At the heart of the Irish soccer team

As Medical Director of the Football Association of Ireland, Dr Alan Byrne has one of the most important jobs in the association.
The most high-profile aspect of his job is his responsibility for the elite professionals who represent the senior Irish international team, but he also has a wider responsibility to all of the players who come under the association’s jurisdiction from schoolboy to senior level.

For that reason, with the assistance and advice of the FAI’s Medical Committee, he has drawn up a cardiac screening questionnaire which has been sent to all the soccer leagues and clubs around the country. In keeping with the recommendations of the Task Force on Sudden Cardiac Death which reported in March 2006 it is recommended that all soccer players aged 14 and over should fill in the questionnaire.
h4. Further advice
Following completion of the questionnaire, says Dr Byrne, some players may need to attend their GP for further advice, examination and/or referral where indicated.
Players who reply “yes” to any one of the questions on the questionnaire (available on the FAI’s website www.fai.ie) are advised to make an appointment with their GP and to bring the completed questionnaire to the consultation.
The questionnaire is just one element of the FAI’s screening policy and Dr Byrne is also overseeing a screening programme for the under-15 international team. “I think it is important to remember that no screening tool is perfect,” said Dr Byrne, “and I think that is an important starting point. When we set out to write our protocol for the screening programme of our elite under-15 schoolboy team I spoke to people here and looked what was happening in particular in England and then looked at the evidence from around the world.
“What we decided to do was to write a protocol and form a template that dealt with what we felt were the most important needs in the Irish context, bearing in mind that there was nothing there before that. That is why we chose the under-15 schoolboy team as a pilot programme.”
The FAI, he said, is currently looking at the pilot and considering what is the best way to go forward. The under-15 programme, carried out with the assistance and guidance of the team’s manager Mr Vincent Butler, Dr Richard Quigley, the under-15 team doctor, and the players’ clubs and schools, involves a squad of 20 players, including three with clubs in England – Arsenal, Spurs and Chelsea.
“The process is that, along with the international call-up documents, were: letters from myself and from Mr John Delaney, the Chief Executive Officer of the FAI; an information leaflet so that parents knew what we were trying to achieve; and a consent form,” said Dr Byrne.
“Once the documentation went out, we met with all the parents and guardians and got consent to proceed. The parents were extraordinarily supportive despite the fact that they knew there was a risk that their sons might be excluded. We then went about doing our cardiovascular examination, a document developed with the cardiologists in Tallaght and my own colleagues on the FAI Medical Committee. Each player then had a resting ECG. I then sent the documents to the clubs in England and they were extremely supportive.”
The next step, following the announcement of the squad, was to review the results. “On the basis of that, we decided that two more of the players needed echo-cardiograms, one player needed a halter monitor and one player needed a stress ECG. All the players had very good results and we let them know by phone and in writing, with the important proviso that no test is perfect,” said Dr Byrne.
h4. Extend the programme
The board of the FAI has also been very supportive, he said, and he is hoping that they will approve a plan to extend the screening programme to the next under-15 squad that will be chosen in November. “I would also like to expand it to the under-15 girls development squad,” said Dr Byrne.
Before he became a GP, Dr Byrne went to school in Terenure College and when he left school he joined the Terenure past pupils’ team. His father Johnny Byrne was the manager of Shelbourne and assistant manager of Shamrock Rovers.
At the top level of senior international football, the decision to pass a player fit or unfit can sometimes mean the difference between winning and losing a game, but Dr Byrne stresses that as with all forms of medicine, the safety and well-being of the patient is the only thing that matters.
“It is nice to be working in a sport that you have loved for many years,” he said. “Football is an emotive game, like a lot of sports, and people can tend to think with their hearts. On a personal level, there are times, as a supporter that I would like to be able to pass a certain player as fit to play, but as a doctor it’s an easy decision to make. Decisions boil down to understanding the player, agreement and respect with the manager and an understanding with the clubs.”