Any holistic/integrated approach to medicine in allopathic schools?

[Dragonfly411]

For those of you who are medical students or just graduated from medical school (both osteopaths and allopaths), I really need your advice.

I want to become a physician who considers mind, body, and spirit when treating patients. I understand that osteopathic schools take this holistic approach, and I have been seriously considering whether I want to become an osteopathic physician. I have read extensively on the philosophy behind osteopathy, and it resonates well with my beliefs in medicine.

However, I am concerned about the education of osteopathic schools. In particular, I am uncertain as to how much the osteopathic education is geared towards fulfilling this holistic philosophy, because most people say that D.O.'s and M.D.'s are the same anyway, except that D.O.'s use the osteopathic manipulation technique (OMT). In fact, some osteopathic students on SDN have expressed dissatisfaction because their basic sciences education is not well-centered on the holistic approach, and instead, they just learn OMT as an extra technique. So, is the philosophy behind D.O. schools distinct from M.D. schools solely because of this technique, instead of integrating it in the whole curriculum? And in the classroom, are osteopathic students learning the same way and same things as allopathic ones?

My other concern about attending D.O. schools is that I feel I most likely will have to take both the COMLEX AND USLME when applying to allopathic residency programs (since the D.O. residencies are few, and they may not provide as well qualified medical training as allopathic ones, as commented by osteopathic students on SDN), and I want to avoid that situation because I feel that taking one set of Boards is enough. Also, I've heard that it may be more difficult for D.O.'s to get into certain allopathic residencies when compared to M.D. students. Second, I feel like the education in an allopathic school would be more competitive, because the students seem more qualified in terms of their intellectual abilities (as evidenced from higher MCAT scores and GPA). I want to be in a competitive environment because I feel it would challenge me and raise my standards for learning. (Granted, I know this may be a judgmental statement, so if anyone feels differently, I welcome your comments.)

Thus, by attending an allopathic school, I feel I may receive a better education, but the downside is, I may not be trained in the holistic way I want to practice medicine.

So, that being said, here are my questions for you:

1) For those of you who attended or are attending allopathic schools:
A. Do you feel that your basic sciences education involved any holistic approach? Or was the philosophy behind your education strictly "treat the disease" instead of "treat the patient"?
B. During your four years, were you aware of any opportunities for exploring medicine in a holistic manner? E.g., Can you complete certain fellowships, certification, or extra training in alternative medicine techniques or OMT?

2) For those of you who attended or are attending osteopathic schools:
A. How did your science classes incorporate the holistic philosophy in its curriculum?
B. How do you feel about the effectiveness of OMT?
C. Do you feel that your school was competitive, or did it seem laid-back?

My goal is to become a physician who ensures the well-being of his/her patients, and I feel that practicing medicine in a holistic manner is the best way. I know that once you receive your degree, you are ultimately responsible for your further education, so I feel that even if I do become an M.D., I can pursue a holistic approach by educating myself in other areas (like alternative medicine and OMT). Meanwhile, I am concerned about applying to D.O. schools because of certain issues, such as taking two sets of Boards, having increased difficulty of acceptance into residency programs, and not being educated in a challenging and competitive environment.

I am young and I am Pre-Med, so I welcome any advice, criticism, or comments from you older and wiser people. Thanks so much for reading all of this.

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[Tanzo]

For those of you who are medical students or just graduated from medical school (both osteopaths and allopaths), I really need your advice.

A. Do you feel that your basic sciences education involved any holistic approach? Or was the philosophy behind your education strictly "treat the disease" instead of "treat the patient"?

Could you explain what you mean by "treat the disease" v. "treat the patient"... Do you REALLY think that any medical school is churning out physicians who are treating individual diseases in a vacuum? I hear people say this all the time, particularly as the difference between DO and MD, and I have to say, after two years of school, I have no idea what they could be talking about... So, I would be happy to answer your question if I felt it was answerable - I just feel that the distinction is nonsense...

