Information for Medical Practitioners
This page is a guide for medical practitioners involved in the care of contestants for combat sports events. It can assist General Practitioners and specialists undertaking annual Certificate of Fitness assessments, as well as Medical Practitioners attending events to supervise contests.
On this page
- What is a combat sport
- Certificate of Fitness Assessment
- Medically suspended contestants
- Serology Testing
- Medical Practitioners attending events
What is a combat sport?
Combat sports are defined as sports or activities in which a person strikes, kicks, hits, grapples with, throws or punches another person. Different combat sports use different combinations of these techniques. In the ACT, these sports and activities are regulated under the Controlled Sports Act 2019.
Certificate of Fitness Assessment
All contestants seeking to be registered with the ACT Government must undergo a Certificate of Fitness assessment with a registered medical practitioner. This can be their regular GP. After initial registration, a contestant's Certificate of Fitness must be renewed every 12 months unless they have been directed to do so earlier (for instance, following a medical suspension of their registration).
- prior and existing head injuries (including concussions); and
- existing medical conditions that may inhibit a person's ability to compete;
- risk factors for Blood Borne Viruses (HIV, hepatitis B and hepatitis C)
What should I look out for?
A Medical Practitioner undertaking this assessment should review the answers given by the contestant to determine if there is any unacceptable risks of a contestant competing in combat sports contests, for example:
- prior head injuries
- resulting impairments
- broken bones
- extreme weight loss/ rapid weight cutting
- unmanaged blood borne virus
- skin infections such as staphylococcus
- any other matters you consider place the contestant at risk when competing
** Please note, registration does not cover training aspects of combat sports. If you declare a contestant unfit to compete, you may wish to have a conversation with them about the appropriateness of training, in particular sparring with others where head contact is involved. **
Medically suspended contestants
Contestants may be medically suspended at a contest on the recommendation of the treating medical practitioner. This may be for a variety of reasons, but could include a head injury or concussion. Medical practitioners asked to review the contestant's fitness and re-issue a Certificate of Fitness should pay close attention to any symptoms that may indicate an unhealed head injury or concussion, or any prolonged recovery periods that may indicate the need for further specialist follow-up. if you are in doubt of a contestant's fitness to compete, it is recommended that you declare the contestant 'unfit' to compete.
Serology Testing of Contestants
Testing of contestants for blood borne virus such as HIV, hepatitis B or hepatitis C is at the treating medical practitioner's discretion. The ACT Government’s approach to testing for blood borne viruses, as part of the Certificate of Fitness requirements,has been considered with a human rights framework in mind, balanced with the risk of transmission.
There is a potential risk of blood borne viruses being transmitted during controlled sports from the bleeding or exudative skin wounds of a contestant with a blood borne virus to other contestants via injured skin or mucous membranes. Although data is limited, the generally understood consensus amongst medical professionals is that the likelihood of such transmission is extremely low.
The Certificate of Fitness will include a declaration to be completed by contestants that they are not knowingly competing with an unmanaged blood borne virus. It also includes a number of questions to help the medical practitioner to determine the risk that a person has a blood borne virus. Further information about the risk factors can be found in the Blood Testing Policy. If you determine that a contestant requires testing, please complete the Blood Testing Form for submission with their registration application.
It is recommended that all contestants consider being vaccinated for hepatitis B prior to competing or participating in a controlled sport. Contestants at risk of getting HIV, can also speak to their medical practitioner about using PrEP (pre-exposure prophylaxis) to help them remain HIV negative.
In deciding whether a contestant is ‘fit’ or ‘unfit’, a medical practitioner should consider the following—
- whether further testing is required to confirm exposure to a blood borne virus, determine carrier versus cleared viral status (for hepatitis B and hepatitis C) or measure viral load;
- whether the patient is receiving appropriate treatment;
- whether the patient has a detectable viral load;
- the discipline/s of controlled sport the contestant plans to compete or participate in; and
- whether additional advice from a medical practitioner who specialises in the management of the relevant blood borne virus should be sought.
Medical Practitioners attending events
Register to be an attending medical practitioner here.
It is a requirement of the Controlled Sports Act 2019 that all registrable controlled sports events have a medical practitioner present to supervise the whole of every contest. These medical practitioners must be registered with the ACT Government, Controlled Sports Official registration in order to perform this role. You can register here. There is no fee to be registered. Please have your APHRA details ready.
An attending medical practitioner has a number of responsibilities to perform under the Act. These include:
- supplying certain medical equipment
- treating an injured contestants on-site (and referring to emergency services if necessary)
- undertaking a pre-event medical assessment for every contestant
- supervising the whole of every contest
- stopping a contest where you feel the contestant is no longer fit to compete in the event
- undertaking a post-contest medical assessment for every contestant
- completing the information in the contestant's Medical Record Book
- completing any reports to the Controlled Sports Registrar for recommended medical suspensions or cancellations of a contestant's registration
- completing any reports where a significant injury or fatality occurs at an event
Supply of medical equipment
The registered Medical Practitioner is responsible for supplying all necessary medical equipment. The following equipment must be supplied (additional equipment is at the registered Medical Practitioner’s discretion):
- basic doctor’s bag kits, including disposable gloves and gauze swabs
- auriscope and opthalmoscope
- airway support equipment
- oxy-viva mask
Supervision of contests
The attending Medical Practitioner is on site to treat contestants either at contest side, or in the dressing rooms when required. Unless another practitioner is supervising the remaining contests, the contests must not continue until the medical practitioner is present at the contest side to supervise.
