Influencing the Future of Sport and Exercise Medicine Education in the NHS

Introduction
This PhD by published works aims to influence and develop the future direction of medical education in the medical speciality of Sport and Exercise Medicine (SEM). SEM involves musculoskeletal medicine, exercise medicine and team care. This commentary aims to provide an introduction, link the various published outputs and place the work in context. The overall portfolio contains 20 items of which there are 17 published peer-reviewed papers, one book and two book chapters. Six original research papers and one textbook form the central outputs of the portfolio.

Methods
A mixed methods approach has been used across the central published peer-reviewed papers. The key papers are formed from two key methodologies, that of semi structured interviews and the Delphi consensus method. Qualitative research performed by semi structured interviews and analysed via thematic analysis forms three of the published outputs. Two published Delphi studies develop the findings of the previous qualitative research to form an undergraduate and postgraduate syllabus for SEM and gain consensus.

Findings
Stakeholders of SEM, highlight a lack of awareness of the speciality of SEM in the NHS. SEM clinicians and stakeholders highlighted that SEM in the NHS should focus on musculoskeletal medicine and concussion. Interviews with NHS doctors suggested a need to increase exercise medicine related education in both undergraduate and postgraduate education. An SEM undergraduate and postgraduate syllabus was developed and consensus gained via a modified Delphi method using an expert panel of 45 clinicians. The final undergraduate syllabus had 58 learning objectives grouped into 9 subthemes while the postgraduate MSc SEM syllabus had 133 learning objectives divided into 11 subthemes. Finally, the textbook Sport and Exercise Medicine: An Essential Guide was published by Routledge which mapped to the majority of the postgraduate learning objectives developed.