How holistic of an approach do D.O. schools take?

[Dragonfly411]

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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.

 

[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?

I posted this to response to your post in the other forum, but here it is...

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...

 

[LloydDObler]

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?

We are taught biochem the same way as allopathic students. I don't know what the "holistic" way of teaching physiology would be. I do feel that we are taught to think holistically in our OTM class and our clinical skills class. In fact, I often wonder, no offense meant, how MD students learn to touch patients and palpate structures, etc..., since they don't have the OTM stuff.

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.)

After reading this, I am unclear as to why you are even interested in osteopathic schools. If you are already planning an allopathic residency, then there is probably no point in going DO. To speak to your specific points, it sounds like you have been reading SDN ALOT, and I would suggest actually going to visit a DO school and an MD school to get a more realistic experience. Or shadow some doctors. The basic sciences taught at both schools are the same. You don't have to take both boards to go to an allopathic residency. Some will take COMLEX. However, you can't sit for the allopathic boards if you don't take the USMLE. Residencies happen. As for competitiveness. Those folks are EVERYWHERE, and I avoid them like the plague. My DO class has many competitive students, and many laid back students, as I am sure is the case at most DO and MD schools. More "qualified"? If you are choosing to base "qualified" for medical school on undergrad grades and MCAT, then I suppose you could say that there are more and less "qualified" DO and MD schools. If this is particularly important to you, then you may want to focus on schools that advertise high scores.

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?

They don't incororate any philosophy into basic sciences. As I said, I don't know how this is really possible. Basic sciences are just that. Learning glycolysis with a wholistic bent isn't particularly useful. We learn anatomy and OTM together, so that when we are learning the back, for instance, we are learning it in both classes. Which I think is helpful, by the way. Again, the OMT and clinical class are taught with the approach of examining the entire patient situation, not just the presenting symptoms. Is this specific to my school? I really doubt it.

B. How do you feel about the effectiveness of OMT?

I think it is very effective. Aside from its effectiveness, there is something very powerful about touch. It is very cool to be able to treat patients manually and they respond well to this. You should go see a DO who practices manipulation to see what you think.

Competitivness? We have both slackers and freaky gunner people. I am guessing this is mostly the same everywhere.



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 don't know what to say about your concerns. I don't want to say that they aren't valid, but I think that if you were really into osteopathy, they wouldn't be that big of a deal. And I can definitely say that med school is challenging and competitive regardless of the school. There's no way you won't be challenged, unless you are a super genius who can memorize loads of information. I just took my last final of my first year, and I am exhausted. I'm guessing the Harvard kids are tired too.

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.

Good luck. Go see some schools. Go see some doctors. That's how you'll figure this out.

 

[Adapt]

I posted this in your other thread but I'll post it here again. The following is an article from the JAOA comparing the status of alternative medicine at MD and DO schools.

http://www.jaoa.org/cgi/content/full/104/3/121