Knowledge-based sports medicine certification in Japan: current status and gaps among stakeholders

BACKGROUND: Sports medicine knowledge is vital for ensuring athlete safety and performance, yet significant gaps in understanding of medical conditions persist among coaches, parents, and athletes. These disparities highlight the need to better assess and improve sports medicine knowledge across those involved in sports. METHODS: This study analyzed data from 18,418 individuals who took the Japan Sports Medicine Certification Examination between 2017 and 2024. The exam is open to diverse stakeholders, including medical professionals, coaches, and athletes, and is designed to assess sports medicine knowledge rather than confer a physician specialty certification. It is offered at three levels - basic (Grade 3), intermediate (Grade 2), and advanced (Grade 1). It covers topics such as injury prevention, anatomy, and return-to-play guidelines. Demographic and survey data from 6629 respondents were linked to exam scores. Linear regression analyses were conducted to identify factors associated with performance. RESULTS: Medical professionals consistently scored higher across all exam levels. Male participants outperformed females in Grades 1 (Coefficient 3.66, 95% Confidence Interval [CI] 2.68-4.65, P<0.001) and 2 (Coefficient 1.62, 95% CI 1.11-2.13, P<0.001). In addition, younger examinees scored higher in Grade 1, whereas older participants performed better in Grade 3. A history of sports injury was positively associated with higher scores in Grades 1 (Coefficient 1.47, 95% CI 0.29-2.64, p=0.014) and 3 (Coefficient 1.75, 95% CI 1.09-2.41, P<0.001). CONCLUSIONS: Knowledge gaps exist among non-medical stakeholders, particularly coaches and athletes. Policymakers and sports organizations may consider integrating basic sports medicine training into coaching certification or athlete development programs.