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BACKGROUND: Football has the highest injury rate among high school sports, yet few studies have assessed medical staffing of high school games and practices. OBJECTIVE: To gather information from Chicago public high schools to evaluate medical supervision of varsity football games and practices. METHODS: Athletic directors of all 77 Chicago public high schools were faxed questionnaires to complete. If questionnaires were not returned, investigators called athletic directors, and the survey was then completed over the telephone and the results tallied. RESULTS: A total of 59 (76.6%) of the surveys were completed by the schools. Of the 47 schools with football programs, 10.6% had a physician on the sideline at games, 8.5% had an athletic trainer present, and 89.4% had a paramedic available. No high school reported having a physician or paramedic present at football practice, and only one school had an athletic trainer available. Hence, in all but one school, coaches were the only staffers available at practice to deal with medical problems. In 89.4% of the schools with football teams, coaches were certified in first aid and cardiopulmonary resuscitation. CONCLUSION: Comparison of this study with a similar one done in 1980 reveals that, despite greater recognition of athletic injuries, appropriate medical supervision during games and practices for high school athletes is still lacking. Better care of high school football players may be achieved by the use of certified athletic trainers. In addition, physician involvement may be improved by increasing musculoskeletal training for physicians in medical school and family medicine training. [ABSTRACT FROM AUTHOR]