 

[SKloggGirl]

1) For those of you who attended or are attending allopathic schools:
A. Do you feel that your basic sciences education involved any holistic approach? Or was the philosophy behind your education strictly "treat the disease" instead of "treat the patient"?
B. During your four years, were you aware of any opportunities for exploring medicine in a holistic manner? E.g., Can you complete certain fellowships, certification, or extra training in alternative medicine techniques or OMT?

There are certainly allopathic medical schools with more access to alternative/integrative/complementary medicine clinics/facilities/faculty through which you could rotate during your clinical years and from whom you can be exposed to integrative philosophies of healing. I go to a medical school that is very "traditional" by reputation, which amounts to some of the positives that you have mentioned, like a solid education in the established, evidence-based sciences that have to be known no matter what your "approach to the patient" is. During my first two years, I was discouraged by how black-and-white, rigid, and tunnel-visioned everything we learned seemed to be in many of the basic sciences; the idea of the whole being more than the sum of the parts was to be pondered on your own time and after you passed the exams. Disease is presented as an "other" -- an outside attacker to be squelched and excised or overpowered by pure science and chemicals.

YET, if you keep your eyes open, no matter where you are (if you do your best to pick a school that isn't blatantly opposed to your goals), you can find faculty to have goals very similar to what you mentioned. I came to seek something very similar to what you have described. Based on a couple, rarely interspersed lectures on botanical medicine, eastern philosophies of healing, and mind-body medicine, I found mentors who I have been able to help me to cultivate this part of my goals, while still getting the "rigid" science background that is necessary. For example, here at Jefferson, they have a Center for Integrative Medicine that is available for clinical rotations, with faculty who are very open to receiving students interested in this approach. The University of Arizona School of Medicine (an allopathic school) is home to the only accredited fellowship in Integrative and Alternative medicine that I know of in the country. This is where the ever popular guru in Alternative Medicine, Andy Weil, is based. I believe you have to have done a primary care residency to apply for this fellowship, and there aren't many positions. Yet, if you were there, you would be surrounded by faculty who could help you develop that side of your professional goals while you were in medical school (preceptorships, research, electives, etc.). There are many such allopathic medical schools with well-developed Integrative and Complementary facilities on their campuses, such as the University of Maryland, which is highly funded by the NIH NCCAM division (complementary and alternative medicine).

The way I see it, the "integrative" philosophy is a state of mind in the student or the physician much more than it is a set body of information that you must expose yourself to. If you have the former, you will be able to find the latter in many places and create the education you want to find. I realized, probably the hard way in many aspects, that I was getting frustrated with my "environment" not because of a deficiency in the environment as much as my expectation that the people around me would feed me what I wanted. That just isn't the mentality of the medical profession as a whole yet. We are making progress towards open-mindedness in many ways, but it is still an infantile-stage movement, and because of that, you have to be more of a "creator" of the education you want to find than a participant. For example, one of the mentors that I referred to was actually an emergency medicine physician with desires very similar to what you have mentioned; he went to different places all over the world to learn and practice those methods of care, and people come from all over the city to see him and others in their practice now. It didn't take an official fellowship -- just finding like-minded people and putting yourself around them. There is something to be said for the basic sciences, no doubt. Without them, the abstractions and bridges that we build into the arenas of complementary and alternative care would at best be the empty advertisements and pop-medicine that is so prevalent in the press; even worse, they could be harmful. That same mentor once told me something that I will never forget. He said that when he first started working in the E.R., he would get frustrated with what he saw as all the different clinical opportunities where alternative methods of care would have been a better way to go. And then, he realized, that in many cases (especially in that setting), the answer really was "no -- not the right approach," and many of the patients very well would have died without the measures of care they DID receive. A time and a place for everything was the lesson I suppose.

Hope this helps...

 

[Jasminegab]

For those of you who are medical students or just graduated from medical school (both osteopaths and allopaths), I really need your advice.

