Omt

[dude11]

Have you guys gone over to the osteopathic thread? I have been looking into their discussions and they talk about OMT and have a lot of opinions about it. The DO students basically talk about how they have to study OMT but that it's not really evidence based or there is little scientific research to back it up. Also, they said they have hard time in lab doing OMT because some people are good at it while others are not and produce different results.

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[USArmyDoc]

Have you guys gone over to the osteopathic thread? I have been looking into their discussions and they talk about OMT and have a lot of opinions about it. The DO students basically talk about how they have to study OMT but that it's not really evidence based or there is little scientific research to back it up. Also, they said they have hard time in lab doing OMT because some people are good at it while others are not and produce different results.

You will find difference in opinions everywhere. However, you definitely are overgeneralizing. Most DO students I speak with like OMT.

 

[the1doc]

Have you guys gone over to the osteopathic thread? I have been looking into their discussions and they talk about OMT and have a lot of opinions about it. The DO students basically talk about how they have to study OMT but that it's not really evidence based or there is little scientific research to back it up. Also, they said they have hard time in lab doing OMT because some people are good at it while others are not and produce different results.

I think this is one important thing that all prospective DO students should consider. You essentially have the same curriculum as MD students, but you also spend a significant amount of time in OMT lab every week. (At my school 4+ hours/week).

OMT is one of the major downsides of being a DO for me. I went into my educational experience trying to be open-minded about OMT, but it turned out to be a real disappointment. While some of the techniques used in OMT seem to be beneficial, others are suspect. Look into cranial osteopathic therapy if you want to research some of the...interesting....aspects of OMT further. On the positive side, OMM lab introduced me to being "hands on" and trying to palpate a pt. On the down side, I could have utilized my PRECIOUS time learning other things....rather than sitting in a lab for half of a day every week trying to "palpate" something that I'm not even sure exists (such as cranial rhythmic impulse.)

 

[the1doc]

You will find difference in opinions everywhere. However, you definitely are overgeneralizing. Most DO students I speak with like OMT.

I would say this is true. I probably represent the minority of DO students. However, at least in my experience, there are at least a fair amount of students from every class who dislike OMT.

 

[MikeyLu2010]

Are the insecurities of DO coming back???

 

[CatsandCradles]

Are the insecurities of DO coming back???

I suspect that the ones who are most critical about the osteopathic profession are the DOs themselves.

Or they are pre-meds who are going the allopathic route and just enjoy sowing dissent among the osteopathic ranks.

 

[dude11]

I suspect that the ones who are most critical about the osteopathic profession are the DOs themselves.

Or they are pre-meds who are going the allopathic route and just enjoy sowing dissent among the osteopathic ranks.

I'm just wondering what all the fuss is about over in the osteopathic thread about omt? I really don't know what omt is? I know what how to pronounce it but is it like physical therapy, massage, or chiropractics? The one thing that I heard from the MD is that omt make you study human anatomy and the musucloskeletal very well. Two of my friends are MDs and they told me to go the DO route because they work with DOs on a regular basis and they told me that they find their DO colleagues to be very knowledgeable and know more than they do about the human body. Otherwise, I really don't know what omt is? Is it like acupuncture, where except for using needles, you use your hands and massage different parts of the body?

This kinds of remind me of that episode from batman cartoon where he learned a technique called the fatal blow or from kill bill the movie where there is a point in the body that if hit can cause a person to drop.

 

[HunterGatherer]

dude11,

maybe you should try to meet with a DO that practices OMT. I think you live in the NY/NJ area so it should not be too difficult. Read up some more before you meet your DO.

You have a lot of concern with going the DO route and you need to be sure it is something you can live with if you decide to matriculate.

 

[gclax30]

Have you guys gone over to the osteopathic thread? I have been looking into their discussions and they talk about OMT and have a lot of opinions about it. The DO students basically talk about how they have to study OMT but that it's not really evidence based or there is little scientific research to back it up. Also, they said they have hard time in lab doing OMT because some people are good at it while others are not and produce different results.

I definitely understand where this is coming from... take a quick stroll through the halls of my school on a Tuesday and you'll hear a lot of the dissent and grumbling about having to go to OPP. But I think the majority of this is because of the incredible academic work load that we have, and most students (myself included) feel that our time would be better spent learning the "high yield" subjects like pharm, path, etc. So it basically comes down to studying what OMM you need for boards and that's it.

Another area of frustration is the meager amount of literature out there on manipulation. It is hard to legitimize something like cranial manipulation when entire studies can't even define what that impulse IS let alone if manipulating it will do anything worthwhile. This is one of my biggest problems with the way the OPP curriculum is taught... most of the studies cited in the lectures are 20, 30 years old. However, where the rubber meets the road is when I actually do cranial (or what I think is cranial ) on a woman that suffers from horrible migraine headaches that no medication can even touch, and her symptoms vanish and she can go back to work, take care of her kids, etc. So even though a large volume of research in these areas is lacking, I know it works and for many people is the only option. It is a lot to take on faith when you're learning it but it does have its place.

I think the frustration also depends on the attitude of the OPP department and how it is presented. There are one or two profs here that think omm is the end-all be-all of medicine. But the majority realize that omm has its unique place in medicine and is very effective in some, not all, instances. When they have a realistic approach, it makes it a much easier pill to swallow.

 

[the1doc]

Are the insecurities of DO coming back???

