OMM residency and pain management

[landotter]

Hi everyone,

I am a second year DO student and am very interested in doing an osteopathic manipulative medicine (OMM) residency once I finish. I believe OMM can play a very important role in managing pain and I was curious if OMM residency trained physicians can do a pain fellowship afterwards. How difficult would it be to attain this fellowship? And how many programs are out there that would accept such physicians? Do any of you know of physicians who have done such a thing?

Thanks!

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[Taus]

I can't directly answer your question, but...

There are plenty of DO's who go into PM&R-->Pain/Sports/Spine who incorporate OMT into their practices...just something to consider.

 

[PMR 4 MSK]

Never heard of someone going from DO to OMM to pain fellowship. I find it unlikely that most pain fellowships would consider that, as most are much more geared toward anesthesia, a few to PM&R, and all of those tend to be in high demand.

You'll likely have to decide which side you want to get in bed with for residency and just stick with it - allopath or osteopath.

 

[Ligament]

David Russo did an OMM pre-doc fellowship, PM&R residency, and then Anesthesiology pain fellowship. He'd be the one to ask.

As for doing OMM in a pain practice, it is a great service to offer your patients. I use OMM for my patients and its a great tool to have.

 

[drusso]

David Russo did an OMM pre-doc fellowship, PM&R residency, and then Anesthesiology pain fellowship. He'd be the one to ask.

As for doing OMM in a pain practice, it is a great service to offer your patients. I use OMM for my patients and its a great tool to have.

OP,

I think most people would be very skeptical of an applicant from an osteopathic OMM/NMM residency background applying to a pain fellowship. In fact, if you want to do an ACGME-accredited fellowship you need to come from an ACGME-accredited residency so you would be "pre-weeded" right from the get go.

On the whole, the OMM stuff is very useful background knowledge, and I don't regret the extra year of training, but I'm hard pressed to say that it has very many practical applications to most of specialty pain management. Every once in a while I see a patient with a "rib somatic dysfunction" or something that has been mistaken for everything from a ruptured aortic anuerysm to renal carcinoma. A little indirect and muscle energy (combined with some skelaxin and PT) does the trick. Usually, the PT's find this first.

Most of the stuff you can "fix" with manipulation or manual medicine modalities has already been "fixed" way before those patients end up in the waiting room of a pain clinic. OMM has much more practical applications in primary care or sports medicine than sub-specialty medicine. On my family practice rotations in medical school, we often got the "Doc, I woke up with a crick in my neck..." patients who responded very well to manual treatment. In pain medicine, it's the "Doc, I've got high grade cervical stenosis and no one wants to touch me patients." Needless to say, no one is very excited about cracking their necks.

If you interested in manual medicine/OMM, do the pre-doc year and then do an anesthesiology, physiatry, or neurology residency if your interests are still in pain.

 

[Disciple]

Most of the stuff you can "fix" with manipulation or manual medicine modalities has already been "fixed" way before those patients end up in the waiting room of a pain clinic. OMM has much more practical applications in primary care or sports medicine than sub-specialty medicine.

Isn't Sports Medicine a sub-specialty?

 

[landotter]

Thanks everyone for your input.

drusso, or anyone else for that matter, I was wondering which PMR programs would allow me to learn/do more OMM and do these same programs have a good match rate for pain fellowships? I would love to split my time between a pain practice where I can perform procedures and also perhaps an OMM practice if that's at all possible.

 

[drusso]

Isn't Sports Medicine a sub-specialty?

Sure, I guess I never really thought of it that way...

 

[freddydpt]

Thanks everyone for your input.

drusso, or anyone else for that matter, I was wondering which PMR programs would allow me to learn/do more OMM and do these same programs have a good match rate for pain fellowships? I would love to split my time between a pain practice where I can perform procedures and also perhaps an OMM practice if that's at all possible.

Nassau sounds like a match.

