Opening the Chamber of secrets: our response to “The end of the beginning”

Short abstract

The importance of exercise medicine and its impact on public health has been recognised by sports medicine physicians in Britain

This is a formal response to the editorial, “The end of the beginning”, published by the editor of this journal in January of this year.¹

The year 2006 heralds a new dawn for those in Britain working in sport and exercise medicine (SEM). We now have a combined single professional organisation, we are looking forward to six years of planning the 2012 London Olympics, and, perhaps most importantly, we have now been recognised as the newest medical specialty by the Department of Health. The excitement of these developments was palpable at BASEM's 2005 congress in Edinburgh. Imagine therefore our surprise that the first BJSM editorial of 2006 talks in such negative tones about the state of philosophical readiness of those of us engaged in and campaigning for our specialty.

We agree that the SEM physicians of the future may be different. Indeed it would be surprising if they were not, given the newly developed curriculum and a training scheme designed to be complementary to the ideals of modernising medical careers and the needs of the health service of today. However, to state that there exists a philosophical gulf between those leading SEM and the Department of Health is disingenuous.

To suggest that British sports medicine has not embraced the importance of exercise medicine does BASEM, its members, and the wider community of SEM a huge disservice. As long ago as 1997, the British Association of Sports Medicine recognised the importance of the exercise component of our practice and changed its name to the British Association of Sport and Exercise Medicine. When, in 2003, sports physicians and others had preliminary discussions with Richard Caborn about applying for specialty recognition, the importance of exercise medicine and its impact on public health was emphasised by clinicians as well as politicians. The subsequent creation of the SEM curriculum specifically addresses exercise as a primary and secondary therapeutic strategy. A succession of BASEM congresses have sought to highlight the importance of exercise medicine within its scientific programme. Later this year at our Oxford congress, we have keynote sessions examining exercise prescription and preparticipation screening. Our longest running SEM course, the general course, emphasises the health advantages of exercise and introduces the concept of exercise prescription.

None of us is any doubt about the important role that our specialty has in terms of mobilising an increasingly sedentary population. We fully appreciate the devastating impact that childhood obesity and physical inactivity will have on our children's future health. We embrace the “activity over sport” argument, but equally recognise the potential benefit for sports participation that international sporting success can have. We have cited the successful Finnish experience at numerous meetings with local healthcare managers, as we have created innovative medical posts to facilitate the exercise and activity message ahead of specialty recognition.

“We are focused on physical activity as medicine and thus will continue to prioritise exercise medicine within our academic and education programmes”

So “what does SEM need to do?” asks the penultimate paragraph of “The end of the beginning”. The answers that followed are all correct, and would have been appropriate to the same question posed 15–20 years ago. Not now and not in this sport and exercise community. We are focused on physical activity as medicine and thus will continue to prioritise exercise medicine within our academic and education programmes. The developing higher specialist training programmes will put into action the curriculum that we successfully developed around the exercise theme and we will continue to maintain the high priority that exercise and activity has attracted following the announcement that London will host the 2012 Olympic Games. In short, we will continue all the good work that has been going on behind the scenes for so many years. We truly appreciate and understand our new specialty of SEM.

Yes, in literary terms, we have indeed moved from the Philosopher's stone to the Chamber of secrets, but philosophically we have been in a state of suspended readiness waiting for permission to open the front cover to our future.