Again, not to be argumentative or to flame anyone, but there is a lot of discussion on these forums about how similar MD and DOs are with regard to their education, and I agree (save for the OMM part, which I learned nothing about), but what accounts for the large difference in passage rates, and why would curricula need to be altered if you are taught the same stuff as allopaths? Are your curricula now based on just the short-sighted puropse of passing the COMLEX or being a good doc?
It seems as though DOs have access to all the same USMLE prep materials and question banks (Amazon.com) as allopath students, so differences in how questions are worded should be mitigated by proper preparation.
Just curious.
I'll take a stab at this one. I feel like the quality of education may be comparable (i.e. there are good and bad DO schools just as there are good and bad MD schools... while there may not be a John Hopkins of DO land, I think the "average" DO education is roughly comparable in quality to the "average" MD education), but the focus is different.
We learn the same drugs and bugs. We learn the same anatomy, even if the average DO student gets a little more exposure to it. We learn the same physiology and the same pathology. But past that, differences do start to become more apparent, and I for one
do not think that osteo and allo are the same except for the inclusion or exclusion of OMM. Osteopathic education may cover biochem, but at least at my school (which seems to teach more biochem than many others) not to the degree necessary to do well on that part of the USMLE. And molecular is even further behind (though we did have several lectures on this at my school, and I did have several molecular biology questions on my COMLEX).
On the other hand, I'm not convinced that all allopathic students are prepared for the clinical aspects of the COMLEX exam, which I found to be quite different between the two. While the USMLE put a heavy emphasis on clinical diagnosis, the COMLEX goes further and puts a heavy emphasis on clinical management. I didn't have a single question on my USMLE asking what the appropriate drug was (unless it was a very obvious "which one does not have a contraindicated side effect" type of question), or what the best imaging study to order would be, or what the next best step in clinical management would be. I didn't have a single question on how to handle a certain obstetrics case, or manage a guy in back pain. Never was I asked when pharmacotherapy was appropriate or inappropriate, or when medical management was preferred over surgical management. At least a quarter of my COMLEX consisted of just that type of question.
But you could argue that this is more "step II" material, and you'd be right... if you are talking about the USMLE step II. Perhaps this type of early clinical education isn't stressed at many allopathic schools, or perhaps it just isn't tested on step 1. I'm not positive which is the case, but from talking to friends I have to wonder if it is the former.
And I'm not knocking the allopathic education approach in any way... if they think it makes more sense to teach basic science in the preclinical years (and test that), and clinical management in the clinical years, it would be hard to argue with their logic. But it is true that osteopathic education seems to emphasize an early dose of clinical training, well before we are actually on clinical rotations. And I can't say that this approach has no merit either... after all, the end goal is to train us to be physicians, not science teachers.
Bottom line is that the answer to your question is that while many pay lip service to the two extremes (osteo is just allo + OMM, or on the other end osteo has an entirely different philosophy in every way than allo), the truth is that the education
is different... perhaps not in quality of teachers, or difficulty, or scope, but rather focus. There are some things that may be taught and tested in one branch that isn't so much in the other, and that is not limited to manipulation techniques.
Thus, being taught to "pass the COMLEX" isn't short sighted... it isn't just that the NBOME/AOA thinks that it is a good
test, but also that this clinical-heavy approach makes for a good
education - i.e., to "be a good doc" as you state. AOA believes those goals are one and the same, as they should be if you design a test to cover what you feel are essential competency areas.
But not all of those competency areas overlap between the two. And I might catch some flak for saying this, but I believe that if you removed all of the OMM specific content and questions from the COMLEX, pass rates for MD students taking it (hypothetically) would be lower than is the case for the USMLE, just as DO students have lower pass rates for the USMLE than for the COMLEX. I'll catch flack for this as well... but I don't think the difference would be quite as pronounced, even though I think it would exist. MD students have, on average, proven themselves to be better test takers (whether from intelligence, knowledge, discipline, test taking skills, whatever) and I'm sure that would carry over to some degree to the respective board exams.
