The Black Star Medical team does not determine who makes the team | Kafui Dey interviews Dr Pambo

The Doctor on the Bench: A Conversation with Dr. Prince Pambo

He has been to South Africa for a World Cup, to Brazil, to Qatar, to Morocco for AFCON and FIFA tournaments, to Germany for a PhD, to Nottingham for his sports medicine training, and through so many passports that he renews one every year because they fill up. He is a sports and exercise medicine specialist, a PhD holder in sports cardiology, FIFA match doctor, CAFA medical committee member, doping control officer, and lecturer at the University of Ghana. But to 33 million Ghanaians, he is the head of medical for the Black Stars — the man on the bench, 57 days from game one of the 2026 FIFA World Cup, who decides not who plays, but who is available for the coach to make his selection from.

57 Days Out: What the Head of Medical Does

The preparation started long before the countdown. As the major European leagues wrap up and intensity rises toward the end of the season, every weekend and midweek becomes a viewing exercise — multiple screens, monitoring player after player for injuries. The head of medical does not choose the squad. But he determines availability. And availability, as he puts it plainly, equals team success.

The job involves constant contact with club doctors and physios across Tottenham, Atletico, MLS teams, and everywhere else Ghana's players are based. It involves procurement — medications, equipment, logistics — coordinated with the GFA and the Ministry. And it involves the sustained personal relationships with players that make the medical conversations possible when they matter most.

Mohammed Kudus and the Injury

The news of Kudus's injury came when Dr. Pambo was in the US. It hit, he says, like dawn — that moment before you are fully awake. Beyond the football, he has a personal relationship with the player. His first call was to confirm directly. The conversations were devastating. From there, the protocol: inform the head coach, inform the federation, get in contact with West Ham's medical team to understand the nature and timeline of the injury.

The difficulty at this stage is that the club has not issued official timelines, partly because the club itself is under pressure from a relegation battle and partly because the player's treatment path — surgical or conservative — has not yet been confirmed. The club will give the player options, and the player will decide. Until then, there is no definitive answer on whether he will make it.

Dr. Pambo's advice to the new head coach: plan without him. If a player's availability is uncertain, the wisest preparation assumes absence. And being fit, he adds, is not automatic selection — the coach still makes that judgment on form and readiness.

The Most Difficult Decisions

The hardest calls are not medical in a technical sense. They are the moments when the doctor is the only person in the room who can tell the coach that the player everyone expects to play — the player the country is counting on — will not be available.

He has had coaches push back. Some suggest putting the player on the bench anyway — for the psychological effect on the opposition. He can live with that, as long as the player does not play. What is harder is when the going gets tough mid-match and a coach, forgetting all prior medical conversations, signals for the injured player to warm up. The doctor is sitting close enough to see it happen. The player looks back at him, asking silently whether to go. Sometimes the player goes in and plays brilliantly. And the next day, the injury is worse. The report that goes back to the club doctor does not mention the coach's overruling. It just records what was found, what the plan was, and what happened. It is, he says, quite embarrassing to write.

One example stands out: under-20 football, coach Salah Tetteh. A player said he could not play. Dr. Pambo confirmed it medically. The coach called them both into his office and asked directly. In front of the coach, the player said: if you give me the opportunity, I will play. The coach put him in the starting eleven. He scored from the halfway line. He was substituted. Within a couple of years, that injury had ended his career.

Match Day

The first thing you check on World Cup match day is your own heartbeat, your own blood pressure, your own mental state. If you have slept three hours it is a good night, because the final preparations — fixing players, checking logistics, long conversations with coaches — run late. The pressure is not a weakness; it is investment. The doctors who feel no pressure on match day are not competing.

Match day is not for treating injuries. The preparation was done before. Match day is making sure everything is ready: the ice chest full, the cold sprays in place, the massage beds set, the towels out. Ice and cold spray are the two things that go onto the pitch with the physio when a player goes down — applied immediately to slow inflammation, because there is not enough time for a full ice treatment on the field. The freezing spray slows the generation of heat and pain enough to get the player through the next few minutes.

He does not like running onto the pitch himself. His physios handle that. But non-contact collapses — a player who goes down without being struck — are cardiac arrest until proven otherwise. Those, he runs to.

Sports Cardiology and the Black African Athlete Heart

His PhD, funded by FIFA and completed in Germany, studied something that had been quietly causing Ghanaian and African players to fail medical examinations at big European clubs for years. The left side of the heart becomes thicker with sports participation in all athletes. In Black African athletes, it gets significantly thicker than in Caucasian athletes. The result looked, on scans and ECGs, almost identical to hypertrophic cardiomyopathy — a condition affecting the heart muscle that can trigger sudden cardiac arrest. Clubs were disqualifying players on the basis of this finding.

The research — his and that of colleagues in the US and UK studying Black athletes — established that this is not a pathological condition. It is a healthy adaptation. The heart is contracting harder, pushing more blood more forcefully. It is genetic, and it is more pronounced in West Africans than East Africans, reflecting the difference between sprint-based and endurance-based sports. The outcome of this body of research was a new set of ECG interpretation criteria specifically for Black African athletes. What used to be written as abnormal is now documented as the Black African athlete heart.

The field continues to evolve. The current approach when a concerning finding is made is what he calls shared decision making: sit with the player, their spouse or family, present all the options and the realistic probabilities, and let the player make an informed choice. In Africa, the challenge is that agreeing to let someone compete with elevated cardiac risk means guaranteeing rapid emergency response capacity — fully equipped ambulances and trained EMTs at the ground. That, he says, he cannot always guarantee here.

