A new academic year is underway and if you are thinking of going to school to pursue a career in the sports medicine field, medicine, physiotherapy and athletic therapy can all take you the distance to the sports medicine clinic. Leading the sports medicine health care team are physicians who hold diplomas from the Canadian Academy of Sports Medicine (CASM).

Sports medicine is a growing clinical specialty, which has branched out considerably from its original work with elite athletes. In recent years, as new athlete populations have emerged, sports medicine doctors have become sub-specialized in areas such as athletes with disabilities, exercise and pregnancy, elite child athletes and in sports such as skating, running and dance, explains Dr.Julia Alleyne, president of CASM.

Sports medicine physicians work in solo practices and multi-disciplinary team clinics with physiotherapists, athletic therapists, sports psychologists, kinesiologists and other professionals. In order to obtain the CASM diploma, physicians complete a 1-2 year sport medicine fellowship after they have obtained certification in a medical specialty such as family practice, paediatrics, emergency medicine or orthopaedics, says Alleyne. The numbers of fellowship training programs have increased from three a decade ago, to eight, with more planned, so that most Canadian medical schools now offer them.

Physiotherapy, long a mainstay in sports medicine clinics, also offers specialization in the field. The entry – level qualification for physiotherapy is a bachelor's degree, offered at 13 universities across the country. Competition for admission is tough: only about one in five candidates recently applying to U.B.C.'s school of rehabilitation medicine was accepted says Lesley Bainbridge, director of the school. Applicants need a GPA of about 84% in their pre-requisite courses and must have completed 70 hours of hands-on volunteer time with disabled people, as well as an English test.

However, in 2010, the entry – level qualification will be upgraded to a two year professional master's degree, which the Canadian Physiotherapy Association feels will enhance the ability of physiotherapists to work with the greater range of patients they are now caring for, in more varied settings than before. "The healthcare context in which physiotherapists practice is more complex now and they need a good understanding of evidence-based practice,"says Bainbridge.

Physiotherapists can specialize as sports physiotherapists through a three level certification system offered by Sport Physiotherapy Canada (SPC), a division of the Canadian Physiotherapy Association. They must submit documented evidence of continuing professional development to SPC every three years.

Sports physiotherapists work in private practices, generally as part of inter-disciplinary teams, and are an integral part of medical teams at national and international sports events. Tyler Dumont graduated with his physiotherapy degree 10 years ago and completed his sport physiotherapy diploma four years ago. He works with a wide range of athletes, from children to masters' at the University of British Columbia’s Allan McGavin Sports Medicine Clinic, which he calls "an amazing inter-disciplinary setting." He also teaches part-time at UBC's school of rehabilitation medicine, and often volunteers to work with local club and provincial teams at weekend events. Sports physiotherapists need to be good team players themselves, adept at working with coaches and parents as well as their athlete patients, says Dumont.

Athletic therapists, like physiotherapists, work in sports medicine clinics and with sports teams from recreational to international levels as part of multi-disciplinary health care teams. Their entry-level qualification is a bachelor's degree and Ontario's Sheridan College's Bachelor of Applied Health Sciences in Athletic Therapy is the first applied degree of its kind in Canada. Gaining entry to a degree program is almost as competitive as for physiotherapy programs, says Deanna Schick, an assistant professor in human kinetics at Trinity Western University. Applicants to the Sheridan program need a GPA of at least 65% in their Ontario Secondary School Diploma and 100 hours of volunteer work with an athletic or sport physiotherapist. Graduates are certified by the Canadian Athletic Therapists Association (CATA), after completing examinations, and athletic therapists must participate in ongoing professional development every year to maintain their status.

Schick has both CATA and the U.S. National Athletic Trainer's Association (NATA) certifications. She decided to obtain the dual credentials because about half of her students are American and need information on NATA, and because it offers her the flexibility to work south of the border. When Schick obtained her NATA qualification earlier this year, the procedure was relatively simple, however, from December 31, 2003, applicants will have to attend an American institution to prepare for the examination, she says.

Schick says that athletic therapists have to be flexible, willing to keep up to date with the rapid changes in health care, and to commit to working long hours with sports teams, especially as a student. However, the effort can pay off, she says. B.C. has lots of room for athletic therapists to create their own niche, partly because there are fewer of them here than in many other provinces.

Schick has carved out her own niche: as well as teaching full-time at Trinity Western she is working on her Ph.D. at Simon Fraser University, studying injury rates in women's rugby and concussion in women's hockey.

Heather Kent is a Vancouver freelance medical writer. She is a regular contributor to North American health and medical publications.

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