Manipulations

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HoumanMD

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I am a 3rd year medical student at an allopathic medical school and am very interested in doing a one month rotation in musculoskeletal manipulations in my 4th year. However, I havne't been able to set it up through any DO programs. Please help,
Houman
 
you could try to accomplish something like this through a PM&R outpatient rotation. find somewhere that's heavy in mskel medicine. I know Harvard has courses in OMM so that might be a place to check out. I would contact programs and specifically ask about exposure to outpatient manual med.

I'm not sure any of the DO schools will allow you to rotate. Good luck

-J
 
HoumanMD said:
I am a 3rd year medical student at an allopathic medical school and am very interested in doing a one month rotation in musculoskeletal manipulations in my 4th year. However, I havne't been able to set it up through any DO programs. Please help,
Houman

I'm a former physical therapist turned medical student. Any large teaching hospital with a good sized outpatient physical therapy department likely has a certified therapist with many years of manipulation/mobilization experience. Personally, I wouldn't trust the PM&R docs that I've worked with to do any manipulations on me. Physical therapists are great, and they are fanstastic teachers. Check them out.
 
I think DOctor Jay might have been referring to DO PM&R docs. Look at UPENN PM&R.
 
HoumanMD said:
I am a 3rd year medical student at an allopathic medical school and am very interested in doing a one month rotation in musculoskeletal manipulations in my 4th year. However, I havne't been able to set it up through any DO programs. Please help,
Houman

You might try to contact DO's that do manipulation personally. In other words not through the clinical ed department of a DO school. You can go to the directory and look for your geographical area and just call and see who does omm and who might be interested in taking students.
http://www.osteopathic.org/directory.cfm

I would be glad to look in AZCOM's preceptor database for contact info too if you want to PM me your geographical location. I also know an MD that has an all OMM practice in Kansas if you are in that area he might be very excited to have you rotate with him.
 
thanks for all the quick input guys, now this begs the question, how much of OMM can I pick up in a month?
 
Antiviral22 said:
I'm a former physical therapist turned medical student. Any large teaching hospital with a good sized outpatient physical therapy department likely has a certified therapist with many years of manipulation/mobilization experience. Personally, I wouldn't trust the PM&R docs that I've worked with to do any manipulations on me. Physical therapists are great, and they are fanstastic teachers. Check them out.

PT does not equal DO. It depends on what type of "manipulation" you want to learn. If you want to learn PT, rotate with a PT. If you want to learn manipulative medicine (which can't really be accomplished in a 4 week rotation, but at least you could get some exposure to know what we do), then you need to find a DO.

You might be better off finding a private DO OMT specialist than trying to go through a school.

Good luck.
 
yeah, I'm a continuing PT and also med student. You would learn a lot of manual med from a PT but it sounds like you want to learn manipulation specifically (PTs are limited in most states in terms of being able to do HVLA type manipulations so not the best choice here).

4 weeks wouldn't be enough to become proficient but you would probably at least get exposed to a good range of techniques in that time. You may have to put in a lot of time with the doc before they let you practice on their pts though.

J
 
HoumanMD said:
thanks for all the quick input guys, now this begs the question, how much of OMM can I pick up in a month?

I am not sure how motivated you are. I know it definitely took me longer than a month (ok probably longer than 6 months) until I felt totally comfortable even diagnosing something with some degree of certainty. However, if you are really interested. Your preceptor could recommend a lot of reading and show you a lot of techniques and discuss a lot of concepts with you. If you could then do another month later with the same preceptor after practicing on all of your friends like 6 - 8 months later you might really benefit. You are right though - DO students have 2 years of practice and theory before we hit the preceptor's office. Maybe you might want to wait and take some of the manipulation for MD classes after you graduate I think MSU does them, but I am not 100% sure. I know they are out there though.
 
You could just go to the anual AOA convocation or pick yourself up a copy of Savarese OMT review for basic concepts or An Osteopathic Approach to Diagnosis and Treatment. The only reason I mentioned PENN PM&R is b/c they have quite a few DO's there that do manipulation and it may be easier than trying to get your school to approve an OMM rotation.
 
What about looking at chiropractic colleges?? They are MUCH better trained than DO and PT's in manipulation simply due to the longer time they spend learning and honing the skill.

Just an idea...
 
jesse14 said:
What about looking at chiropractic colleges?? They are MUCH better trained than DO and PT's in manipulation simply due to the longer time they spend learning and honing the skill.

Just an idea...
better then the avg student...probably...then an OMM specialist.....no....and its a pretty different scope/style of tecniques except for HVLA (the high velocity thrusting stuff)
 
jesse14 said:
What about looking at chiropractic colleges?? They are MUCH better trained than DO and PT's in manipulation simply due to the longer time they spend learning and honing the skill.

Just an idea...

I don't think an md could get credit for a rotation at a chiropractic college - he could probably get family practice credit for an OMM rotation - most are boarded in family practice. Ditto what Taus said -but I must admit the OP is getting a bunch of good brainstorming on this thread!
 
HoumanMD said:
I am a 3rd year medical student at an allopathic medical school and am very interested in doing a one month rotation in musculoskeletal manipulations in my 4th year. However, I havne't been able to set it up through any DO programs. Please help,
Houman

Houman,

Why don't you try getting in contact with the West Virginia School of Osteopathic Medicine? I know their department allows allopathic students if they have no osteopathic students scheduled. Your contact person would be Dr. William Lemley.
 
JuniorsMom said:
Why don't you try getting in contact with the West Virginia School of Osteopathic Medicine? I know their department allows allopathic students if they have no osteopathic students scheduled. Your contact person would be Dr. William Lemley.

