EJECUCIÓN DEL PROCEDIMIENTO EN LOS CONCURSOS DE INGRESO

Securing the position of doctor in an Olympic sport was largely dependent on personal contacts with 71.4% of doctors indicating that this was how they were recruited into their current post. The majority of respondents suggested that they were approached by a doctor from another national governing body or a team coach offering them a role in their sport. In many cases, doctors were contacted personally by a senior member of the British Olympic Association medical team who asked doctors whether or not they would be interested in taking medical responsibility for athletes from a particular sport. Only one doctor stated that s/he applied for the post after seeing an advertisement in a journal or newspaper, and none stated that they had replied to an advertisement in a medical journal. A greater number of non-EIS doctors were recruited into their positions via personal contacts with (87%) of respondents suggesting this method of appointment in comparison to (50%) of EIS respondents. Just over half (52.4%) of all doctors were interviewed for their role with a NGB. However, only 40% of non-EIS doctors were interviewed in comparison with 84% of EIS doctors. The majority of doctors (65%) had a written job description, with a relatively even split between EIS (66.6%) and non-EIS doctors (60%).

Doctors were generally employed in their sports on a part-time basis with the majority of doctors (61.9%) also, and primarily, employed as GPs. In comparison with the full-

time role that physiotherapists had within the EIS, EIS employed doctors usually combined their EIS duties with a number of additional roles such as lecturing on sport and exercise medicine courses and private clinical practice. The majority of doctors (61.9%) were responsible for one Olympic sport. However, doctors were more likely than their physiotherapy counterparts to have roles with two (14.3%) or three (9.5%) sports6. Many doctors had sports-specialist qualifications (76.2%), usually in the form of a postgraduate qualification. There was a greater number of doctors who had undertaken these qualifications since 2002, with 46.7% of doctors completing these qualifications between 2002 and 2003. The number of doctors completing postgraduate qualifications in these years may have been stimulated by the establishment of the EIS in 2001/2002. Postgraduate qualifications such as these were described by the majority of respondents in the later interviews to be an essential requirement to be involved in the medical treatment of Olympic athletes. All doctors employed by the EIS had a postgraduate qualification in comparison to 66.6% of non- EIS doctors.

The number of CPD courses doctors participated in per year varied, with three courses per year the mode (30%). Additional training organised by doctors’ national governing bodies also varied with just over half (55%) of the doctors receiving anti- doping training and 40% further medical training. EIS doctors were more likely to take part in sports medicine related CPD. For example, 66.6% of EIS doctors had undertaken medical CPD compared to only 28.6% of non-EIS doctors; ethical training was completed by 66.6% of EIS doctors compared with 14.3% of non-EIS doctors; half of EIS staff participated in pre-event training in comparison with 21.4% non-EIS

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One consequence of doctors being responsible for more than one sport is the possibility that there are fewer than 35 doctors on the British Olympic Association Medical Committee. For example, with 3 doctors responsible for 2 sports and 2 doctors responsible for 3, only 28 doctors would be required on the committee to represent all sports. If this were the case the response rate for the questionnaire would be 75% rather than 60%.

doctors; and 83.3% EIS completed anti-doping training compared with 42.8% non- EIS.

There were a number of doctors who attended events associated with their sports, international fixtures being the most common at 85.7%. Of those doctors who attended international fixtures, 22.2% of them attended approximately 25 days per year. Domestic fixtures and training sessions were not as well attended by doctors as international fixtures, with the greatest percentage of doctors attending between 10 and 12 days per year (22.2%) and between 4 and 5 training sessions per year (35.2%). Like EIS physiotherapists, EIS doctors were more likely to attend home ground training (a comparison of 83.3% EIS to 60% non-EIS) and domestic fixtures (a comparison of 83.3% EIS to 66.6% non-EIS).

6.3.1. Olympic doctors: Motivations, duties and routines

When asked what were their main reasons for undertaking the role of sports medicine doctor, 85% stated that it was because of a "general interest in sport". None of the respondents indicated that payment was a reason or motivation for being involved in sports medicine, which indicates that payment for these doctors, like those in English football and rugby union, may be modest relative to other areas of medicine. Indeed, when asked if payment was a reason for undertaking their role, a couple of questionnaire respondents wrote additional comments highlighting, somewhat sarcastically, the absence of payment, such as "I receive NO payment" or "Definitely not!!!". Just over half of the total questionnaire sample (55%) stated that a salary was the usual method of remuneration. However, whilst 83% of EIS doctors received a regular salary, 57.1% of non-EIS doctors received no income at all from their

Questionnaires revealed that fewer than half of the doctors (42.8%) saw athletes either daily (23.8%) or weekly (19%). 19% of doctors only saw athletes on a monthly basis and a further 23.8% saw athletes at "other" times such as at national and international meets. In addition, 19% of respondents indicated that they "rarely" saw athletes or doctors added a comment to the effect that contact was irregular. When asked how they normally kept in contact with athletes, the majority of doctors (90.5%) were contacted by an athlete personally and 57.1% of doctors indicated that athletes were often referred to them by a physiotherapist. In addition, 57.1% indicated that coaches would request an appointment for their athlete. Regular fixed appointments were not common overall with only 28.6% of doctors indicating this as a method of keeping in contact with athletes. EIS doctors (66.6%) were much more likely to have fixed appointments than non-EIS doctors (13.3%). It was more likely for appointments with non-EIS doctors to be requested directly by athletes, whereas athletes were frequently referred to EIS doctors by a number of people including doctors, physiotherapists, coaches and other support staff (e.g. strength and conditioning coach). The various methods by which athletes were referred to EIS doctors may be a consequence of the EIS containing a network of integrated individuals. Whilst the majority of EIS respondents highlighted the EIS as the main location for medical consultations to take place, questionnaires indicated much greater diversity in the places non-EIS doctors conducted their consultations. In the main, the training ground or sports club was the usual location (66.6%). However four respondents (26.6%) noted that they held consultations in their own home, and a further three (20%) provided home visits for athletes. When asked how they usually maintained communication with other members of the medical team, the majority of doctors (71.4%) identified email. It was more likely that EIS doctors communicated personally with other members of the medical team (66.6%) in comparison to 46.6% non-EIS doctors.

Involvement in the recruitment of other staff was relatively high with 66.7% of doctors having a role in the recruitment of other doctors and 57.1% being involved in the recruitment of physiotherapists. This involvement largely consisted of sitting on an interview panel (57.1%). Like EIS physiotherapists, EIS doctors were more likely than their non-EIS counterparts to have been involved in the recruitment of other medical staff. 83.3% of EIS doctors had been involved in the design of a job description in comparison to only 20% of non-EIS doctors. EIS doctors had also been involved in personally selecting someone with 5 out of 6 doctors highlighting their involvement in this in comparison to 20% of non-EIS doctors.