Sports Orthopedics
EDITORIAL

Sports Medicine Professorships in Germany – „Quo-Vadis“?

Sportmedizinische Lehrstühle in Deutschland – „Quo-Vadis“?

University Sports Medicine in Germany will face a relevant change in the next few years. Based on actual information, 12 Professorships are currently vacant or will become vacant by the end of 2026. It is therefore of central importance for the stability of the independent existence of Sports Medicine at German universities that the professorships involved are filled and continued.

Experiences in the past show, however, that new appointments to directing positions in Sports Medicine at the universities cannot be taken for granted. Professorships are not everywhere announced with consistent provisions, the independence of the department is sometimes not given and there have been reports of failed appointment procedures. As a result, affected sports-medical departments may be integrated in other areas or in unfavorable cases, cancelled. The causes of failed appointment procedures are multifariousand don’t permit detailed reflection here.

Growing Importance of Sports Medicine

From the contents, it should be impossible to imagine any of the university locations without our discipline. The growing importance of sport-medical expertise in the training therapy of various diseases, in activity-related prevention, health management in high-performance sports or, as observed recently during the SARS-CoV-2 pandemic, in sports-medical diagnostic procedures in the clinical and scientific setting goes without question.

Nonetheless, in many places there is a tendency to incorporate the required sports-medical expertise into the individual disciplines, which in turn bears the risk that independent further development of activity-medical expertise may be left to chance or become less important. The same applies for the medical care of state-supported junior and elite sports. In Germany, this is in large measure organized at the sports-medical departments of universities and thus accessible for broad and well-founded clinical care and clinically-oriented research in elite sports.

Another factor which must be taken seriously, and one which is also partially cited by faculties seeking to fill a vacancy, is the candidate situation. In Germany up to early 2000, the vacancy announcements of larger sports-medical professorships would attract 20 to 30 applicants, nowadays a two-digit number of applications is seldom attained. This results in part also from a certain discrepancy between the location-specific situation and the profile of the interested candidates. In addition, a very small proportion of female candidates respond to announcements for sports-medical director functions in Germany. Even the goal of reaching at least the 2021 federal average of women professors at university hospitals of 27% (3) is not attained.

Newly Created Department

What is to be done? The Scientific Council of the German Society of Sports Medicine took on the topic of new-filling of Sports-Medical Professorships by creating a special task area. In the first step, a survey was taken by the Scientific College at the sites in order to record the sometimes very different profile of sports-medical facilities at the universities. Among other things, information on the structure, tenure of the professors, clinical and scientific orientation, and placement within each faculty was recorded.
Moreover, the Scientific Council offers the sites assistance when a professorship vacancy becomes apparent for age reasons. Ideally, such a process should be begun before the Structure Commission assigned for the announcement begins its work to support the university’s strategic planning in light of location-specific conditions. A proactive contacting of the sites by the Scientific Council supports this procedure.

However, the acceptance is seen to be variable, ranging from a close exchange with those making the decisions at the site to absolutely no reaction to the inquiry from the Scientific Council.

Promoting the Next Generation is Essential!

To improve the candidate situation, it is essential to pursue successful fostering of the rising generation. The Symposium for junior scientists run by the Scientific Council since 2017 and the establishing of Interest Groups are the first important steps. In the attendant exchange with the many highly-motivated colleagues in our discipline it becomes clear, however, that despite the high interest in the discipline, there is uncertainty concerning the career possibilities.

One reason may be the lack of a Specialist for Sports Medicine degree, which means that for a later managerial position in a clinically-oriented sports-medical facility, specialist competence should be attained in one of the core disciplines like Internal Medicine, Orthopedics and Accident Surgery or Family Medicine. The relevant educational possibilities arising in Sports Medicine are variously organized in Germany and made more difficult through possible rotation regulations. It is imperative to improve this at our sites to make possible a parallel clinical education with the goals of Specialist recognition and scientific development.

The integration and promotion of lateral entrants should also be supported, that is, colleagues who already have a clinical specialist status, or have already completed a part of  the clinical education when they switch to a sports-medical facility. It must be made clear to them that the unique characteristics of our discipline, but also its great interdisciplinary potential, offer attractive possibilities for linking the clinic and research, and that the chance of obtaining a managerial position is sometimes greater than in other disciplines.

Work-Life-Balance Seems more Important than Salary and Position

In the competition for bright candidates, we also have to face the altered framework conditions. The goal “Professorship” appears to have lost some of its attractiveness and is not pursued „at all costs“. According to a survey of Senior Physicians at German university clinics, a healthy work-life balance is more important than a high salary (2). Just under 39% of the respondents said they found a university ordinariat attractive or very attractive, considerably fewer than remaining in a senior physician position (63%). Across disciplines it is seen that establishing concepts to promote the compatibility of family and profession must increase the social incentive to fill managerial positions (1).

The occupants who leave the post play a central role in guaranteeing the site in the sense of continuance of the sports-medical professorships. Most important is an early exchange about targeted support of the process of announcing the vacancy. Based on site-specific detailed knowledge, the person still holding the chair usually knows best which future structural and content orientation of the professorship to be filled is likely to fulfill the goal and is realistic, taking the site profile into account.

As presented at the last meeting of the Scientific College of the DGSP at the Sports, Medicine and Health Summit in Hamburg, the topic of professorships has one of the highest priorities for the Scientific Council. The Scientific Council put creating a detailed paper on its agenda. I hope this editorial will contribute further impetus to the discussion.

References

  1. DE RIDDER D. How to add more „family“ to the work-life-balance?- family friendliness in medical under- and postgraduatestudies and the workplace. GMS Z Med Ausbild. 2012; 29: Doc22.
    doi:10.3205/zma000792
  2. MUMMERT R. [Work-life balance more important for seniorphysicians at university hospitals than high salary].Ausgeglichene Work-Life-Balance für Oberärzte an Uniklinikenwichtiger als hohes Gehalt. [18 July 2023].
    https://www.rochusmummert.com/wp-content/uploads/2020/06/Studie_Ausgeglichene_Work-Life- Balance_f%C3%BCr_Ober%C3%A4rzte_wichtiger_als_hohes_Gehalt_2.pdf
  3. STATISTISCHES BUNDESAMT. [Proportion of Women Professorsin Germany in 2021 by Subject Group. Wiesbaden: FederalStatistical Office; 2023]. Frauenanteil in der Professorenschaftin Deutschland im Jahr 2021 nach Fächergruppen. Wiesbaden:Statistisches Bundesamt; 2023. [18 July 2023].
    https://de.statista.com/statistik/daten/studie/197908/umfrage/frauenanteil-in-derprofessorenschaft-nach-faechergruppen/
Prof. Dr. med. Andreas M. Nieß
Abteilung Sportmedizin
Department Innere Medizin
Universitätsklinikum Tübingen
Hoppe-Seyler-Str. 6, 72076 Tübingen
andreas.niess@med.uni-tuebingen.de