On November 1 this year, sport and exercise medicine is set to be recognised as a specialty under Medicare. There has been a specialist-standard training program in sports medicine in Australia since 1992, but it has taken 18 years to be assessed and recognised by the federal Department of Health and Ageing. It would take pages to detail the succession of delays that have resulted in a single bureaucratic process taking 18 years, but it is worth mentioning that sports lover Tony Abbott oversaw a few years of the stonewalling himself when he was the Health Minister under the Howard government. One of the consequences of lack of recognition has been zero government funding for training of sports physicians, so the number who have received training, self-funded by the Australasian College of Sports Physicians (ACSP), has been a trickle. Despite lots of sport being played in their districts and their towns being fine parts of Australia in which to live, there is only one sports physician in Bob Katter’s electorate and none in Tony Windsor’s or Rob Oakeshott’s electorates. This isn’t likely to change any time soon, as it is a minimum of four years to complete a specialist medical training program. Come November 1, the ACSP is meant to be negotiating with the health minister about, among other things, whether any additional training positions can be funded by the government. If Parliament is deadlocked then another year of delays will probably be chalked up. The story is similar for other new (s-xual health and addiction medicine) and many existing specialties where there is a workforce shortage. One of the "other" big mooted reforms of Kevin Rudd was a federal takeover of the health system to end the buck-passing about systematic inefficiency. Hopefully this issue is also on the agenda of the independents, who might be able to get bipartisan support for this important health system reform. If they can’t, at the very least they can argue for high-speed rail links to the country areas. If there isn’t the will to get enough medical specialists trained by our health system, at the very least you can offer country people a fast train to get them into the cities for their appointments. John Orchard is a city sports physician who undertook specialist training from 1992-95 and will be pleased to have this recognised by Medicare in 2010.