Exercise in medicine: challenges and opportunities integrating qualified exercise professionals (QEPs) into Canadian healthcare

Despite growing evidence on the role of physical activity in preventing and managing chronic disease, integration of qualified exercise professionals (QEPs) into the Canadian healthcare system remains limited and inconsistent. We explore the systemic and professional challenges hindering QEP integration, based on findings from a national initiative led by Exercise is Medicine Canada. Consultation occurred with numerous stakeholders across Canada and 10 leaders in health and exercise professions were interviewed. Using thematic analysis, four key barriers were identified: (1) overlapping and unclear scopes of practice; (2) insufficient clinical training and experiential education; (3) limited public and provider understanding of QEP roles; and (4) a reactive healthcare system that undervalues prevention. Participants emphasized the need for standardized, competency-based education and credentialling pathways aligned with clinical expectations, as well as improved communication of the distinct value QEPs offer in chronic disease management and health promotion. These findings highlight opportunities for coordinated action among academic institutions, professional bodies, and healthcare policymakers to advance the integration of QEPs and better support physical activity and exercise as a cornerstone of healthcare.