Sports and Exercise Medicine CESR Portfolio Guide

Able to function successfully within NHS organisational and management systems

• Aware of, and adheres to, the GMC professional requirements
• Aware of public health issues including population health, social determinants of health and global health perspectives
• Demonstrates effective clinical leadership
• Demonstrates promotion of an open and transparent culture
• Keeps up to date through learning and teaching
• Demonstrates engagement in career planning
• Demonstrates capabilities in dealing with complexity and uncertainty
• Aware of the role and processes for commissioning
• Aware of the need to use resources wisely

Able to deal with ethical and legal issues related to clinical practice

• Aware of national legislation and legal responsibilities, including safeguarding vulnerable groups
• Behaves in accordance with ethical and legal requirements
• Demonstrates ability to offer apology or explanation when appropriate
• Demonstrate ability to lead the clinical team in ensuring that ethical and legal factors are considered openly and consistently

Communicates effectively and is able to share decision making, while maintaining appropriate situational awareness, professional behaviour and professional judgement

• Communicates clearly with patients and carers in a variety of settings
• Communicates effectively with clinical and other professional colleagues
• Identifies and manages barriers to communication (e.g. cognitive impairment, speech and hearing problems, capacity issues)
• Demonstrates effective consultation skills including effective verbal and non-verbal interpersonal skills
• Shares decision making by informing the patient, prioritising the patient’s goals and wishes, and respecting the patient’s beliefs, concerns and expectations
• Shares decision making with children and young people
• Applies management and team working skills appropriately, including influencing, negotiating, re-assessing priorities and effectively managing complex, dynamic situations

Is focussed on patient safety and delivers effective quality improvement in patient care

• Makes patient safety a priority in clinical practice
• Raises and escalates concerns where there is an issue with patient safety or quality of care
• Demonstrates commitment to learning from patient safety investigations and complaints
• Shares good practice appropriately
• Contributes to and delivers quality improvement
• Understands basic Human Factors principles and practice at individual, team, organisational and system levels
• Understands the importance of non-technical skills and crisis resource management
• Recognises and works within limit of personal competence
• Avoids organising unnecessary investigations or prescribing poorly evidenced treatments

Carries out research and manages data appropriately

• Manages clinical information / data appropriately
• Understands principles of research and academic writing
• Demonstrates ability to carry out critical appraisal of the literature
• Understands the role of evidence in clinical practice and demonstrates shared decision making with patients
• Understands public health epidemiology and global health patterns
• Demonstrates appropriate knowledge of research methods, including qualitative and quantitative approaches in scientific enquiry
• Demonstrates appropriate knowledge of research principles and concepts and the translation of research into practice
• Follows guidelines on ethical conduct in research and consent for research
• Recognises potential of applied informatics, genomics, stratified risk and personalised medicine and seeks advice for patient benefit when appropriate

Acts as a clinical teacher and clinical supervisor

• Delivers effective teaching and training to medical students, junior doctors and other healthcare professionals
• Delivers effective feedback with action plan
• Able to supervise less experienced trainees in their clinical assessment and management of patients
• Able to supervise less experienced trainees in carrying out appropriate practical procedures
• Able to act as a clinical supervisor to doctors in earlier stages of training

Leading and managing a multi-disciplinary team

• Understands the principles of, and uses, effective inter-professional collaboration to optimise patient and population care across all care settings
• Understands the features of good team dynamics
• Demonstrates flexible and adaptable leadership styles to optimise team cohesion and productivity
• Demonstrates ability to synthesise complex clinical and psychosocial information leading to patient centred clinical decision making in all settings including NHS, sport, military and community environments
• Demonstrates ability to support, educate, influence and develop members of the wider multi-professional team to quality sport and exercise medicine care across all care settings for all patients
• Shows an ability to coordinate care across multiple agencies to address physical, psychological and social needs in community, secondary care, recreational and sporting environments and across all healthcare settings
• Demonstrates attitudes and behaviours that assist dissemination of good practice
• Understands personal and team resilience and its impact on team effectiveness
• Supports an open and transparent approach to incident and complaint investigation, management and resolution