I want to become a physician who considers mind, body, and spirit when treating patients. I understand that osteopathic schools take this holistic approach, and I have been seriously considering whether I want to become an osteopathic physician. I have read extensively on the philosophy behind osteopathy, and it resonates well with my beliefs in medicine.

Thus, by attending an allopathic school, I feel I may receive a better education, but the downside is, I may not be trained in the holistic way I want to practice medicine.

My goal is to become a physician who ensures the well-being of his/her patients, and I feel that practicing medicine in a holistic manner is the best way. I know that once you receive your degree, you are ultimately responsible for your further education, so I feel that even if I do become an M.D., I can pursue a holistic approach by educating myself in other areas (like alternative medicine and OMT). Meanwhile, I am concerned about applying to D.O. schools because of certain issues, such as taking two sets of Boards, having increased difficulty of acceptance into residency programs, and not being educated in a challenging and competitive environment.

I am young and I am Pre-Med, so I welcome any advice, criticism, or comments from you older and wiser people. Thanks so much for reading all of this.

Dragonfly,

Although I share your outlook in a healthcare system that is in need of serious reform, this topic has been covered before and many SDNer's feel that anyone interested in holistic medicine is a quack. However, you don't have to take my word for it. Just do a search on naturopathic medicine and you'll see that the majority of SDNer's feel that holistic medicine should not even exist. I have even started a thread on doctors who get the MD/NMD and then open integrative medical practices and it was as if I said something that plucked a nerve on SDN.

As far as you getting a holistic medical approach while in an Allopathic medical, sure some offer a few courses but that's about it. Your not going to have the knowledge or the respect from the naturopathic community. I've seen both sides. The naturopathic medical student point at the short coming of allopathic medical students and allopathic medical students point at the short coming of naturopathic medical student.

If you truely want a holistic medical approach to medicine, sadly I can't say that it exist as of yet. Everyone is tossing stones at each other and we have just begun to try to unite both sides. Of course you can always take a few courses here and there. However, if you want to be truely accepted you must decide which direction your going to take.

Hope this helps....

 

[Su4n2]

in reply to treating disease vs patient question.

say you have a 55 year old African Americal woman coming to your office with high b.p even though you have adviced her tostay of salt, etc
she tells you that her boyfriend is in jail, her daaugter is pregnant, her mother is very ill and they both live with her. she works all day as a waitress to make ends meet as she is solely supporting her family. she keeps mentioning the stress of having all these situations. you keep lecturing about the low salt, taking her meds, etc. that is treating the disease. treating the person would mean that you see how her socio-economic status, family situation, work contribute to her b.p. this was an actual case we read about while i was getting my m.p.h

to the OP, if you are interested in osteopathic medicine, PM me, i think you are quite wrong in some of your assesments, but i don't want to get into it here. Interms of OMM, this is the whole body approach. one of its basic tenets is that the whole body is interconnected - nerves, muscles, ligaments, bones, viscera and that is why you should never just treart isolated problems but treat the whole person.

 

[Gleevec]

MD or DO is just a degree, a body of knowledge made manifest in two letters after your name. However, it by no means dictates the manner in which you practice or choose to further educate yourself.

Holistic medicine seems to be more jargon than a set curriculum. If you want to practice holistic medicine, I dont see how a medical school curriculum will be a particular boon or disadvantage to that goal. You will get the knowledge via either path, its how you implement it that determines whether you're practicing "holistic medicine"

MDs are oftentimes misconstrued as "not treating the patient, only the disease." I think a lot of that has to do with MDs being known as the research arm of medicine, as well as the fact that MDs make up a higher percentage of specialists. And as anyone who has done research knows, you break down the problem into solveable compartments. However, that doesn't mean that in treatment that you ignore other factors. In seeing MDs take a history, they almost without fail take into account lifestyle and socioeconomic factors (aspects I imagine that are generally classified as "holistic"). To not do this makes one a poor doctor, MD or DO.

