Screw it.

Gods, you must be having an easier time than me if you're advocating MORE stuff for us to learn.

I think some schools teach the OMM as part of CME. You may want to look into it.

I realize those things may be controversial or not fully established, at least in allopathic circles.


They're probably even more controversial in osteopathic circles.

http://forums.studentdoctor.net/showthread.php?t=326142

I've heard about some schools starting to include a class or two about alternative/complementary/integrative medicine in their curriculum, which seems like a great idea to me. As you say, if patients are going to be using herbs, supplements, OMM, whatever, it behooves us to know a bit about it. I've heard some talk around my school about making the Rakel book, "Integrative Medicine" a required text, which would be used for some case studies.

Its' good to know the issues surrounding modern health care. I think my med school really lacks information regarding the practice of healthcare in today's world....we spend so much time talking about the touchy feely side, we neglect the practical aspects of practicing medicine.

As an allopathic medical student who will one day be responsible for the care of patients who may inquire about OMM, I think I should have at least some basic idea of what it is, what it does, and so on. I realize those things may be controversial or not fully established, at least in allopathic circles. But my point is, we should know more than we do as future health care providers; whether we buy into it or not, OMM is out there and patients will encounter it and may ask us about it.

I honestly think/hope that within 10 years, there will be some video answers to this. Imagine Bates physical exam videos but more thorough and about OMM. My school, for example, video streams lectures. I can go back and view videos, relearn techniques, etc. It's a matter of time before this goes commercial or gets properly distributed for all interested parties to share in the knowledge and make informed decisions.

*stands shuffling feet, looking at the ground*

As an allopathic medical student with a small bit of recent exposure to osteopathic manipulative medicine (OMM or OMT as it's called), I have a thought regarding allopathic education.

As an allopathic medical student who will one day be responsible for the care of patients who may inquire about OMM, I think I should have at least some basic idea of what it is, what it does, and so on. But my point is, we should know more than we do as future health care providers; whether we buy into it or not, OMM is out there and patients will encounter it and may ask us about it.

You can always become certified in OMM (personal decision) if you wish to incorporate OMM into your practice or you can refer your patients much the same as you would refer a patient who needs a lap chole to a general surgeon.

Nothing prevents you from exploring OMM and becoming knowledgable about it as opposed to adding to the medical school curriculum. I actually believe that osteopathic medical schools would serve their students better by moving OMM to CME or elective as opposed to a curriculum requirement but that's my medical school curriculum development side coming out.

Part of the art of being a good physician is being able to upgrade your knowledge for the good of your patients. There would be no point to residency training and Continuing Medical Education (CME)( I promise you will become well versed in CME when you obtain a permanent license) if all you relied upon in medical practice was what you were taught in medical school. You can fill your CME requirements in any manner that you wish as long you can get CME credit. My hunch is that there are some OMM courses out there where you could pick up some CME credit and learn to your heart's content.

The allopathic medical curriculum has been invaded enough with the inclusion of USMLE Step II CS Exam (added another couple of thousands of dollars to your already expensive curriculum and fees). I don't think that OMM needs to be there.

You can always become certified in OMM (personal decision) if you wish to incorporate OMM into your practice or you can refer your patients much the same as you would refer a patient who needs a lap chole to a general surgeon.

Nothing prevents you from exploring OMM and becoming knowledgable about it as opposed to adding to the medical school curriculum. I actually believe that osteopathic medical schools would serve their students better by moving OMM to CME or elective as opposed to a curriculum requirement but that's my medical school curriculum development side coming out.

Part of the art of being a good physician is being able to upgrade your knowledge for the good of your patients. There would be no point to residency training and Continuing Medical Education (CME)( I promise you will become well versed in CME when you obtain a permanent license) if all you relied upon in medical practice was what you were taught in medical school. You can fill your CME requirements in any manner that you wish as long you can get CME credit. My hunch is that there are some OMM courses out there where you could pick up some CME credit and learn to your heart's content.

The allopathic medical curriculum has been invaded enough with the inclusion of USMLE Step II CS Exam (added another couple of thousands of dollars to your already expensive curriculum and fees). I don't think that OMM needs to be there.

Hi there,

I'm not advocating adding OMM itself to allopathic curricula. *sigh* I'm advocating adding some information about OMM to allopathic curricula so it's not the black box that it is now. I'm certainly NOT advocating that we be tested on our ability to use OMM much less even be taught the technique itself.

