Hey guys, as of right now I know that I am really wanting to go into sports medicine for a career but after reviewing all the different types of sports medicine physicians I am kind of confused on which one I should go for. I know there are orthopedic sports medicine surgeons, primary care sports medicine physicians, and emergency sports medicine physicians. I am finding it hard to find out what exactly is the difference between all of them (mainly just primary care and emergency), and some pros and cons about each of them. Would love for some input from you all.
Well obviously the major difference is that those people completing sports med fellowships after family practice, internal medicine, pediatrics or EM residencies are NOT going to be cutting on you. Medical management of injuries is important obviously because not everything is a surgical issue.
As far as pros and cons for these medical specialties, a lot of it depends on the type of residency you do and what sort of practice you get into. Obviously the goal for a lot of people in sports medicine is to work for some sort of team, be it professional or collegiate, but obviously that's a difficult position to achieve. But there are lots of other options. Some may team up with orthopedists to create a more comprehensive sports medicine practice, it may include PT's and OT's assist with rehab. There may also be psychologists around to do the neurocognitive testing that is now part of concussion monitoring. Others may continue in their primary care setting, just utilizing the sports medicine training as needed (sprains and strains happen frequently enough). Particularly for pediatricians that go on to a sports medicine fellowship, there may be opportunities with local school districts to oversee their medical staffing at competitions, provide training to coaches about things like concussions or heat stroke, or be involved at a more individual team or player/physician level. (This is also an option for the family med providers - often in more rural settings, this is something that kind of just "happens" by nature of being one of the few docs in the area, but having the additional expertise can be helpful). Some pediatricians who have done sports medicine may parlay it into an opportunity to limit their practice to mainly adolescents, using the sports medicine fellowship (1-2 years) in favor of the adolescent medicine fellowship (3 years).
For the ER physicians, the options are diverse here as well. Perhaps more than the others (though not always the case), the sports medicine aspect probably ends up being more of an "extra". In other words, these guys are less likely to end up doing sports medicine full time. You might have some ER docs who do their three ER shifts a week, then work in a clinic or with a team on other days of the week. Alternatively they may simply use their knowledge of joint anatomy, casting, splinting, etc as just part of their knowledge base for patients they see in the ER. The other options I mentioned above are also open, although probably not the Adolescent medicine option.
Cons: from what my friends who are considering sports fellowships (they're peds residents) have discussed, it seems to me that sports medicine is one of those fields where the desirability at the top of the field (working with a major sports team) is through the roof, but if you're not doing that, what's left is not nearly as enticing. So while there are lots of options, they're often things that are still open to you without doing the fellowship. If you want to work with a local high school or school district, you probably can. If you want to just have that "extra" knowledge, you can learn much of it on your own (either on electives in residency or through self-study). And from a peds perspective, working for a professional team is kind of out of the question (you kind of go into a peds residency because you DON'T want to take care of adults). The other con is that if you work in one of those combined practices - one with the orthos - there may be the possibility of ending up having to shovel the ortho's scut.
If you're a pre-med, then don't worry about it. Wait until you've got to decide on a residency. Once you know your USMLE score, if you like being in the OR or the ER or if a clinic setting is more your style, then you can make a better decision.