If you want to practice holistic medicine, ultimately that is a decision left up to you as opposed to the medical school curriculum that you choose. Knowledge and practice are two seperate things, and someone who desires to treat the "patient as a whole" can do so readily from either knowledge base (which from what I understand, is generally quite similar with the exception of OMT).

 

[Gauss]

crap
reading this garbage gives me a headache
I'm gonna go chew on some roots and then do some bloddletting, maybe that'll help my headache

why is a pre-med asking about osteopathic med in the allopathic forum?

 

[8744]

There is no difference betweeen DO or MD education except that DO schools do a little "manipulation." (Somebody correct me if they don't) We all are taught to treat the "whole patient." In fact, unless you take consults by email or over the phone it is impossible to not treat the whole patient. I want somebody to explain how an MD is less able to treat the "whole" patient. Are you all confused because most DOs go into primary care where by definition they treat more of the whole then a specialist?

Now, are we taught in an MD school to get inside the patients head, follow him home, learn his language, and otherwise engage in some kind of glorious, emotional masturbatory cross-cultural empathetic circle-jerk?

No.

Sorry.

On the other hand, all of this "naturopathic" holistic stuff is just crap. Snake oil and worse which both DOs and MDs should shun. If the DO profession is going to embrace "aromatherapy" and "colonics" then go for it but don't complain when people associate you with chiropracters.

 

[8744]

in reply to treating disease vs patient question.

say you have a 55 year old African Americal woman coming to your office with high b.p even though you have adviced her tostay of salt, etc
she tells you that her boyfriend is in jail, her daaugter is pregnant, her mother is very ill and they both live with her. she works all day as a waitress to make ends meet as she is solely supporting her family. she keeps mentioning the stress of having all these situations. you keep lecturing about the low salt, taking her meds, etc. that is treating the disease. treating the person would mean that you see how her socio-economic status, family situation, work contribute to her b.p. this was an actual case we read about while i was getting my m.p.h

to the OP, if you are interested in osteopathic medicine, PM me, i think you are quite wrong in some of your assesments, but i don't want to get into it here. Interms of OMM, this is the whole body approach. one of its basic tenets is that the whole body is interconnected - nerves, muscles, ligaments, bones, viscera and that is why you should never just treart isolated problems but treat the whole person.

I hear this all the time. What's there to understand? The most important thing here is to understand that she can't afford expensive medications so HCTZ might be better then an ACEI in her case. Other then that I challenge you to tell me how your greater understanding of her underlying social pathology is going to get her to stop eating so much fat and salt and to exercise.

I mean, what you're saying is that her hypertension is a cultural thing and only your greater empathy will manage it which is horse****. Either the patient respects the physicians abilities and opinions or they don't. If the patient's culture makes them mistrustful of modern medicine then you are out of luck.

 

[Jalopycat]

I was visiting a friend during Thanksgiving last year and while there, her mother-in -law started talking about how she sees a DO for her RA and how she prefers the DO because their philsophy is that "they treat the whole person and not just the disease". It was all I could do to keep from laughing when she said that. Anyone who believes that DO's have some special "gift" at treating "the whole person" over an MD has been sold a bill of goods.

MDs and DOs both treat the whole person! If you want to be a DO, then fine. But don't go to DO school thinking that (other than manipulation therapy) your education will be that much different, especially if you choose an MD residency. 🙂

 

[8744]

I mean, you can treat their minds and spirits 'till the proverbial cows come home but until you get their hypertension or their diabetes under control you are just engaging in expensive amateur psychotherapy.

I believe some of you folks are setting yourself up for disappointment in medicine by getting all geared up to treat the sophisticated "boutique" patient who believes in the latest pseudo-scientific snake oil du jour. When you get in the trenches, say at a charity hospital you will find that the patients don't want you to get on their level. Much of the reason they respect you is because you do not share their background and have eschewed a life of crack-whoredom to study medicine. If they want to relate they'll hang out at the trailer park.

