Dr Hamid’s experience: IOC Diploma in Sports Medicine

Our last day at the workshop – a photo with Dr Antonio Pellicia, a world renown sports cardiologist.

26 Jun 2015

The International Olympic Committee (IOC) launched a Diploma in Sports Medicine program in 2013, aimed at further building education and knowledge in the important field of athletes’ health protection. The two-year, postgraduate online course is targeted to primarily meet the needs of team physicians from the National Olympic Committees (NOCs) and International Federations (IFs). Its intended focus was on health and performance implications of participation in elite sport with consideration towards physical activity, nutrition and other lifestyle factors in promoting good health in general. The course is run by the IOC’s Medical Commission and operates under the academic oversight of an International Academic Advisory Board, which will be responsible for all aspects of academic standards. The course consists of distance-learning on a part-time basis for a period of six months from October each year, taking two years to complete. Modalities of instruction includes lectures in electronic format, web-based materials, paper-based reading, an online forum and concludes with a residential workshop with a written examination.

I am a trainee in Orthopaedic Surgery with Singapore General Hospital, with a keen interest in the sub-specialty of Sports Surgery. Within the domain of sports surgery, I wish to develop a niche in the holistic care of the athlete. This formed the impetus for me wanting to seek greater knowledge and skill in the care of the athlete. The Diploma in Sports Medicine offered by the IOC was a timely opportunity for me to pursue my interest. At the time of application, I was not a team physician for the Singapore National Olympic Council (SNOC) nor a IF. However, I had plans on wanting to be a team physician after completion of my specialty training. In fact, I had volunteered as an events doctor for several sporting events in Singapore and had completed the Basic Team Physician Course.

Being of the younger participants of this course with relatively little experience with elite athletes, I knew that the task at hand was going to be daunting. It was always going to be a steep learning curve but I was confident that I would be able to do well. Understanding certain concepts was challenging but I grew with the course. I was consistent in my reading and my grades for the assignments were relatively good given the high expectations of the renowned faculty. Well, if you are expected to take care of elite athletes, I guess the bar would have be set high.

The highlight of the course to me was the residential workshop. It was a great blessing to be able to visit an IOC Centre of Excellence. I was given an option to choose between the centres in Rome, Calgary, Prettoria and Oslo. I chose Rome as it was the closest to home! My mind immediately raced back to the Rome Olympics and I was excited to visit a place rich in the Olympics culture and history.

The first day of the residential workshop consisted of the written exam followed by lectures. The second day consisted of more didactic lectures and the third day was an interactive one with a walk-about around the Institute of Sports Medicine and Science of the Italian National Olympic Committee (CONI). The workshop was an eye-opener as I met big names from various nations which included Brazil, Chile, Greece, United Kingdom, Australia, Egypt, Switzerland, Poland and Bosnia! I was surprised to find that the majority of the delegates were of the same ‘breed’ as me – an orthopaedic surgeon! It was a marvelous experience exchanging knowledge and experience and I wished I were a sponge. There was also time for some mingling as some of the delegates gathered for dinners and others toured the wonderful city of Rome.

The workshop ended with a bang with a tour of the facilities. It was indeed state-of-the-art and an absolute eye-opener for me. Technology was applied at its best for both medical evaluation of the athlete as well as performance enhancement using biomechanical as well as physiological intervention. I will attempt to bring you through my experience with some pictures.

So it all started with us reporting to our lecture room for the written exam as well as our lectures. This is where we were served delicious tea as well as where all the delegates interacted and participated in invigorating discussions and sometimes debates regarding issues pertinent to the care of the elite athlete.

This picture shows a triathlete on a specialized stationary cycle that records key physiological parameters that would then be interpreted by the team physician, physical therapists as well as the coaches. Modifications to the athlete’s training and technique are made if necessary. The cycle is plugged to a laptop so that the evaluation is ‘live’.

This is a flume pool where a competitive environment is created for the elite swimmer. Again, the athlete is put through his/her paces in the flume pool and key physiological parameters such as heart rate, respiratory rate, maximum volume of oxygen (VO2 max) can be recorded. Stroke length, kick-off strength can also be measured.

This picture shows one of the sports scientist at the institute explaining how a lactate assay can be used as a biochemical parameter in the assessment of the athlete. Lactate levels are assessed for several different reasons such as determining sustainable threshold, peak, tolerance and clearance values. The reason to assess is relative to the desired performance outcome and the lactate levels are often related to speed, power or heart rate. Sustainable threshold values are the most common assessment outcome and are used by endurance athletes primarily. To determine sustainable lactate levels, subjects perform exercise at incremental loads, for 12 to 15 minutes, while having blood drawn in droplets either from a finger or earlobe. Regarding performance, lactate levels are used as an indicator or marker of fatigue even though lactate has been shown to provide energy for the body.

This picture shows a sports physician explaining the function of the “Bod Pod”. The “Bod Pod” is a machine that offers body composition solutions. It is an air displacement plethysmograph which uses whole-body densitometry to determine body composition in adults and children, and can accommodate a wide range of populations. A full test requires only about 5 minutes, and provides highly accurate, safe, comfortable, and fast test results. It is one of the state-of-the-art systems in body composition measurement although it may be looked upon with irk by athletes with claustrophobia!

Having returned from the residential workshop as well as completing the course, I am invigorated to contribute more to the care of elite athletes in Singapore. I hope to be given an opportunity to share my experiences and thoughts to the hierarchy at Singapore National Olympic Council to see how we can advance the care of our athletes.

I hope that the knowledge and skills that I have gained through the course will guide me towards providing service excellence in the medical and surgical care of athletes in my nation.

Dr Hamid Rahmatullah Bin Abd Razak
MBBS (NUS), GDFM (NUS), MRCS (Glasgow), MMed (Ortho), DipSpMed (IOC)
Orthopaedic Resident
Singapore General Hospital