Warning Signs Nobody Should Ignore

Chest discomfort of any kind. Breathlessness or difficulty catching breath. Dizziness. Palpitations — a heartbeat you can suddenly hear or feel when you never noticed it before. Fatigue that is disproportionate to the exertion. All of these apply equally to athletes and to the general public. He has lost two close friends recently, both with warning signs they did not act on. There is almost always a warning sign. The tests — ECG, echocardiography, cardiac MRI — are available in Ghana. ECGs are affordable. Nothing, he says, is more expensive than a life.

Doping Control

As a FIFA and CAFA doping control officer, he has worked tournaments across Africa and the Middle East. The process begins with education — ensuring athletes and medical staff know which substances are prohibited. The list is dynamic and available through WADA's website; he checks it himself before procuring medications.

Testing can happen out of competition — any time from 12 hours before a game to the gaps between matches in a tournament. A central command chooses which players to test; the doping control officer does not select them. In-competition testing in football typically means two players from each side, chosen from the central command, notified by the match doctor five minutes before the final whistle. The players go straight from the pitch to the doping control room with chaperones.

Urine samples — minimum 90 millilitres — are the most common collection. After a match, dehydrated players can sit in the doping control room for three or four hours before they can produce enough. A player who refuses is sanctioned with a minimum four-year ban. Cannabis is a prohibited substance if detected above a threshold level. In football, he says, doping is genuinely uncommon — technique and positioning matter far more than raw endurance, and the substances that enhance endurance dull the focus and decision-making that football actually requires.

Injuries: What Fans Get Wrong

Timelines. A player trains normally in the morning. By the afternoon, the medical team has scanned a knee and found a partial ACL tear, a meniscus issue, a ligament problem not visible to the eye. The doctor tells the coach. The coach tells the media: ruled out. The fans saw the player training fine two hours ago and cannot understand how this is possible.

The most common injuries at Black Stars level are muscle injuries — contusions, tears, soft tissue trauma — and, increasingly, ACL ruptures. The rise in ACL injuries across world football is a direct consequence of match load: the volume of games played, especially in the English Premier League where players can be on a Sunday-Wednesday-Sunday cycle while also serving their national teams. The head of medical's role includes advising coaches on training load regulation. When there are persistent injuries at a club, the medical team must examine whether pitch quality, hydration, or training volume is contributing.

Life on the Bench

He sits fourth from the head coach. The doctor, the physios, and the masseurs all work the bench. When the team is losing in the 85th minute and haven't scored, everyone on the bench is insulting the coach under their breath, wanting substitutions that have already been made. The coach sometimes hears it. Sometimes not.

After a defeat, nobody speaks. The medical team keeps working — there are still bruises to dress and knees to check — but the room is heavy. If the team played well and lost against a good opponent, some coaches come in and acknowledge the effort. If it was a shameful result, everyone works in silence, cleaning up the ice chests and packing the sprays, privately rehearsing exactly which pass, which slip, which missed goalkeeper timing led to the moment.

Ghana Armchair fans and pundits who tear into players on television and then meet those same players at events and immediately become effusive supporters are a consistent source of private amusement for the medical team. The pressure they create, however, extends to families. His daughter, aged six at the time, was told by her teacher after a Ghana defeat to go home and tell her father to take better care of the boys. She called him in tears.

The World Cup Moments

He was in South Africa for 2010, attached to the team in an organisational and medical support capacity but not yet the first doctor. The penalty moment against Uruguay — Asamoah Gyan stepping up in the last seconds — he experienced the way every Ghanaian did. For weeks afterwards he would wake up checking to see if FIFA had sent some communication overturning the result. He saw Gyan two weeks before the interview. You don't have those conversations, he says. You just laugh.

Brazil 2014 he was in camp as second doctor. Qatar 2022 was his first World Cup as head of medical. The team played Portugal, lost but played well, then beat Korea. He looks forward to the US, Canada and Mexico with quiet excitement — and with 57 days left on the clock.

His favourite personal role is not Black Stars head of medical. It is FIFA match doctor — the role where he has no emotional stake in either team, exists purely to support colleague doctors and protect players on both sides, and can watch the game with clear eyes.

On Ghanaian Stadiums and Fan Safety

Ghana's stadiums are not adequately equipped. He does not enjoy watching club matches at the stadium because he knows that if something happened — a cardiac arrest in the stands, which he has responded to before, including at the Accra Sports Stadium — the right tools would not be there. The single most important item every stadium should have is an AED, the automated external defibrillator. After that: a fully equipped ambulance with trained emergency medical technicians present throughout the match. In the US and Morocco, this is standard. Here, it is not yet.

The Person Behind the Job

He grew up in the north. His father was a king in Buliman. He attended St. Charles Minor Seminary in Tamale — the best school in the northern region at the time, a Catholic institution he converted to qualify for. He came in wanting to become a doctor. The seminary produced four priests from his class, a disproportionate number of doctors, engineers, and one notable lawyer.

He studied medicine at KNUST, did clinical work at Komfo Anokye, traveled to St. George's Medical School in London for electives, and then returned. The sports medicine path opened in 2008 during AFCON in Ghana — working alongside foreign team doctors at the tournament, watching how they operated, and thinking: this is something I want to do. He found Nottingham University's programme online, secured a scholarship, and went. The PhD in sports cardiology followed, in Germany, funded by FIFA. The question he brought to it — what is happening to the hearts of Black African footballers? — is the question that changed how those players are medically assessed.

He teaches exercise physiology to postgraduate physiotherapy students at the University of Ghana, covering the cardiovascular and respiratory systems and their response to training and sport. He works as medical director at Parliament House Clinic and medical superintendent of the Civil Service Polyclinic. He spends perhaps 200 days a year outside Ghana. He renews a passport every year because it fills up with stamps.

What keeps him awake at night is simpler than any of that: he wants to see his daughters become independent before he dies. That is the real pressure — not the scores, not the injuries, not the fans. Just time.