I exxagerate, of course, but what the patient wants from a doctor is respect, an understanding of their medical problem, and a clear treatment plan which is carefully expained to them. Nowhere is it necessary to make their cultural background a priority unless it interferes with the logistics of your treatment. If they didn't want western medicine they'd skip the hospital and have a their local witch-doctor sprinkle some chicken blood on them.

Jeez, people.

 

[tubbs]

if you can make it into an allopathic school go for it. the DO vs. MD is just a load of crap. as mentioned before, i don't know of any allopathetic doc who was trained to simply cure the disease. we all look at the patient as a whole too. when you're in med school, you're not forced to think a certain way. if you want to consider the "spiritual" aspects of medicine...you can do that on your own at any med school. there's a lot of bs of DO's treat the patient where as MD's simply treat the disease. this is so ******ed. listen, if you want to get into a good residency program there shouldn't be any hesitation in choosing MD...otherwise you're in for a very rough ride. and you and everyone else knows this as well. basically, go for MD, but if you can't make it and still wanna be a doc, go for DO.

 

[Jalby]

I personally believe the person with hypertension should have been given ginko biloba or something else that hasn't been proven to do anything. Or maybe ephedra. Something that would kill her.

Personally, I don't think much of alternative medicine. Anything in alternative medicine that is usefull or more usefull would have already been found.

As for doctors become whole people, you get tested on it all the time on the boards (I'm serious) There are tons of questions where they give you a scenario and then give you choices of what to say. So you do have to be a good person in order to score well on the boards.

 

[Su4n2]

Panda,

yes, in that womans case it is essential for her to take the hypertension drugs and to reduce her salt. but an understanding of her social and family situation will make u understand that nmaybe salt reduction is not her #1 priority. a visit with a social worker, nutrtionist, etc may help her deal with her underlying issues which may make her much more willing to listen to the doc's "reduce salt" message.

i never said this was unique to DOs, in fact i tink what started the "whole body approach" of DO's is the fact that OMT is the whole body approach.

- ok back to path

 

[sophiejane]

Dragonfly,

You will get more responses from people who are actually at DO schools and can more accurately answer the questions you wanted answers to from specifically from DO students if you post on the osteo board.

Otherwise you are going to get a lot of secondhand information and speculation.

SJ

 

[mjs]

Univ of Washington has a CAM research program and there's a lot on Complementary and Alternative Medicine awareness in the curriculum. According to the stats I've heard, you'll see CAM use in a large minority of your patients in any urban setting. Furthermore in immigrant and Native American populations its even more common, so we talk a little bit about how to talk to CAM practitioners.

As far as "Treating the patient" style medicine goes: it is hard to find in textbooks, but good GPs always find a way to make it their priority, be they MD or DO. There's less and less difference between the two than either discipline likes to think.

 

[zenman]

Posted by Panda Bear: If they didn't want western medicine they'd skip the hospital and have a their local witch-doctor sprinkle some chicken blood on them.

You are aware that's what's happening aren't you...at least with MD office visits?

 

[Dragonfly411]

Dragonfly,

You will get more responses from people who are actually at DO schools and can more accurately answer the questions you wanted answers to from specifically from DO students if you post on the osteo board.

Otherwise you are going to get a lot of secondhand information and speculation.

SJ

Hi sophiejane,
Actually, I already posted my question on the Osteopathic forums, and I haven't received any responses from osteopathic medical students.

Just want to thank everyone for responding to my post. I really appreciate your comments!

 

[jake2]

I'm confused about what you mean by "holistic" and "mind, body, and spirit."

If your question is are MDs and DOs trained to deal with psychosocioeconomic issues that patients deal with, then the answer is yes. Once you are in your clinical med school years and beyond, you will see and deal with these issues on a very regular basis (patient is noncomplient, patient can't afford meds, patients problem is worsened to do stress in life, patient is engaged in self-destructive activities, etc.)