As an aside, I'm somewhat surprised that the term "CME" has come to be justification for not teaching important or relevant material. It's the waste paper basket term that apparently encompasses all that isn't covered in medical school but should be. Enter "independent learning," the favorite cousin of waste paper basket. How much does medical school cost? Forgive me, but I think that certain things, such as, oh say a widely practiced technique (OMM) embraced by the only other branch of modern medicine (Osteopathy) ought to be at least mentioned. I think my tuition dollars should afford some teaching. I am glad that it sounds like some schools do at least mention it.

*stands shuffling feet, looking at the ground*

Now I know I'm going to piss some people off with this thread. I am, however, interested in genuine responses to what I'd like to say.

As an allopathic medical student with a small bit of recent exposure to osteopathic manipulative medicine (OMM or OMT as it's called), I have a thought regarding allopathic education.

Regardless of your thoughts or opinions regarding OMM, I don't think many can deny that its totally absent from allopathic education. You may be thinking, "duh, hence why it's allopathic and not osteopathic." And I agree, but what I mean is, we are not even taught ABOUT it, in terms of its existence and basic principles. That puts US in a position of ignorance, because osteopathic medical students learn everything we do, PLUS OMM. We are the ones without knowledge, we are the ones in ignorance... again, regardless of whether or not you buy into OMM. As an allopathic medical student who will one day be responsible for the care of patients who may inquire about OMM, I think I should have at least some basic idea of what it is, what it does, and so on. I realize those things may be controversial or not fully established, at least in allopathic circles. But my point is, we should know more than we do as future health care providers; whether we buy into it or not, OMM is out there and patients will encounter it and may ask us about it.

can't you refer these people to an osteopath, chiropractor or even a massage therapist? if you wanted to learn manipulation, then why didn't you go to an osteopathic school? there's plenty we already have to learn already. if patients ASK you about it, you refer them to other people. if you're doing a PM&R residency, most likely you WILL learn something similar... but it makes no sense for a radiologist to learn it, for example (well this is true of many things) - but it seems to fit with the generally accepted dogma that many osteopaths enter primary care and thus may have to use it.

It seems to me as well that in many, many fields of medicine OMM has absolutely no place. So YOU are not the one in "ignorance" if you want to go into anesthesiology, critical care, dermatology, radiology, nephrology, CV surgery, etc etc etc.

That's like saying that a well-trained Family Practioner is in "ignorance" because he doesn't know how to do an ex-fix on a compound-fractured tibia...

can't you refer these people to an osteopath, chiropractor or even a massage therapist? if you wanted to learn manipulation, then why didn't you go to an osteopathic school? there's plenty we already have to learn already. if patients ASK you about it, you refer them to other people. if you're doing a PM&R residency, most likely you WILL learn something similar... but it makes no sense for a radiologist to learn it, for example (well this is true of many things) - but it seems to fit with the generally accepted dogma that many osteopaths enter primary care and thus may have to use it.

you can refer them, but (i think) the OP was just pointing out that some medical students have never heard the term OMM - some mention of it within the allopathic curriculum might help you decide to which practitioner you want to refer your patient. your patient has some back pain (or whatever) that you think could be helped by one of the before-mentioned people - how do you decide which person might best help your patient? a little education about the differences/similarites between the fields will help you better advise your patients.

Hi there,
I'm not advocating adding OMM itself to allopathic curricula. *sigh* I'm advocating adding some information about OMM to allopathic curricula so it's not the black box that it is now. I'm certainly NOT advocating that we be tested on our ability to use OMM much less even be taught the technique itself.
As an aside, I'm somewhat surprised that the term "CME" has come to be justification for not teaching important or relevant material. It's the waste paper basket term that apparently encompasses all that isn't covered in medical school but should be. Enter "independent learning," the favorite cousin of waste paper basket. How much does medical school cost? Forgive me, but I think that certain things, such as, oh say a widely practiced technique (OMM) embraced by the only other branch of modern medicine (Osteopathy) ought to be at least mentioned. I think my tuition dollars should afford some teaching. I am glad that it sounds like some schools do at least mention it.

