The EMRA Sports Medicine Division is excited about its mission to increase awareness, resources, and opportunity for those emergency medicine (EM) residents and medical students interested in pursuing a career in sports medicine (SM). Initiatives are aimed at providing EMRA members with access to sports medicine-specific resources, including fellowships, mentorship support, elective opportunities, career guidance, and clinical content as it pertains to the treatment and prevention of injury and disease in the active individual.
The field of primary care sports medicine (PCSM) is quickly gaining popularity because the vast majority of all sports-related injuries are non-operative. SM specialists are board-certified in EM, family medicine, internal medicine, pediatrics, or physical medicine and rehabilitation. Since 1992, PCSM has been a recognized subspecialty by the American Board of Emergency Medicine (ABEM). Developing a unique niche by blending career interests within EM and sports medicine is a rewarding strategy to deter burnout and promote career longevity.
There are more than 140 ACGME-accredited PCSM fellowships. Of these, 124 programs accept EM-trained candidates, with that number growing each year. Most SM fellowships are based in family medicine, but 7 are EM-run programs.
Today, there are approximately 160-200 EM-SM certified physicians practicing in the United States. Therefore, it can be challenging for students and residents interested in SM fellowship training to gather the knowledge and resources necessary to become well-prepared and competitive as EM- trained applicants. The Sports Medicine Division wants to bridge that gap by providing a general guide for the emergency physician seeking an SM fellowship.
Pre-game: Medical School
Focus on your coursework and clinical experiences. This is the time to build a strong foundation in the fundamental principles of medicine that will carry you throughout your career.
Get involved. You should already be a member of your school's EM Interest Group. Also join the SM Interest Group. If your institution doesn't have one, consider starting your own! There are Medical School Interest Group leadership positions within the American Medical Society for Sports Medicine (AMSSM) and American Osteopathic Academy of Sports Medicine (AOASM). Don't forget to become a member of the EMRA Sports Medicine Division. It is never too early to start networking and seeking leadership roles.
Make contacts. Reach out to local sports medicine physicians to find out how they incorporate their advanced training into daily practice. Get firsthand exposure by shadowing these practitioners, volunteer to provide pre-participation physicals for local middle and high school athletes, and familiarize yourself with the sports medicine team as whole - athletic trainers, physical therapists, exercise physiologists, psychologists, and nutritionists. Through these endeavors you will begin to form relationships within the SM community while determining whether a future in sports medicine is right for you.
Choose a residency program. It's important to choose programs that are a great fit for you and your careers goals in emergency medicine. Consider a residency with a PCSM affiliation that can provide you direct access to game and event coverage, research opportunities, and faculty trained in SM. Residencies that do not have their own SM fellowship may provide a specialized fellowship track that incorporates exposure to PCSM beyond the EM core residency education.
1st Period: Intern Year
Start your CV and keep it updated. Staying on top of your CV will save you time and headaches later. How many times have we heard, “If you didn't document it, it didn't happen”? In this case, if you don't document it, you will likely forget it. EMRA's CV prep makes it easy to keep your CV current.
Get connected. Join as a resident member of the EMRA Sports Medicine Division. We are in our infancy, so there is an abundance of opportunities and projects in which to get involved. If you are interested in a leadership position, submit an application for Vice Chair. Joining a national organization like the AMSSM, AOASM, or American College of Sports Medicine (ACSM) will get you connected to additional online resources, publications, and networking opportunities within the world of sports medicine.
Cultivate mentorship. ACEP supports a mentorship program through its Sports Medicine Section that links experienced EM-SM physicians to those desiring further guidance in the field of sports medicine. Visit emra.org/committees-divisions/Sports-Medicine-Division or acep.org/sportsmedfellowship to get started.
Consider a fellowship preparation track. If your program does not have a formal sports medicine track, use the sample curriculum provided by the AMSSM as a general guide of activities to pursue during residency to increase your strengths as a clinician and fellowship candidate (Table 1).
Don't get overwhelmed. Residency is a huge adjustment, so start small. Use this outline to set short-term goals and update them as needed. Never forget your primary goal: to become an excellent emergency physician. Peter Rosen, MD, gave a great piece of advice during intern year: “Revisit your ideals often.” Think about the ideals that led you to pursue a career in medicine, and hold them close when times get tough.
TABLE 1. Sample Fellowship Preparation Track Curriculum
- 4-week elective in sports medicine
- 1 year of longitudinal team physician experience with local high school team
- Provide medical coverage at 1 mass participation event
- Present at 2 or more sports medicine conferences
- Present at least 1 journal club article related to sports medicine
- Complete a scholarly project in sports medicine
- Attend at least 1 sports medicine conference
Source: American Medical Society for Sports Medicine
2nd Period: PGY-II
*Note: If you are completing a four-year program, spread the PGY-II activities over PGY-II and PGY-III years.
Take on more responsibility. Consider starting a longitudinal coverage experience for a local high school team in the fall of your PGY-II or PGY-III years. Volunteer at a mass participation event. Pump up your CV and clinical knowledge by completing a case presentation and/or journal club critical appraisal on a musculoskeletal or sports medicine related topic.
Attend a national or regional meeting. It is a valuable way to expand your clinical knowledge, network, collaborate with like-minded colleagues, and enjoy an environment dedicated to topics you are passionate about. If you present at a conference, your residency program may offer funds to offset travel and attendance costs. Additionally, the AMSSM offers resident scholarship assistance to attend their annual meeting.
Research fellowship programs. Not all programs accept EM trainees, so check out the most up-to-date list of EM-friendly PCSM fellowships on the EMRA SM Division Web page. Attend the EMRA Job & Fellowship Fair during ACEP Scientific Assembly and a similar fair at the AMSSM annual meeting, where you can meet programs face-to-face.
Complete an elective. Electives are typically 2-4 weeks in length and are suggested in the second half of the year. Some opportunities have an application deadline up to 6 months before the rotation begins, so start looking early. Similar to 4th-year audition rotations, be prepared and put on your game face.
Start the application process. In the spring you should update that CV, start working on your personal statement, and begin collecting letters of recommendation (LOR). You will need 3-4 LOR, including your program director and at least one SM certified physician.
3rd Period: PGY-III
Submit your application. SM participates in the July ERAS subspecialty cycle. Programs may start accessing applications around July 15 of each year.
Audition elective. Set up a fall rotation at a fellowship program you are strongly interested in, giving yourself the opportunity to interview at the same time.
Jet set. Interview season typically occurs between October and December.
Meet your future colleagues. If you have the opportunity to attend ACEP Scientific Assembly as a senior resident, stop by the Sports Medicine Section meeting to see all of the major EM-SM players in one room. We would also love for you to attend an EMRA Sports Medicine Division meeting at ACEP or SAEM to share your fellowship application experience!
Be a musculoskeletal rock star. There are more than 4 million ED visits each year for musculoskeletal-related complaints, providing plenty of opportunities on shift to hone your skills. Perfect your musculoskeletal exam. Expand your musculoskeletal ultrasound techniques. Review various sport medicine texts and publications. Your patients will benefit, and you will be extremely well-prepared to start fellowship.
Stay tuned for more to come from the new EMRA Sports Medicine Division. If you believe a career in sports might interest you, please join us! There are plenty of projects in the pipeline, ways to get involved, and leadership opportunities available. We hope to meet you at our next division meeting at SAEM 2016 in New Orleans!