If your question is do mainstream MDs and DOs use alternative medicine, I think the word "alternative" answers your question. A doctor simply shouldn't prescribe a treatment for a medical problem that has not been shown to work on a regular basis. Even when prescribing a drug off-label, studies should be available to show that it works and there is usually a basic science, mechanismic justification for its use. The exceptions to this rule are 1) of course when you are trying to prove a drug works during clinical trials. There are very well described procedures for clinical trials and studies. 2) When trying to reduce the patient's stress, improve their lifestyle, or treat non-pathological processes in general. In these situations, I have seen physicians recommend acupuncture, yoga, etc., pretty much anything that likely won't have any ill effects. (Chiropractic medicine, when improperly practiced, for example, can definitely be dangerous.)

If your question is do allopathic physicians treat the body's organ systems in complete isolation, or "ignore the bodies ability to heal itself" as many snake oil salesmen claim, the answer is very obviously no. Anybody who has spent any time in medical school, allopathic or osteopathic, quickly realizes the absurdity of these claims and you will usually get a very indignant response if you make such a statement.

 

[8744]

You are aware that's what's happening aren't you...at least with MD office visits?

But that doesn't mean chicken blood has any curative powers beyond a placebo effect. Trust me, if a patient want's to try something wacky I've got no objection as long as it doesn't interfere with my treatment and the patient doesn't ask for my approval. I had a patient ask me about aromatherapy once. I said it was harmless, probably pleasant, but her renal failure was going to require dialysis. Other then that if she wanted to throw her money away I have no objection. She needed to hear this from her doctor (well, her student-doctor anyways) because most patients respects their doctor's opinions.

Folks, if naturopathic or herbal medicines have any efficacy they will be brought into the evidence-based medicine practice. There are no shortage of diligent researchers trying to prove that some of these things work. But the majority of the "alternatives" are utter crap on par with crystal therapy and pyramids. I suppose that anything will work if you factor in the placebo effect. On the other hand, it is now considered unethical to give a patient a placebo.

 

[zenman]

Posted by Panda Bear: On the other hand, it is now considered unethical to give a patient a placebo.

How do you figure that since the placebo effect CAN be stronger than anything else? Also much surgery is placebo.

 

[Tanzo]

How do you figure that since the placebo effect CAN be stronger than anything else? Also much surgery is placebo.

Are you saying that as long as a treatment is effective, it is ethical?
Also, how would you plan to get informed consent for your placebo?

 

[8744]

How do you figure that since the placebo effect CAN be stronger than anything else? Also much surgery is placebo.

No. If you give the patient a medicine which you know to be useless but the patient thinks is good medicine then you are fooling the patient and violating the ethical requirement for informed consent and patient autonomy. I am not referring to the placebo effect you get from any medications, particullarly anti-depressants, which are prescribed in good faith with a reasonable knowledge of their mechanism of action and probable effects.

Not to mention that sometimes you have to say "what the hell," and give the patient a harmless medication if he insists it makes him feel better. This is part of the "art" of medicine. But I wouldn't build a whole treatment paradigme on this.

The placebo effect may be strong but it is not a substitute for real treatments. I don't know of any cancers which can be encouraged to go into remission by sugar pills. And laughter, except that it decreases stress which decreases cortisol levels and disinhibits the immune system to some extent, is not the best medicine.

I also don't know what the placebo effect has to do with an appendectomy or small bowel resection except that, for reasons similar to what I said above, a happy patient will heal faster all other things being equal.

The problem as I see it is that, not being content to nibble around the edges of medicine offering an occasional good idea and serving as an outlet for patient's frustrations, alternative medicine is trying to impose itself as an equally valid treatment modality with evidence based medicine. It is clearly no such thing and has the same problems which inflict chiropractic, namely it is a haven for quacks, a repository for snake-oil, and plagued with low standards and cheap thrills.

 

[DOnut]

2) For those of you who attended or are attending osteopathic schools:
A. How did your science classes incorporate the holistic philosophy in its curriculum?
B. How do you feel about the effectiveness of OMT?
C. Do you feel that your school was competitive, or did it seem laid-back?[/I]
.