Ability to develop, lead and deliver a comprehensive musculoskeletal service that spans community and hospital settings for adults

• Understand the burden of musculoskeletal problems across socio-economic and ethnic minority groups, military personnel, those with disability and co-morbidity and athletes
• Demonstrates the ability to develop clinical services and pathways that meet with local needs alongside community, primary and secondary care colleagues
• Demonstrates the ability to assess, appropriately investigate and diagnose patients with a wide range of acute and chronic musculoskeletal conditions
• Demonstrates the ability to formulate a multi-disciplinary management plan to optimally treat patients across the spectrum of musculoskeletal problems in accordance with latest guidelines and best practice
• Demonstrates effective consultation, time management and prioritisation skills within a busy outpatient setting
• Understands the pathophysiology of tissue injury and repair and its relevance to management and rehabilitations decisions
• Identify and re-direct management of malignancy, infection and inflammatory pathologies
• Can identify risk factors and contributors to musculoskeletal injury including relative energy deficiency
• Demonstrates knowledge and utilisation of pharmacological and non-pharmacological approaches to the management of musculoskeletal pain
• Safely and appropriately perform intra-articular and soft tissue injections for musculoskeletal conditions using, or referring on, for image guidance where appropriate
• Has full knowledge of different imaging techniques including safe practice and limitations
• An understanding of the theory and physics of musculoskeletal ultrasound (MSKUS), governance around its use and incorporation of MSKUS findings into clinical presentations

Ability to develop, lead and deliver a comprehensive musculoskeletal service that spans community and hospital settings for adolescents and school aged children

• Demonstrates knowledge to recognise, diagnose and manage musculoskeletal problems and their associated complications in school aged children and adolescents
• Demonstrates the knowledge and understanding of working with a child health multidisciplinary team to support the rehabilitation and treatment of school aged children and young people with musculoskeletal problems
• Demonstrates the ability to perform age appropriate history taking and examination
• Can identify risk factors and contributors to musculoskeletal injury including relative energy deficiency
• Identify and re-direct management of malignancy, infection and inflammatory pathologies
• Understands, and appropriately uses, different imaging techniques in the assessment of musculoskeletal problems in school aged children and adolescents
• Demonstrates ability to deliver age and activity appropriate rehabilitation programmes
• Demonstrates knowledge of the anatomical, physiological, psychosocial, sexual and educational development of children and adolescents in the management of musculoskeletal conditions
• Demonstrates knowledge and utilisation of pharmacological and non-pharmacological approaches to the management of musculoskeletal pain in school aged children and adolescents
• Demonstrates knowledge of safeguarding and non accidental injury (NAI) within the adolescent and school age population
• Demonstrates ability to support development of adolescents and young adults independence and autonomy in health care and acknowledging their right to dictate appropriate parent/carer involvement
• Demonstrates knowledge of the aspects that enhance care during transition and transfer between paediatric and adult services, including patients with long term health conditions and disability

Ability to deliver exercise medicine services for adults, encompassing both prevention and management of chronic disease

• Demonstrates knowledge and application of the evidence and guidelines for the use of physical activity in both prevention and management of chronic disease
• Demonstrate the knowledge and application of motivational interviewing and behavioural change theory when prescribing physical activity for the prevention and management of chronic disease
• Demonstrates participation in the development and evaluation of resources for patient, carers, other medical professionals and organisations aimed at increasing physical activity levels
• Knowledge and understanding of normal exercise physiology, the performing and interpretation of relevant investigations and the impact of disease and medication
• To develop an understanding of the effects that the ageing process and the presence of co- existing morbidities can have on an elderly individual’s ability to undertake exercise
• Demonstrates the ability to advise women on undertaking safe exercise, throughout the lifespan and in pregnancy, including advising on energy balance, bone health and hormonal influences
• Demonstrates an awareness of the unique needs of patients with disabilities and the barriers faced in participating in physical exercise
• Understanding the social, psychological and cultural factors that influence physical activity participation and demonstrate initiatives to overcome these