I didn't realize that they did this (I am a student there), but if they do and you can get in, it would probably be a great experience. 3 of the 4 OMM docs are really good, and you can also sit in on 1st and 2nd year Osteopathic Principles and Practice lectures and labs.
 
jesse14 said:
What about looking at chiropractic colleges?? They are MUCH better trained than DO and PT's in manipulation simply due to the longer time they spend learning and honing the skill.

Just an idea...
I completely disagree. You absolutely cannot make the generalization that a chiropractor is better trained in manipulation than a DO. If you are talking about most DO's who do primary care, then yes, probably. However someone who specializes and practices OMM on a daily basis is probably better trained(in my biased opinion) than a chiropractor at getting down to the core underlying problem. I don't know much about different schools of chiropractic thought but I do know OMM and I do know people that are proficient with OMM do AMAZING work.

Like I said, i don't know much about chiropractic philosophy, but OMM is much more than re-alignment.
 
just tagging along, to my knowledge chiropractic school is 4 years and you're done

The most recent addition to DO's who teach OMM at my school are now coming out with the following...
4 years DO school (OMM) + 1 year internship (OMM) + 3 years family medicine (OMM) + 1 year neuromusculoskeletal fellowship (basically OMM fellowship)

With this in mind I think it's a poor assumption to say chiros are "MUCH better trained"

to the OP if you do decide to spend time with a chiro which I'm sure would be much easier to establish, you could probably call it a Complimentary and Alternative Medicine rotation - it's all in the terminology
 
jesse14 said:
What about looking at chiropractic colleges?? They are MUCH better trained than DO and PT's in manipulation simply due to the longer time they spend learning and honing the skill.

Just an idea...

Actually, chiropractors are not better trained at all. And this statement is supported by the chiropractic literature. From: http://www.chiroandosteo.com/content/13/1/10

"While the standards for chiropractic education have advanced over the years, there remains much work to be done. Doxey and Phillips, in their paper on entrance requirements to the various professional health care disciplines demonstrated that chiropractic colleges have the least stringent matriculation requirements [4]. Currently, only one chiropractic college requires a baccalaureate degree as an admission requirement. Seven states currently require a baccalaureate degree before granting a chiropractic license and seven have it under consideration, but few of these require that the degree was acquired before entering chiropractic school [5]. There is currently no required chiropractic college admission test."

"Undergraduate training in chiropractic school consists of approximately 4,200 clock hours of didactic and practical education, with the last year spent treating patients, in some cases while still attending classes. There is only one chiropractic college in the U.S. that follows the academic standard of two semesters per year. Trimesters or quarter systems of education within chiropractic were used in an effort to reduce the time spent in school.

In general, the first four to five academic terms are spent studying basic sciences while also learning the basics of spinal examination and treatment. Terms five through eight are spent in clinical classes such a diagnostic imaging, clinical neurology, physical examination, geriatrics, pediatrics, case management and the like. In addition, it is during these terms that students refine their diagnostic and treatment skills for the management of joint diseases, primarily of the spine."​

4200 clock hours is FAR less than either a DO or a DPT. Oops. But the worst is yet to come...

"Chiropractic externs are currently required to complete 250 joint manipulations, 20 complete history and physical examinations, 20 radiology studies and 15 complete patient workups, from admission to discharge, during their last year in chiropractic school (externship) while treating outpatients. The CCE is mandating that these numbers increase incrementally over the next 6 years to a total of 35.

Often these outpatients seen by chiropractic externs are friends and family members, some of whom are even paid by interns to attend the clinics for care. Nyiendo and Haldeman give credence to this finding in a study in 1986 where they concluded that "patients [in a chiropractic college teaching clinic] are not truly representative of patients seen by chiropractors in the field; they are relatively young, with mild complaints." The study concludes by suggesting that these students' clinical training may not reach the level that is necessary to manage patient problems in active practice after graduation [6]. Nyiendo confirmed these findings in 1990 [7]. Further investigation suggests that these patient types are consistent amongst chiropractic school clinics [8]."​

Now I can assure you that both DOs and DPTs treat actual, sick patients, not recruited family members. An as an allopathic student I performed "250 (medication doses or procedures), 20 complete history and physical examinations, 20 radiology studies and 15 complete patient workups" in my first two weeks of my third year internal medicine clerkship. DOs have the same training. I always knew chiropractic education was a joke, but I never realized it was this bad. Scary, really, really scary.

😎
 
I'm a novice to the DO way of life. Not to hijack the thread, but do any of you feel that traditional Allo students like myself are at a disadvantage by not knowing or even being exposed to any of the OMM techniques that have been mentioned?

Also, thanks for the advice of those of who have posted in this thread. Interesting read.
 
Dunce said:
... do any of you feel that traditional Allo students like myself are at a disadvantage by not knowing or even being exposed to any of the OMM techniques that have been mentioned?

From what I have been exposed to via classroom instruction, anecdotal accounts, and parts of the limited body of osteopathic research, OMT/OMM is pretty cool for a couple of reasons. First, OMT can be used to treat pesky musculoskeletal problems (e.g. low back pain) that end up really affecting the quality of people's lives. Now there are other modalities (PT, acupuncture, massage, etc.) that can be effective here. Where OMT is unique is in integrating structural findings with visceral dysfunction and using structural techniques to modify the ANS and lymphatic function. One classic cohort study (I think) from the early 1900's compared hospitalized patients during a flu epidemic who received OMT to those that didn't and found dramatically improved outcomes with OMT (decreased length of stay and mortality, I think). It also seems like I heard some data about OMT dramatically reducing postoperative ileus in a lecture once. While a lot of research needs to be done to validate the efficacy of OMT, I am pretty confident that much of it will prove beneficial to patients and perhaps even useful for lowering healthcare costs (decreased hospital stay= decreased healthcare costs). 👍
 
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