Hi Dragonfly,

As an osteopathic medical student entering my 3rd year, I can give you my perspective. To answe your questions above:

A. There is really no integration of a "holistic" philosophy in the basic science curriculum. Physiology is physiology, Biochem is biochem, pathology is pathology. There is no way to get around this. Facts are facts.

B. OMM is the main difference between the allopathic curriculum and osteopathic curriculum. The main focus of OMM is homeostasis of the neuromusculoskeletal system and pain reduction. That's pretty much it. There are many techniques that have been used for year by many practitioners (currently manual medicine in physiatry is being highly researched and many osteopathic physicians are entering this specialty.) As far as my opinion of OMM, there are many techniques that are extremely successful, there are also some that do not work very well, and have only shown anecdotal success in journal articles. In reality, you will use the techniques you are personally comfortable with, and this is ONLY if you enter a specialty where this is acceptable.

C. This third question makes me laugh. Medical school is medical school. 3- 4 points on the MCAT and .2 difference in average undergrad GPA will not make a school easy. During medical school, you are not competing with anyone except yourself. There are always gunners in every class. There are also slackers. You will also find students who some how have the ability to apparently do nothing and still perform at the top of the class. Most people, however work their A$$ off. I can say that at least at NYCOM, 2nd year is hard. I can say that I worked harder this year than I ever have in my life. If you want to challenge your self, you will definitely have every opportunity.

As far as taking the COMLEX and the USMLE,.......

Well, I can say this. ~65-70% of graduates of NYCOM enter allopathic residencies. Not all of them took the USMLE. Personally I am taking the USMLE, but this is just to keep as many doors open for me as possible. I would also have to say that there are EXCELLENT osteopathic residency programs out there. There are osteopathic urology, ophthalmology, derm and neurosurgery programs that are extremely competitive and you must make top scores to even be considered. NYCOM's neurosurgery program in my opinion is the only one I would even consider in the osteopathic world. It is simply phenominal.

Ok, let me get back on topic. AS far as alternative medicine, we take a course at the begining of the second year in complementary and alternative medicine. This course mostlt focuses on the many herbal medications that patients take. This course DOES NOT teach you to use or prescribe herbals, but it does teach you the common drug drug interactions that can occur if a patient is using an herbal medication. That's about it.

As was said before, your personal style of medical practice is really up to you once you graduate and finish your residency training. The difference between allopathic medicine and osteopathic medicine is really not that significant, so my suggestion would be to choose a medical school you are comfortable with. You can practice medicine any way you wish when you are finished. Do not choose a school solely based on the degree offered. I hope this helps.

 

[merlin17]

these quotes are interesting. i think that my allopathic school discusses how the patient's situation affects his/her disease almost every day and i go to a very research heavy school. that is almost exclusively what i get out of tutorial (we do pbl). every case we discuss has some sort of "social message" where we get to discuss issues of ethnicity, socioeconomics, age, gender, religion and spirituality etc. and how they affect our relationship with the patient, the patient's experieince with disease and the patient's experieince in the healthcare system. i almost feel like i'm being hit over the head with it! now this is not discussing alternative therapies (that would be nice, but i guess i can't complain too much)...although i have been taught over and over again how important it is to determine what non-traditional therapies the patient is using and also to make sure that i understand the patient's explanatory model for their illness and how his spirituality affects his perception of his disease.

i'm only a first year...i'm hoping there will be more to come.

