• Dr Lim Zhuang Li
  Zhuang Li Lim
  Published on: 13 September 2023
• Reply to editor and authors
  Volker Scheer, Heinz Lohrer, Nikos Malliaropoulos and Beat Knechtle
  Published on: 7 May 2023

• Published on: 13 September 2023

  Dr Lim Zhuang Li

  • Zhuang Li Lim, Sports and Exercise Physician Hospital Tengku Ampuan Afzan, Kuantan, MALAYSIA

  Many thanks for producing the thoroughly enjoyable article on SEM practitioners around the world. We would like to add that SEM in Malaysia has also been well established as a standalone speciality since 2002. The impetus for for kickstarting the speciality was having being appointed the host city for Commonwealth Games 1998 (Kuala Lumpur). Our training programme, was in effect a combined 4 year run-through standalone clinical training, in its inception together with Rehabilitation Medicine originally, of which very early then branched out into an independent Sports Medicine Masters training program in the early 2000s, with on average 4 to 6 trainees a year qualifying out of the program. At the moment, we have approximately nearly 60 practitioners throughout the broader Malaysia with a large number of my contemporaries working within the Ministry of Health Malaysia. Our core service focuses on optimising musculoskeletal health across all spectrum of age and health, performing diagnostic imaging and guided-pain interventional, therapeutic and regenerative procedures, sideline and team physician management, prescriptive exercise clinics and fitness/performance testing, and various collaborative work with public health in being an advocate for healthy living. The training program is indeed quite similar as to how the Australasian and British FSEM curriculum content-wise, and has been traditionally done at the University of Malaya throughout the whole clinical course. Many of...

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  Many thanks for producing the thoroughly enjoyable article on SEM practitioners around the world. We would like to add that SEM in Malaysia has also been well established as a standalone speciality since 2002. The impetus for for kickstarting the speciality was having being appointed the host city for Commonwealth Games 1998 (Kuala Lumpur). Our training programme, was in effect a combined 4 year run-through standalone clinical training, in its inception together with Rehabilitation Medicine originally, of which very early then branched out into an independent Sports Medicine Masters training program in the early 2000s, with on average 4 to 6 trainees a year qualifying out of the program. At the moment, we have approximately nearly 60 practitioners throughout the broader Malaysia with a large number of my contemporaries working within the Ministry of Health Malaysia. Our core service focuses on optimising musculoskeletal health across all spectrum of age and health, performing diagnostic imaging and guided-pain interventional, therapeutic and regenerative procedures, sideline and team physician management, prescriptive exercise clinics and fitness/performance testing, and various collaborative work with public health in being an advocate for healthy living. The training program is indeed quite similar as to how the Australasian and British FSEM curriculum content-wise, and has been traditionally done at the University of Malaya throughout the whole clinical course. Many of us are also attached with the broader sporting teams across the country. We are presently actively engaging medical students during their undergraduate program to build the awareness of the speciality and services going forward. Collectively, SEM Malaysia are presently represented by the Malaysian Association of Sports Medicine (MASM) and we are currently working to create a collegiate under the Academy of Medicine Malaysia (AMM) to get better advocacy and visibility nationally and internationally.

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  Conflict of Interest:
  None declared.

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• Published on: 7 May 2023

  Reply to editor and authors

  • Volker Scheer, Sports and Exercise Medicine Consultant Ultra Sports Science Foundation, Pierre-Benite, France; Univerity UDIMA, Madrid, Spain; RRU RAF Honington, UK
  • Other Contributors:
    • Heinz Lohrer, Orthopedic Suregon, Sports Orthopaedics
    • Nikos Malliaropoulos, Sports and Exercise Medicine Consultant
    • Beat Knechtle, General Practitioner

  Dear editor/ dear authors,

  We read with interest your editorial ‘Sport and exercise medicine around the world: global challenges for a unique healthcare discipline’ [1] in BMJ Open Sport and Exercise Medicine. We would like to congratulate the authors for bringing the challenges of our speciality back into the spotlight again.

  While Sports and Exercise Medicine (SEM) may be a modern and more inclusive terminology than sports medicine, many of the challenges of our speciality have remained the same over the years. Societies such as the European College of Sports and Exercise Physicians (ECOSEP) have championed for years for the advancement of sports medicine/ SEM speciality across Europe by providing education, publishing research, organising congresses, collaborating with other organisations and serving as a source of information to the public [2–4]. ECOSEP has been promoting exercise for prevention and treatment to policy holders, creating post-graduate programmes and seminars to provide further training for physicians and bringing practitioners together, not only with biannual congress but also through promoting professional dialogue and standards [2–4]. Other societies, like the European Federation of Sports Medicine Associations (EFSMA) have been champing for a common sports medicine speciality within Europe for over 20 years, providing a detailed curriculum for sports medicine practitioners [5]. Even back then they recognised that sports medicine is a m...