Speaking for myself, if I wanted to learn about osteopathic techniques I would've gone to an osteopathic school. If I wanted to become a welder I would've gone to welding school, but I didn't so I enrolled in an allopathic medical school. The fact that lots of people practice OMM doesn't much matter to me; plenty of people take herbs and lots of folks get stuck with needles and some even lay on big magnets all day. If one day I become curious about OMM, or any of these other practices, I'm sure there is tons of free info out there online, or I could find a good textbook or two to read. I have great respect for DOs and view them as equals to MDs in many areas of practice, some don't. If you're arguing that some information regarding osteopathy could help bridge this prejudice gap I could see your point, but I think this it is shrinking on its own anyway. I don't think my school owes it to me to teach it on the same plane as lymphoma pathology and reading EKGs, because it's not on the same level in terms of scientific validity anymore than acupuncture or chiropracty. Plus anyone can start an interest group -- we have one for just about everything imaginable -- but you're talking about forcing everyone to learn this stuff.
I don't think my faculty go out of their way to ignore osteopathy, either; we don't have a blacklist of heretical osteopathic textbooks in the library, and we're not taught to treat DOs as inferior or view OMM as a hoax. I feel like almost everything I learn day in and day out at my allopathic school is important stuff, and adding information about OMM (aka including it in the curriculum, not sure what the difference is) would necessarily displace some of it. There is already a mountain of allopathic information out there but no time to teach it. Later on if somebody asks me an OB question and I'm a surgeon, I'm going to consult an OB or have the patient see one. If for some reason I don't know what they're talking about I'll get out my laptop and google OMM or whatever, then direct them appropriately.

I'm not quite sure how the OP started this topic, but to put in my thoughts...
I think that as a future physician and therefore coordinator of health professionals, I should be aware of other possible complementary techniques. Not that I should have studied them or know specifically how they are proposed to work, but that when a patient presents with insomnia and mentions valerian root/melatonin or my back pain patient mentions acupuncture or OMM, I should have some clue what they're talking about. Otherwise how do I even know where to look? This is especially impt when you consider that patients often take supplements or herbs/etc and don't consider talking to their physician about it as they don't see these as medicine. This isn't an argument for knowing everything about everything, but knowing enough about other modalities to understand what your patient presents with, or even offer your expert advice on efficacy and risks of other types of treatment. If they're taking valerian and I don't know that or what it is and I prescribe lorazepam or zolpidem, my patient could suffer respiratory depression or worse and then I'm screwed for not knowing about these things.
I may not have a huge interest in OMM or acupuncture and I may not agree with the prescribing of unregulated and unverified substances, but I need to know that these things are out there to keep myself aware of my patients' choices, that's my responsibility as their physician. So I don't think that a footnote in the lecture about it and it's benefits and risks is too much.
Well, that's my rant.

when a patient presents with insomnia and mentions valerian root/melatonin or my back pain patient mentions acupuncture or OMM, I should have some clue what they're talking about. Otherwise how do I even know where to look? This is especially impt when you consider that patients often take supplements or herbs/etc and don't consider talking to their physician about it as they don't see these as medicine. This isn't an argument for knowing everything about everything, but knowing enough about other modalities to understand what your patient presents with, or even offer your expert advice on efficacy and risks of other types of treatment. If they're taking valerian and I don't know that or what it is and I prescribe lorazepam or zolpidem, my patient could suffer respiratory depression or worse and then I'm screwed for not knowing about these things.

You do realize that valerian root and melatonin, among others, are mentioned in First Aid for the USMLE step 1? I think you're underestimating people...

You do realize that valerian root and melatonin, among others, are mentioned in First Aid for the USMLE step 1? I think you're underestimating people...
Nope, didn't realize that...man I gotta get a copy of FA...didn't think boards were coming up so soon.
I apologize for insinuating an insult, that wasn't my intent.
Still, I see that as supporting my point. Complementary therapies and treatments are indicated as an objective in the USMLE, so some sort of introduction/mention should be made during lectures so that future physicians are at least aware of these modalities.
I'm not a huge proponent of many alternative treatments, but if my future patients are undergoing chiropractic or OMM treatments, then I should be aware of that as their physician. The same goes for their treatment by a cardiologist, orthopedic, or neurologist...etc. I guess what I'm advocating is a full and open shared knowledge base about the patient and their treatment. I don't think you should just refer a patient and not have any idea what the result was or have no idea what procedures were performed or prescriptions written.
If I misunderstood the topic matter and the points you made, then I apologize, but that's my reaction.