 

[8744]

these quotes are interesting. i think that my allopathic school discusses how the patient's situation affects his/her disease almost every day and i go to a very research heavy school. that is almost exclusively what i get out of tutorial (we do pbl). every case we discuss has some sort of "social message" where we get to discuss issues of ethnicity, socioeconomics, age, gender, religion and spirituality etc. and how they affect our relationship with the patient, the patient's experieince with disease and the patient's experieince in the healthcare system. i almost feel like i'm being hit over the head with it! now this is not discussing alternative therapies (that would be nice, but i guess i can't complain too much)...although i have been taught over and over again how important it is to determine what non-traditional therapies the patient is using and also to make sure that i understand the patient's explanatory model for their illness and how his spirituality affects his perception of his disease.

i'm only a first year...i'm hoping there will be more to come.

The basic explanatory model of many patients, and I say this without rancor, is that they are lazy, ignorant, and helpless. I don't know if this is an ethnic thing because it seems to cut across all races. When you start treating patients who won't buy their blood pressure medication because it cuts into their cigarette money you will understand what I mean. $150 per month for Kools. $20 per month for HCTZ. No contest. Same with the patient who can't afford the Nicoderm patches because, and follow me here, they cost almost as much as his monthly tobacco bill.

For many, the only non-traditional therapies they are using are KFC 1 Bucket PO TID. I think your professors are romanticising your patient population. It is true that you may encounter some exotic specimen from an alien culture who swears by marmoset testicles as the only cure for heart disease but most of your patients will be just normal folks who will place their trust in Western medicine. Even the "exotics" must know, on an instinctual level, that whale penis is not as efficacious as Ciprofloxin otherwise they wouldn't come to your hospital.

 

[Amy B]

Hi Dragonfly,

As an osteopathic medical student entering my 3rd year, I can give you my perspective. To answe your questions above:

A. There is really no integration of a "holistic" philosophy in the basic science curriculum. Physiology is physiology, Biochem is biochem, pathology is pathology. There is no way to get around this. Facts are facts.

B. OMM is the main difference between the allopathic curriculum and osteopathic curriculum. The main focus of OMM is homeostasis of the neuromusculoskeletal system and pain reduction. That's pretty much it. There are many techniques that have been used for year by many practitioners (currently manual medicine in physiatry is being highly researched and many osteopathic physicians are entering this specialty.) As far as my opinion of OMM, there are many techniques that are extremely successful, there are also some that do not work very well, and have only shown anecdotal success in journal articles. In reality, you will use the techniques you are personally comfortable with, and this is ONLY if you enter a specialty where this is acceptable.

C. This third question makes me laugh. Medical school is medical school. 3- 4 points on the MCAT and .2 difference in average undergrad GPA will not make a school easy. During medical school, you are not competing with anyone except yourself. There are always gunners in every class. There are also slackers. You will also find students who some how have the ability to apparently do nothing and still perform at the top of the class. Most people, however work their A$$ off. I can say that at least at NYCOM, 2nd year is hard. I can say that I worked harder this year than I ever have in my life. If you want to challenge your self, you will definitely have every opportunity.

As far as taking the COMLEX and the USMLE,.......

Well, I can say this. ~65-70% of graduates of NYCOM enter allopathic residencies. Not all of them took the USMLE. Personally I am taking the USMLE, but this is just to keep as many doors open for me as possible. I would also have to say that there are EXCELLENT osteopathic residency programs out there. There are osteopathic urology, ophthalmology, derm and neurosurgery programs that are extremely competitive and you must make top scores to even be considered. NYCOM's neurosurgery program in my opinion is the only one I would even consider in the osteopathic world. It is simply phenominal.

Ok, let me get back on topic. AS far as alternative medicine, we take a course at the begining of the second year in complementary and alternative medicine. This course mostlt focuses on the many herbal medications that patients take. This course DOES NOT teach you to use or prescribe herbals, but it does teach you the common drug drug interactions that can occur if a patient is using an herbal medication. That's about it.

As was said before, your personal style of medical practice is really up to you once you graduate and finish your residency training. The difference between allopathic medicine and osteopathic medicine is really not that significant, so my suggestion would be to choose a medical school you are comfortable with. You can practice medicine any way you wish when you are finished. Do not choose a school solely based on the degree offered. I hope this helps.

A great, well written post!!!