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Medical education in a medical school, residency, and fellowship provides a physician with the scaffolding to provide appropriate care for athletes. Continuing medical education and years of experience are essential for a team physician to establish credibility in treating active individuals.

Becoming a Physician

A physician is an individual who holds an unrestricted medical license and the degree of Medical Doctor (MD) or Doctor of Osteopathic Medicine (DO). To become a physician, one typically completes an undergraduate degree before attending 4 years of medical school. Classroom didactics constitute the first 2 years of medical education, and the final 2 years include both required and elective medical rotations. On medical school graduation, a person is considered a physician but cannot practice unrestricted medicine. The physician must pursue a residency in a medical specialty. The first year of residency training is called the internship year. Residency training lasts from 3 to 6 years depending on the specialty. After successful residency graduation, the physician may become “board eligible,” and after completion of a certification examination and specialty requirements he or she may become “board certified.” Board certification signifies to the lay public that the physician is a recognized specialist in that field.

One may pursue an additional 1- to 2-year specialty education titled fellowship training. This training further refines the physician as an expert in a more specialized field of medical expertise.

The Team Physician

A team physician is primarily responsible for the health and welfare of the individual athletes or athletic teams. The team physician coordinates care with the remainder of the health care team, including athletic trainers, physical therapists, sport psychologists, nutritionists, and other allied health professionals. The responsibilities of a team physician include coordinating preparticipation screening, evaluating injuries and illness, managing injuries on the field of play, developing rehabilitation protocols, establishing return-to-play guidelines, and referring to appropriate specialists outside the team physicians’ scope of practice.

Team physicians usually come from two main areas of medical expertise: primary care and orthopedic surgery.

Primary Care Sports Medicine Team Physicians

The American Medical Society for Sports Medicine (AMSSM), founded in 1991, and the American Osteopathic Academy of Sports Medicine (AOASM), founded in 1984, are primary carebased multidisciplinary organizations with the mission to care for the medical and nonsurgical musculoskeletal needs of active individuals.

Many primary care team physicians have completed fellowship training to learn the art and science of sports medicine. Prior to 1999, primary care team physicians who had completed a residency program could sit for the Certificate of Added Qualifications in Sports Medicine exam. Today, a physician must be board certified in family medicine, internal medicine, pediatrics, emergency medicine, or physical medicine and rehabilitation and should have completed a 12- to 24-month accredited primary care sports medicine fellowship to take the certification examination. On successful passing of the examination, one is considered a “sports medicine specialist.” Recertification is required both in the primary medical specialty and for the Certificate of Added Qualifications in Sports Medicine on a 7- to 10-year basis. There are two organizations that certify the physicians. They are the American Board of Medical Specialties (ABMS) and the American Osteopathic Association (AOA) Bureau of Osteopathic Specialists. A claim of “board certification” or “certificate of added qualifications” must be accredited by one of these two organizations.

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