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From GP to GPwSI SEM

Dr Richard Collins, 21 Jun 2018

From GP to GPwSI SEM

Dr Richard Collins, BASEM Education Chair was receiving lots of emails from GPs (or soon to be GPs) asking how to expand their career into Sport and Exercise Medicine.  Richard found that his responses were distilling into some core themes, so he decided to post a thread on twitter of his advice.  Here is his 13 step guide to becoming a GPwSI SEM.

  1. Do SEM training!  I know training places are limited and financial and location concerns are prohibitive, but believe me, it’ll make your life easier in the long term and I can only see the Speciality growing.  Having a CCT will be more and more important.  Check out the training pathway on the FSEM(UK) website.


  1. If you’re a new GP, then you’re looking at a 7 – 8 year journey to high competence (maybe 5 – 6 if you’re very lucky with jobs).  Between courses, exams, reduced earnings from time given gratis, and low wages in Sport, you’ll probably spend £80K+ during that journey.  So, just take another look at SEM training.  4 years, ST4 – 6 (unbanded, but time to locum) with a clear route to CCT.


  1. If training is an absolute no no, then you’ll need to do 4 sessions/week minimum in normal General Practice.  Fixed post, stable practice, get a list of patients, embed in the practice etc., this is your ‘sofritto’.  You build from here.


  1. Public Health – not an aspect of SEM everyone instinctively thinks of, but it is hugely important and one of the 2 cornerstones we’re building our NHS profile on.  NHS England doesn’t have any World Championships under their remit, it does, however, have lots of diabetic, obese people.


  1. Public Health and General Practice are like Rhubarb and Custard.  Loads you can get your teeth into during your ‘jobbing GP’ years.  You’ll get good at Exercise Medicine and will be able to network in local NHS politics (very important for opening doors).


  1. MSK – this is the biggie and where we have a clear specialist profile.  Non-Orthopaedic, Non-Rheumatology Doctors dealing with MSK Pain and Locomotor Dysfunction and sifting through layers of co-morbidity and complexity.  You cannot wing this stuff, you need skills and that takes time and effort.


  1. Most of the 8 years is going to be given towards acquiring expertise in MSK Medicine.  Courses, Masters, Exams, CPD, observing others along with a dedicated caseload.  You’ll also need mentors and supervisors.  Outside of SEM training it’s the do it yourself route.


  1. In the first few years your GP caseload is sufficient and a taught Masters combined with reflective learning and mentorship will get you to early intermediate level.  Link that with your Exercise Medicine focus and you’ve got the healthy green shoots of a SEM career.


  1. With some GP experience, a MSc under your belt and fledgling MSK medical skills, you are ready for Sport.  You need to find a context you enjoy and, to be frank, can get an opportunity in.  It’ll be low pay, weekends, travel and trips abroad and needing to use annual leave.


  1. If you do about 50 sessions/year of this type of work (one match/week, or 3 weeks or trips/year – ideally a combo) then you’ll cover all the bases gradually and get to use MSK skills with a different caseload


  1. By now you’re starting to look like a SEM GPwSI and this is where it’s imperative you get a NHS MSK post covering 3 – 4 sessions/week.  With mentorship this is where you’ll break through the intermediate plateau to expertise.  You’ll want the FSEM(UK) MFSEM at this point


  1. You should now be a part jobbing GP (with exercise medicine focus), part involved in Sport, part MSK doctor in development.  Marinate that for a couple of years (getting MSKUS skills whilst you go) such that you now have a thriving GPwSI SEM career.


  1. However…. having come that far you’ll likely not want to stop there.  You’ll likely decide you want to be on the specialist register, and so you’ll meet the CESR process at which point you will tell everyone who asks to do the SEM training!

At the beginning of your journey you should consider becoming a member of BASEM.  The BASEM Foundation Skills course is hugely popular for those just starting out in their SEM career.  At present, BASEM also provides a revision course for the FSEM(UK) MFSEM exam.  For both BASEM courses, as a member, you can take advantage of reduced fees to attend.

The BASEM website provides you with information on MSc courses to attend and links to MSK, Physical Activity and Team Care resources.  In the members’ area there is access to education resources such as the online learning portal, providing online learning with videos presentations by speakers at BASEM courses and conferences.

2 relevant resources to help you during your journey is access to the BJSM and OrthoEvidence.

Networking is essential throughout your journey and BASEM provides this opportunity at courses and conferences, where you will meet like-minded individuals, all eager to advise and learn from each other.  Anything specific you require?  BASEM has a multi-disciplinary membership, that is really helpful in providing advice and shadowing opportunities.

Take a look at the list of membership benefits BASEM has to offer and its membership categories.  You can join online at any point and receive an annual membership subscription that is sure to help you with the support, advice and contacts you need to reach your goal.

If you have any questions in regard to membership of BASEM, please contact

Dr Richard Collins

Richard Collins


  • Senior MSK Physician & Clinical Director for the NHS Bedfordshire MSK Service
  • Sport Physician with the English Institute of Sport
  • Team Doctor for British Judo & British Para-Archery
  • Match Day Doctor for Northampton Saints Rugby
  • Experienced MSK Sonographer (PGCert MSKUS University of East London)

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