Why is sports medicine a fellowship and not just a residency?

[deleted959484]

Might be a dumb question but genuinely curious if anyone has an answer besides historical reasons..

As a future M1 with a interest in sports med I think it would be cool if it was an integrated four year program.

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[runfastnow]

You've hit the mark. A blend of IM/FM/PM&R in a 4 year program with integrated training room/sports coverage would be the ideal set up for being a well rounded sports medicine physician.

If all you want to do is sports medicine each of these specialties "waste" your time with ICU, OBGYN, inpatient rehab/SNF work, etc. however they are useful if you enjoy the base specialty or want a blended practice (i.e. I still enjoy taking care of amputees and spinal cord injury patients in addition to sports medicine).

I believe every physician still needs that PGY1 heavy inpatient/medicine year to really get comfortable with a wide range of medical diagnoses and understand concordant diagnoses and their impact on MSK issues ... but IMO an integrated program would be much more beneficial and time efficient than a two year fellowship that the ivory tower is currently pushing.

 

[galactus]

There's talks of potentially having a sports medicine residency happening. It maybe a few years from now though, but there are A LOT of push backs.
The bigger rumblings is changing the fellowship from 1 to 2 years.
In Australia and New Zealand, sports is its own primary specialty, and goes by the name of Sports and Exercise Medicine (SEM).

There are some programs out there that have a somewhat integrated residency in sports. JPS is a 4 year FM residency program, but you have a fourth year dedicated to sports and can do electives during residency. Some residencies have a sports medicine track (at least in FM) so it can help prepare you for fellowship.

That being said, I'm with the previous poster. I enjoy my primary specialty on top of sports.

 

[deleted959484]

There's talks of potentially having a sports medicine residency happening. It maybe a few years from now though, but there are A LOT of push backs.
The bigger rumblings is changing the fellowship from 1 to 2 years.
In Australia and New Zealand, sports is its own primary specialty, and goes by the name of Sports and Exercise Medicine (SEM).

There are some programs out there that have a somewhat integrated residency in sports. JPS is a 4 year FM residency program, but you have a fourth year dedicated to sports and can do electives during residency. Some residencies have a sports medicine track (at least in FM) so it can help prepare you for fellowship.

That being said, I'm with the previous poster. I enjoy my primary specialty on top of sports.

Very interesting... what are some of the main reasons for the push back??

 

[Waterlover]

Do we know for sure about if it is a 1 or 2 year fellowship for 2022-2023 yet or not? Application is supposed to open in June, wanted to know what's finalized by now?

 

[runfastnow]

If this ever came into fruition, that would be awesome.

Interestingly enough, have seen a post PM&R + sports/spine trained go from almost a purely outpatient sports medicine MSK group practice to inpatient rehab (unsure why though). Was making well over 300K+ at the MSK clinic working 40 hour weeks. I guess being a procedural/needle jockey wasn't stimulating enough for the attending I know. Or the attending left for better money at inpatient work (as I recall, very $$$ minded individual). So having other training in either IM/FM/PM&R gives them a chance to leave to other aspects of their scope of training.

For some I know, sports medicine can get boring quickly if not surgical. Knew someone who considered PM&R for sports but found their sports medicine elective in medical school so boring and they ended up applying to a surgical specialty unrelated to MSK (not ortho). Some, it's amazing -- for example, know an EM/Sports medicine trained doc who loves working in outpatient MSK for a much lower pay/hour than working in an ED (chill hours and a colleague who knew the EM/sports med doc well said EM residency burned them out pretty badly).

Ultimately it is all about what you want to do and get satisfaction. Outpatient MSK can get monotonous if you can't find the "little wins" throughout your day of helping people get back to higher levels of function/athletics.

For the OP - I would not anticipate a sports medicine residency in your training lifetime. Also, I would have a very hard time recommending a 2 year sports medicine fellowship to a PM&R resident unless that person wanted to be in academics with clearly defined research and/or academic leadership goals OR if their PM&R residency was an extremely inpatient heavy program with less than 6 months of outpatient MSK/spine/EMG. If it ever does go to 2 year fellowship think heavily about IM/FM/EM.

 

[galactus]

Do we know for sure about if it is a 1 or 2 year fellowship for 2022-2023 yet or not? Application is supposed to open in June, wanted to know what's finalized by now?

It will be 1 year fellowship. There are 2 year fellowships out there though.
Trust me everyone will know if the powers that be decide that this will be a 2 year fellowship for all.

 

[Waterlover]

It will be 1 year fellowship. There are 2 year fellowships out there though.
Trust me everyone will know if the powers that be decide that this will be a 2 year fellowship for all.

Yessss, wonderful haha thank you