The solution to MCPS' dire athletic trainer shortage

Empty Athletic Trainer Room

Photo: The empty athletic trainer room at Blair high school.

The empty athletic trainer room at Blair high school. Photo courtesy of Beck Rowe.

Blair junior and varsity basketball guard Hoang-Van Cao limped across Blair Boulevard hoping to find a trainer. He recently suffered an ankle injury from basketball and needed to receive treatment, but when he walked to the trainer’s office, he was met with a locked door. Cases like Cao's are all too common. 

Across Blair and Montgomery County, students have felt the consequences of the athletic trainer shortage. Athletic trainers offer vital support for treating and preventing injuries. However, this resource is stretched extremely thin. At the beginning of the 2022-2023 school year, 21 of the 25 MCPS high schools were provided with trainers. There needs to be a surplus to ensure that there is adequate coverage.

In order to provide the proper support to student-athletes across Maryland, schools have had to adapt, sharing trainers while prioritizing high-risk sports.  

The Shortage

A mixture of increasing requirements and COVID-19 caused the athletic trainer shortage. In recent years, the requirements to become a certified athletic trainer have grown dramatically. Before, only a bachelor’s degree was necessary, but now one must also complete a master’s degree from the Commission on Accreditation of Athletic Training Education (CAATE), pass the Board of Certification (BOC) examination for an athletic training license and then complete Continuing Education Requirements. 

Even after a lengthy certification process, athletic trainers work under unfavorable conditions. According to Blair’s athletic director Rita Boule, athletic trainers are underpaid, overworked, and stressed out. "Athletic training is an underpaid profession, people are coming out into athletic training and working incredible hours and their salary is what it is... How long can one do that? They can't sustain that level of care," Boule says.

The COVID-19 pandemic only exacerbated existing challenges as all medical personnel were overworked. The pandemic facilitated change by decreasing the number of available athletic trainers.

MCPS previously used a vendor system; they would hire athletic trainers from vendors like MedStar or Pivot. The system was meant to be beneficial for both parties. The schools would obtain medical personnel while the vendors would gain business from students referred by trainers to use their services. During the pandemic, vendors had trouble providing the proper amount of trainers. In the 2022-23 school year, Northwest, Blake, Poolesville, and Magruder went without an athletic trainer due to the shortage. Blair also lacked an athletic trainer for almost the entire second semester and was not able to refill the position by the end of the year.

The Athletic Trainer Effect

Athletic trainers not only offer medical care, but strengthen the entire school community. Meghan Wilkinson, a former athletic trainer at Blair who now works at Walter Johnson, explains that one of her favorite parts of being an athletic trainer is the set of relationships that she builds along the way. “A lot of my personal stories just come from the relationships I've made throughout the years. Coming back into the school system, I was at a new school and I had parents recognize me from years ago, which was very honoring. ...Something simple, like just taking care of an athlete, is remembered for a very long time,” Wilkinson says.

Montgomery County did not have athletic trainers till around ten years ago. Wilkinson, emphasizes the importance of having athletic trainers in schools. “The county coaches and athletic directors really realized how much [athletic trainers] are needed,...the coaches and athletic directors don’t have the knowledge, education or experience dealing with certain things when they’re trying to coach or manage,” Wilkinson says.

The absence of athletic trainers can cause major issues. When an athlete gets injured, instead of calling for the athletic trainer, the athlete will go to the hospital. Forcing families to deal with injury can be costly, as some sports teams do not require insurance. 

Montgomery Blair had a trainer for the first semester, Dr. Kelce Tanler. According to sophomore wrestler Kevin Arevalo, Tanlers’s care at Blair is what allowed him to participate in sports again. "I fractured my back, and I'm very thankful that she helped me recover, get physical therapy, and helped me stretch. I'm [now] able to run, jump, and lift all because of her,” he says. Athletic trainers make the difference between an injury that ends your high school career and a hiccup on the road to success.

The Solution

To provide the proper amount of support, athletic trainers are now directly employed by MCPS, on the MCPS payroll system, rather than outsourced through the vendor system.

Wilkinson thinks that this new system is a huge step for athletic trainers. “I think it's great for our profession…it’s going to open up a whole bunch of opportunities within the state,” she says. The system makes sure that trainer’s have stable jobs that will not be affected by external pressure. Other counties in Maryland may try to replicate this system as a similar payroll system has greatly benefitted some counties in Virginia. By directly controlling the salaries of trainers, schools can attract more support. Fairfax County, for example, has used the payroll system and now has two athletic trainers per school. 

The switch is no small matter. It completely restructures the system across Montgomery County, changing the relationship MCPS has with vendors entirely. Sullivan describes the time, effort and organization it took to successfully advocate for the new system. "It was a calculated success story in terms of advocacy…I equate it to the athletics world. We joined forces and locked arms to push this forward," Sullivan says. 

The shortage of athletic trainers in Montgomery County schools highlights the need for proper medical support for student-athletes. Athletic trainers play a vital role in ensuring the well-being and safety of athletes, and with the new payroll system, they will become a more reliable source of care. MCPS is leading the way and other counties will soon follow. With this solution — the new payroll system — MCPS has pledged that all schools will have an athletic trainer by the start of the 2023-2024 school year. Blair athletics will have taken an important step towards a balance of competition and safety.