Comparison of training background and characteristics between osteopathic and allopathic team physicians in professional sports leagues
Brandon D. Rust, Ambika Singh, Matthew T. McKinley, Joseph Imler, Mackenzie Elting, Ryan Callahan, Christopher L. Rennie, Leighann C. KrasneyAbstract
Context
Team physicians (TPs) play a critical role in professional sports, providing medical care for athletes under high-pressure conditions. These positions are highly competitive, influenced by previous affiliations, training pedigree, and institutional connections, with fellowship training increasingly essential. Although the number of osteopathic (Doctor of Osteopathic Medicine [DO]) physicians in the United States has grown substantially, TPs in professional sports remain predominantly filled by allopathic (Doctor of Medicine [MD]) physicians, and the training pathways of DO TPs are not well characterized.
Objectives
The objective of this study is to compare the training and demographic characteristics of DO and MD TPs in professional sports leagues.
Methods
Publicly available sources were utilized to identify all DO and MD physicians serving as head team physicians (HTPs), TPs, or consulting physicians across seven major US professional sports leagues (National Football League [NFL], Major League Baseball [MLB], National Basketball Association [NBA], Women’s National Basketball Association [WNBA], National Hockey League [NHL], Major League Soccer [MLS], and National Women’s Soccer League [NWSL]). Data on gender, specialty, medical education, residency and fellowship training, years in practice, clinical practice type, practice setting, and research productivity were collected across the leagues for both osteopathic and allopathic training backgrounds.
Results
Among 676 TPs and consultants, most were MDs (93.3 %) and male (91.3 %), with DOs more often being female (22.2 % vs. 7.8 %) and in early-career stages (p<0.05). Specialty distribution differed by degree, with DOs overrepresented in Family Medicine (15.6 %) and underrepresented in orthopedic surgery (1.2 %) (p<0.001). Training locations partially aligned with current team affiliation, particularly for residency, but research productivity did not differ by degree. The majority practiced in urban settings within private or academic institutions, although DOs were less frequently urban-based (5.0 %) than MDs (p=0.028).
Conclusions
US professional sports team physicians (PSTPs) are predominantly MD-trained and male, with DO physicians and women underrepresented, especially in orthopedic surgery. Career stage, research productivity, and practice settings were generally similar across degree types, highlighting potential external factors, such as the presence of longstanding institutional affiliations and informal referral networks, that may influence access to these roles.