I thought OMM would make me a rockstar at USMLE MSK questions. I was wrong.

[deleted1139416]

It seems like a lot of my friends and I struggle with MSK on USMLE because it feels like the OPP COMAT writers purposely design OMM content to be non-overlapping with USMLE MSK content.

Here is a list of USMLE MSK content I can come up with that NEVER shows up on OPP COMAT:

SCFE
LCP
Charcot marie tooth syndrome
Metabolic/neurological causes of ataxia
Diabetic MSK foot changes
Developmental dysplasia of the hip
I also BARELY see questions about ankylosing spondylitis, lupus, RA, etc
And there are many more examples.

It's like the OPP COMAT writers actively come up with MSK content that comes up on USMLE and then purposely don't put it in there. Also - it's very bizarre that the surgery COMAT doesn't test ortho but the NBME surgery shelf does.

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[DOVinciRobot]

None of those topics have anything to do with OMM… not sure why you think OMM would prepare you for that MSK stuff, or why it should be on the OMM COMAT..

 

[deleted1139416]

None of those topics have anything to do with OMM… not sure why you think OMM would prepare you for that MSK stuff, or why it should be on the OMM COMAT..

Because they are included in the differentials for MSK dysfunctions. A 75 yo m comes to the office with ankle pain - is it a fibular head somatic dysfunction or a diabetic foot? A 16 year old girl comes to the clinic with hip pain - is it an SI joint dysfunction or SCFE?

 

[Cornfed101]

Because they are included in the differentials for MSK dysfunctions. A 75 yo m comes to the office with ankle pain - is it a fibular head somatic dysfunction or a diabetic foot? A 16 year old girl comes to the clinic with hip pain - is it an SI joint dysfunction or SCFE?

Diabetic foot for the first one, SI joint dysfunction for the second.

 

[Osteosaur]

It's pure garbage. Even the "oh, well, it's good for back pain don'cha know! Coming to the office weekly and paying cash saves them a whole ibuprofen pill because they'd totally go into ESRD if not for us!" cope is nonsense.

The OMT treatments or diagnoses barely integrate with actual msk issues.

Always got 50th percentile or so on boards. In preclinical I learned it to pass. After that I figured any time spent learning OMM for boards was time I could spend studying something that might have clinical relevance.

 

[JBM16BYU]

Of the things listed above, I think SCFE, developmental dysplasia of the hip, and LCP all show up on the pediatric COMAT; ankylosing spondylitis, SLE, and RA are all rheumatologic conditions so may show up on the internal medicine COMAT since rheumatology is a fellowship post-IM; CMT, ataxia, and even diabetic foot changes (ex. Charcot joint, diabetic polyneuropathy, etc.) would show up on more of a neurology exam rather than the OPP COMAT (although there is not a neurology COMAT).

It is important to realize though that osteopathic neuromusculoskeletal medicine (ONMM) and musculoskeletal medicine are different. This may be over-generalizing, but typically if someone presents with low back pain, in an ONMM-sphere it will be diagnosed as "lumbar somatic dysfunction"; whereas, if this same complaint came into a PM&R, sports medicine, pain medicine, orthopedic surgery, or neurosurgery practice, diagnoses such as "spondylolysis", "muscle strain", "spondylosis", "mechanical low back pain", "facet arthropathy", etc., will be more commonly used, depending on the history, physical exam, symptom pattern, imaging, etc. The two practice paths may share common complaints; however, the diagnostic approach, terminology of diagnoses, and treatment of these complaints will vary.