Premier league doctor

A full timer

Mike Stone, team doctor at Manchester United Football Club, is one of the few doctors in the United Kingdom who has made a career out of sports medicine. “There are not that many full time sports medicine doctors about,” says Mike, who has been full time club doctor with Manchester United for nearly five years now. “Since there's no specific career path you can follow at the moment, most people do it part time as well as something else.”

How it began

Mike's interest in sports medicine developed while he was a general practitioner (GP) in Stockport, dealing with his patients' training injuries. “I initially gained experience on the pitch by helping out at my son's junior football club,” he says. “I've always played rugby and had an interest in sport, and I do think it is a specialty you should do for the love of it.” After the Hillsborough disaster in 1989 and the subsequent Taylor report, sporting events with a crowd of more than 5000 people have had to have a “crowd doctor” in attendance. As a regular supporter at Old Trafford Mike applied and got the job as one of their crowd doctors. He was later appointed as a part time youth team doctor at Manchester United, continuing his day job as a GP at the same time.

“I did the sports medicine diploma through the Scottish colleges,” said Mike, “And while doing that, the Manchester United club doctor retired, so I took over his job initially on a part time basis. I was in the right place at the right time with the right qualifications. It soon became obvious that there wasn't enough time to do both jobs properly. The club wanted a full time doctor so my GP work had to go.”

Round the clock

As club doctor for the Manchester United team, Mike is on call round the clock to deal with all the medical needs of the players. “Everywhere the first team goes, I go with them,” Mike tells us, “and there isn't a typical day.” As well as doing full medical screenings on all the new players, and dealing with their day to day injuries, Mike attends all the matches. “It's a combined effort between myself and the club physios. We are there during a game to deal with any medical problems.” He deals with all sorts of injuries—from fractures and anterior cruciate ligament tears to degenerative injuries such as osteochondral knee problems—which have ended some promising careers. “Each injury should be treated on an individual basis, as in any branch of medicine,” says Mike.⇓

• Download figure
• Open in new tab
• Download powerpoint

Compromising position?

Being a supporter of the team himself, we ask him if he's ever felt compromised when making a decision whether or not a star player is fit to play? “In big clubs like Manchester United, there are always other players available to play in place of the injured ones,” says Mike. “It's the smaller clubs lower down the league where it is harder to find replacements for the star players, and whether or not a player plays can make the difference between staying in a league and relegation.” However, the decision isn't down to Mike alone. “Myself and the physios discuss it with the coaching staff and the player. Sometimes the decision is easy, sometimes it's not. You can impose pressure upon yourself as a doctor and can sit and worry about what the player can and can't do, but you have to treat them as a patient and not as a superstar.”

“If a player has been advised against a course of action, it's not up to them to go against it of their own accord, but as with any athlete the player's wishes need to be taken into account. If they've trained for 10 years to get into a situation—such as the Olympics—and they have one chance to run a race with an injury, it is up to them to consider the risks and make their own decision. They might never have the opportunity to run at an event like this ever again, and after training for so long and giving up so much, if they are prepared to take the risk, then it is ultimately up to them.”

Litigation risk

So does being a doctor with a high profile sports team carry with it an increased risk of litigation? Mike doesn't think so. “There is a risk of litigation in medicine wherever you are.” He says, “Confidentiality is the problem in sports medicine. The press think they've got the right to know what's wrong with every elite athlete. I don't tend to talk to the press because players need to know they can trust their doctor.”

Although voluntary work with amateur sports teams is an ideal way to gain experience in the specialty, Mike advises that you first obtain the relevant qualifications to avoid litigation should something go wrong. “If you volunteer to help out with an amateur club and something goes wrong, defence unions may have issues about supporting you if you don't have qualifications,” he says. Several institutions throughout the United Kingdom offer a postgraduate diploma or an MSc in sports and exercise medicine (box).² “If you have a broad basis to start with then it makes things easier,” advises Mike. “Attach yourself to different sports teams and get experience in casualty and general medicine—in particular orthopaedics and joint and muscle examination.”

A surge in job vacancies

So once this specialty is established, does Mike think there will be a surge of job vacancies in this area? “There are always going to be people there for elite athletes but there are never going to be that many jobs available for everyone who wants to do it. Amateur teams always need doctors but they have no money to pay, so there will never be that many people working in the area—that's why many people are doing it for the love of it. The job is a team effort. Everyone has an individual area of expertise and when dealing with elite athletes you need to treat them properly.”

For the right sort of person, Mike wouldn't hesitate in recommending sports medicine as a career. “Go for it. If you're interested in sport and medicine then it is possible to combine the two. You won't make a fortune doing it, but if you enjoy doing it—that is more than half the battle.”