Ability to deliver exercise medicine services for adolescents and school aged children, encompassing both prevention and management of chronic disease

• Understand and promote integrated physical activity opportunities for school aged children and adolescents, including those with a disability, and promote a lifelong relationship with exercise
• Demonstrates understanding of the effects of age and educational development, puberty, energy balance, medication and environment on physical activity in children and adolescents
• Demonstrates the ability to support physical activity in chronic diseases alongside appropriate specialist multidisciplinary teams
• The ability to use motivational interviewing and behavioural change models to promote physical activity for the prevention and management of chronic disease
• Can demonstrate collaborative education on physical activity across specialist multidisciplinary teams within a variety of healthcare settings and the family unit
• Demonstrates knowledge of factors that enhance care during the transition and transfer between paediatric and adult services
• Show evidence of knowledge sufficient to engage constructively with other relevant organisations (primary care, social services, local authority, education, mental health services, voluntary organisations) to develop clinical pathways promoting physical activity participation in chronic disease prevention and management

The ability to promote and support population health through physical activity

• Demonstrates knowledge of the epidemiology of chronic disease and the evidence for the role of physical activity in the management of these conditions
• Demonstrates knowledge and ability to measure physical activity levels at an individual and population level and how to critically evaluate physical activity interventions
• Demonstrates an understanding of public health policy development and implementation in relation to physical activity and health
• Demonstrates knowledge and understanding of the services supporting the promotion of physically active lifestyles including local authority, community, voluntary sector, primary and secondary care and private sector, and the importance of collaborative working of these organisations to improve population health
• Understands the theoretical basis of health promotion, the need for multi-agency involvement and the associated potential ethical dilemmas
• Demonstrates understanding of environmental, social and cultural issues affecting health promotion relating to the uptake of physical activity
• Has knowledge of the principles, criteria and implementation of screening programs and how these can be employed within a Sport and Exercise Medicine setting
• Demonstrates the skills to identify the challenges for implementing and/or improving public health practice related to physical activity in either a clinical or community setting and where current practice could be improved using an evidence based approach
• Understands the impact of health inequalities, especially poverty, on health and the influence of culture and beliefs on perceptions of health

Delivering effective resuscitation and early management of the acutely injured and unwell patient in the pre-hospital and hospital environments, including sports related mild traumatic brain injury

• Demonstrates the ability to provide emergency on-site treatment for the collapsed or acutely injured athlete in the pre-hospital setting
• Demonstrates the ability to provide leadership to the medical team providing emergency care for the collapsed or acutely injured athlete in the pre-hospital setting
• Demonstrates the ability to communicate effectively with colleagues in the immediate care of the acutely injured patient, and to work with other specialities as required to manage the patient effectively
• Demonstrates prompt assessment of the acutely deteriorating patient, including those who are shocked or unconscious, and the ability to deliver appropriate, evidence based care to patients with a range of acute medical problems and deliver effective resuscitation when indicated
• Demonstrates an understanding of the causes of sudden death in sport and to advise on screening programmes to detect those at risk of sudden death in sport, and to act on the findings of any abnormalities raised during screening with athletes, family members and carers
• Demonstrates the ability to recognise and manage appropriately the acute head injury in sport
• Demonstrates the ability to recognise and manage appropriately the sequelae of head injury in athletes and to advise on safe return to play following head injury
• Demonstrates the professional requirements and legal processes associated with consent for resuscitation

Currency Window

Evidence of your recent practice will be given more weight to reflect current capabilities, and we suggest that approximately 50% of your evidence for a curriculum outcome is drawn from within the last five years of clinical practice (WTE).

Evidence Volume

around 100 electronically uploaded documents