Pre-event medical assessments
Each contestant competing in an event must undergo a pre-event medical assessment and have the outcome of this assessment recorded in their Medical Record Book (held by the contestant).
The following investigations are required for a pre-event medical clearance:
- An investigation to determine whether the contestant:
- is dehydrated;
- has recently consumed alcohol or used a prohibited substance (see the Medicines, Poisons and Therapeutic Goods Act 2008, section 13); or
- has recently sustained an injury, fracture or wound; or
- is suffering from an illness; or
- has a skin infection or disease; or
- is pregnant; and
- any other investigation to determine whether the contestant is suffering from any medical condition that may prevent the contestant from safely competing in a controlled sports event.
Post-event medical assessments
Each contestant must undergo a post event medical assessment as soon as practicable after their contest, but not before they leave the venue. This assessment should examine for signs of injury, concussion or head injury.
Medical Record Books
Each contestant must have a Medical Record Book issued either by the ACT Government or another regulating Australian jurisdiction (NSW, VIC, SA, WA). The Medical Record Book contains important information for the treating medical practitioner about a contestants previous contests, including any injuries sustained and medical suspensions applied. Contestants must adhere to mandatory time frames between contests (see below).
Stopping a contestant competing in a contest
Before the event commences, the registered Medical Practitioner/s and referee/s must agree on a clear, pre-determined means, whether by bell, hammer, air horn, or prescribed hand signal or another method, by which the medical practitioner can:
- Indicate the need for or desirability of a medical examination of a contestant during the contest; or
- Stop the contest.
An attending medical practitioner has the responsibility to stop a contestant competing in a contest at any time if they believe, on reasonable grounds, that the contestant competing in the event is no longer medically fit to compete at the event. Examples of instances where this may occur include, where the contestant:
- has a head injury or suspected head injury
- is suffering from fatigue or exhaustion
- has a broken bone
- has an open wound
- is suffering from significant blood loss
Reporting to the Controlled Sports Registrar
The medical practitioner is required to report matters to the Controlled Sports Registrar when:
- they make a recommendation for a contestant's registration to be medically suspended or cancelled; and
- where a serious injury or fatality occurs at an event (regardless of who was injured or died).
Recommending suspension or cancellation of a contestant's registration
Use this form to recommend suspension or cancellation of contestant registration. This form must be submitted to the Controlled Sports Registrar within 24 hours of the event to ensure that a medical suspension or cancellation can be applied quickly to avoid further injury.
A medical practitioner may recommend suspension or cancellation of a contestant's registration if in their opinion, the contestant is no longer fit to compete in controlled sports contests.
In addition to the above, the following mandatory suspensions apply, once reported by the medical practitioner:
- A minimum of 30 days medical suspension must be applied following any loss by Knockout or Technical Knockout (not including Tap Out or Submission in Mixed Martial Arts contests), concussion, or loss of consciousness. Longer periods may apply at the discretion of the medical practitioner.
- For subsequent losses by Knockout or Technical Knockout (not including Tap Out or Submission in Mixed Martial Arts contests) or concussion, or loss of consciousness, a longer medical suspension and additional medical testing may apply before registration can be resumed. This may include:
- An exclusion period of 60 days or more for second subsequent Knockout, Technical Knockout, concussion or loss of consciousness;
- An exclusion period of 90 days or more for third subsequent Knockout, Technical Knockout, concussion or loss of consciousness;
- Neurological assessment;
- MRI of the brain;
- Other assessments recommended by a medical practitioner;
- Contestant registration cancelled indefinitely on medical grounds.
Reporting a serious injury or fatality
In the unfortunate event of a serious injury or fatality, the medical practitioner must complete a written report for the Controlled Sports Registrar as soon as practicable after the incident has occurred. Use this form to report a serious injury or fatality.
Controlled Sports Code of Practice 2019 (No 1) - see clauses 51 - 63
Assistance with information on blood borne viruses
Canberra Sexual Health Centre – specialist clinic run by ACT Health – visit https://www.health.act.gov.au/hospitals-and-health-centres/canberra-sexual-health-centre or call 02 5124 2184. Patients can also visit the walk-in clinic. See the website for clinic times and location.
AIDS Action Council ACT – visit https://aidsaction.org.au/, or call 02 6257 2855
The World Health Organisation – provides details on prevalence and high-risk regions of the world. See https://www.who.int/.
To get in touch with us, please email firstname.lastname@example.org or call Access Canberra on
13 22 81.