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  Dear editor/ dear authors,

  We read with interest your editorial ‘Sport and exercise medicine around the world: global challenges for a unique healthcare discipline’ [1] in BMJ Open Sport and Exercise Medicine. We would like to congratulate the authors for bringing the challenges of our speciality back into the spotlight again.

  While Sports and Exercise Medicine (SEM) may be a modern and more inclusive terminology than sports medicine, many of the challenges of our speciality have remained the same over the years. Societies such as the European College of Sports and Exercise Physicians (ECOSEP) have championed for years for the advancement of sports medicine/ SEM speciality across Europe by providing education, publishing research, organising congresses, collaborating with other organisations and serving as a source of information to the public [2–4]. ECOSEP has been promoting exercise for prevention and treatment to policy holders, creating post-graduate programmes and seminars to provide further training for physicians and bringing practitioners together, not only with biannual congress but also through promoting professional dialogue and standards [2–4]. Other societies, like the European Federation of Sports Medicine Associations (EFSMA) have been champing for a common sports medicine speciality within Europe for over 20 years, providing a detailed curriculum for sports medicine practitioners [5]. Even back then they recognised that sports medicine is a multidisciplinary speciality dealing with health promotion for the general population by stimulating a physically active lifestyle as well as providing diagnoses, retreatment, prevention programmes and rehabilitation following injuries or illnesses sustained by participation in physical activities, exercises and sport at all levels [5]. So, while the terminology SEM may be new, the goals and challenges to the speciality have remained the same.

  Another challenge is the common recognition of the speciality across countries; however, this has not even been achieved within Europe, even after years of negotiations with governments and stakeholder. In an open market such as the European Union it makes it challenging for health care professionals, working and traveling with sports teams across Europe as well as being disadvantaged in seeking job opportunitiesin the common market.

  We believe adequate employment opportunities for SEM/ sports physicians are another important challenge to be addressed. Historically sports doctors did not receive payment for attending match days or overseeing competitions/ training camps and although this has changed in some countries, this type of work remains voluntary or poorly paid in other countries. Many big international sporting events such as Olympic Games, Athletic European or World Championship and others rely on SEMs as volunteers and while this may be interesting for some SEM to gain experience or for other reasons, we believe it is a practice that should also be addressed. Many SEMs have a portfolio career, e.g., combining working with a sports team, health prevention programmes, private practice, university etc., however employers/ institutions often do not recognise this working type of pattern and are reluctant or unwilling to adapt to modern ways of working.

  We agree with your statements that ‘SEM should be more visible in the health-based undergraduate curricula’ [1], and we believe it should be taught by appropriately qualified staff with the necessary qualifications. In some countries, however it is still possible to hold a university chair/ professorship in SEM/ sports medicine without even having obtained the necessary country specific sports medicine qualification or specialised training. What message does this send for the promotion of our speciality?

  While we understand that an editorial cannot address all the challenges of our speciality, we hope that some of our challenges maybe also be addressed in future consultations, and we wish the current ‘generation’ of SEMs more success in tackling those challenges compared to previous generations of sports physicians.

  References

  1 Carrard J, Morais Azevedo A, Gojanovic B, et al. Sport and exercise medicine around the world: global challenges for a unique healthcare discipline. BMJ Open Sport Exerc Med 2023;9:e001603. doi:10.1136/bmjsem-2023-001603
  2 ECOSEP. 2023.https://ecosep.eu (accessed 4 May 2023).
  3 Heron N, Malliaropoulos NG. International differences in sport medicine access and clinical management. Muscles Ligaments Tendons J 2012;2:248–52.
  4 West L, Malliaropoulos N, De Jonge S. ECOSEP: bringing the European SEM family together. Br J Sports Med 2014;48:1585–1585. doi:10.1136/bjsports-2014-094167
  5 Ergen E, Pigozzi F, Bachl N, et al. Sport medicine specialty training core curriculum for European countries. J Sports Med Phys Fitness 2008;48:419–33.
   

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  Conflict of Interest:
  The contents reported here do not represent the views of the RRU/ RAF Honington or of UDIMA Madrid in general but of the individual author (VS).

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