 

[drusso]

Thanks everyone for your input.

drusso, or anyone else for that matter, I was wondering which PMR programs would allow me to learn/do more OMM and do these same programs have a good match rate for pain fellowships? I would love to split my time between a pain practice where I can perform procedures and also perhaps an OMM practice if that's at all possible.

You'll have to ask at individual programs. Many programs will probably tell you that their attendings can't supervise a resident in a procedure that their faculty don't know how to perform.

 

[PMR2008]

RUSH and RIC have monthly lectures by OMM fellows from CCOM. The lectures are excellent. There are also DO attendings who are more than willing to teach at both places. Michigan State is another program that incorporates OMM in the PM&R training.

 

[PMR 4 MSK]

Thanks everyone for your input.

drusso, or anyone else for that matter, I was wondering which PMR programs would allow me to learn/do more OMM and do these same programs have a good match rate for pain fellowships? I would love to split my time between a pain practice where I can perform procedures and also perhaps an OMM practice if that's at all possible.

Look on the program's websites to see if they have DO's in their departments. Then give them a call to see if they do and teach OMM.

 

[colchicine]

Just curious...are there any DO pain programs ???

I am a DO anesthesiology resident (CA2) interested in pain fellowship...I am an average student/resident as far as scores and my anesthesia residency program is considered "middle of the road program".

To be realistic, what are my chances of getting a pain spot ???

 

[fozzy40]

I heard MSU is a pretty good program that incorporates a lot of OMM.

 

[colchicine]

MSU ?
Where is it ?

Is this an AOA or AMA program ?

Do they still do a good amount of interventional pain ?

 

[drusso]

Just curious...are there any DO pain programs ???

I am a DO anesthesiology resident (CA2) interested in pain fellowship...I am an average student/resident as far as scores and my anesthesia residency program is considered "middle of the road program".

To be realistic, what are my chances of getting a pain spot ???

If you start getting the right experiences now, you'll be fine. Does your anesthesia program have a pain clinic? Can you get some publications or write up some regional or pain related case reports?

 

[fozzy40]

I believe MSU's program is dually accredited.

 

[Whirly]

I am personally aware of one person that did an OMM/NMM residency and then did an anesthesiology-based pain program.... So, it has been done.

With that said, having done an OMM pre-doc fellowship and currently in a PM&R residency, in my opinion, going to a PM&R residency as opposed to an OMM residency is the better way to go if you want to go the pain route. You could still do a pre-doc OMM fellowship, PM&R residency, then pain fellowship - I know of several people that have done this.

At the University of Missouri, Columbia, we have OMM training in the curriculum and are expected to try to use it/learn it at the VA. We also get a chance to use our skills in the outpatient clinics. We have several attendings who have had manual manipulative training, and if you have had prior osteopathic training and want to use it, you will be as busy as you want to be with it.

As far as match rates with fellowships, our program's residents have not had a problem getting spots. We have a solid program and this year we added a former resident, now a pain fellowship trained physician to the staff.

 

[ampaphb]

... and this year we added a former resident, now a pain fellowship trained physician to the staff.

Yeah, but he trained under Steve, and worked with me, so he has all sorts of baggage! 😉

 

[drvlad2004]

I think that the combo of doing an OMM fellowship while in med school, then PM&R residency, and finally pain fellowship will probably make you best well-rounded in MSK and pain mgmt. As far as AOA-approved PM&R programs, the 3 are MSU, Long Beach (LI), and my program at Nassau. I do ton of OMM at Nassau. Thankfully, we have an awesome OMM specialist on staff, who does solely OMM and teaches a lot.

 

[Ligament]

Thanks everyone for your input.

drusso, or anyone else for that matter, I was wondering which PMR programs would allow me to learn/do more OMM and do these same programs have a good match rate for pain fellowships? I would love to split my time between a pain practice where I can perform procedures and also perhaps an OMM practice if that's at all possible.

University of Michigan PMR incorporates and encourages OMM.