Not sure what you mean by that. I think that most DO students recognize that OMT is not supported by valid research. I also think the fact that we can talk about OMT in an open and honest way shows security, not insecurity.

 

[MikeyLu2010]

I was referring to the OPs previous posts...On one hand..he's scared that DO's get discriminated as shown in one thread...and another thread he started, he talks about DO pride and putting bumper stickers and whatnot on cars and stuff boasting the DO profession...And then now..he seems insecure again....

 

[the1doc]

I was referring to the OPs previous posts...On one hand..he's scared that DO's get discriminated as shown in one thread...and another thread he started, he talks about DO pride and putting bumper stickers and whatnot on cars and stuff boasting the DO profession...And then now..he seems insecure again....

gotcha...well...hmmm....

 

[Taus]

Don't mean to sound condescending, but you shouldn't take what you read on SDN so seriously w/o doing your own research...ie looking outside the world of SDN....

Over the years I've compiled some links about OMT, but their is also a HUGE link of research available on SDN in the Osteopathic medicine journal club thread:

Tons of Research: http://forums.studentdoctor.net/showthread.php?t=99957

some more decent links on OMT that can help describe what it is:

http://ommguru.blogspot.com/2005/11/what-is-it-like-to-get-osteopathic.html
http://www.osteopathic.org/index.cfm?PageID=ost_omt
http://www.thealo.com/maloblog/index.asp?ci=6&s=category
http://www.acofp.org/onlinecme/New/online/omtforent/index.html
http://archfami.ama-assn.org/cgi/content/full/8/6/477

 

[Nate]

I don’t feel that the 2.5 hours spent on OMM per week is wasted at all. We have anatomy second semester at UMDNJ and I can tell you from having taken OMM for a full semester before touching anatomy that OMM really does help you understand anatomy more easily. It provides extra instruction and reinforcement on nerve innervations, bone articulations, body mechanics, physical diagnosis, and just the awesome power of human touch. Some of this stuff we breeze over in Physiology, Anatomy, Neuroscience and other classes and some of it is barely mentioned so this is just a bonus. Sure, I admit that I am probably never going to professionally use OMM but that does not mean I regret learning it! I can also say that the 2.5 hours it takes to go to this class is not going to detract from my other studies because either way, my studies get done and I still have plenty of time left over to watch Scrubs, work out, read, post on SDN, and play video games. I do feel lucky to be here though because our OMM docs are really open-minded and cut through the crap but anywhere you go one of the most important skills you will learn as a medical student and even as a doctor is to cut through the crap and dissect out the relevant and useful information in any subject!
As for your other question about what OMM is, well there is plenty of reading for you to do about it but I can tell you there is research backing a lot of it up. Check out the journal club sub-forum of the Osteopathic forum and do a search in pubmed. It most definitely is not the cure-all end-all of medicine, at least in my opinion, but in the very least it is a powerful diagnostic tool and handy to have in your bag of tools in addition to medicine and surgery.

 

[the1doc]

I don’t feel that the 2.5 hours spent on OMM per week is wasted at all. We have anatomy second semester at UMDNJ and I can tell you from having taken OMM for a full semester before touching anatomy that OMM really does help you understand anatomy more easily. It provides extra instruction and reinforcement on nerve innervations, bone articulations, body mechanics, physical diagnosis, and just the awesome power of human touch. Some of this stuff we breeze over in Physiology, Anatomy, Neuroscience and other classes and some of it is barely mentioned so this is just a bonus. Sure, I admit that I am probably never going to professionally use OMM but that does not mean I regret learning it! I can also say that the 2.5 hours it takes to go to this class is not going to detract from my other studies because either way, my studies get done and I still have plenty of time left over to watch Scrubs, work out, read, post on SDN, and play video games. I do feel lucky to be here though because our OMM docs are really open-minded and cut through the crap but anywhere you go one of the most important skills you will learn as a medical student and even as a doctor is to cut through the crap and dissect out the relevant and useful information in any subject!
As for your other question about what OMM is, well there is plenty of reading for you to do about it but I can tell you there is research backing a lot of it up. Check out the journal club sub-forum of the Osteopathic forum and do a search in pubmed. It most definitely is not the cure-all end-all of medicine, at least in my opinion, but in the very least it is a powerful diagnostic tool and handy to have in your bag of tools in addition to medicine and surgery.

First, some schools require more than 2.5 hours a week. CCOM required (requires?) 4. And that is the minimum. Second, OMM can serve as a review for anatomy, but anatomy composes only a portion of what is covered in OMM. The OMM I learned covered technique and osteopathic principle in detail. I really had no desire to learn those things because I knew I'd never use them. Third, if you are required to know cranial techniques and lymphatic pump techniques to pass your practicals and written exams, there is no "dissecting" out of information. You need to know it all - whether you think it is relevant or not. Finally, look at the studies on OMM carefully if you are going to research it yourself. Anyone with a basic background in science will quickly see that the majority of "OMM research" is not scientifically valid. We know that OMM can help some people. The studies that I've read in JAOA (which I receive at my house) have not been impressive. I'm not saying that there aren't any studies that support the theories of OM. I am saying that if there was REALLY a large body of valid research to support OM, it would be more respected in the medical community.

Having said all this, I don't think there is anything wrong with DO students having some healthy skepticism about OMT. After all, we aren't expected to prescribe drugs based on anecdotal evidence and poorly controlled research. It is hypocritical to not apply that same skepticism to OMT. But read up on the studies and see what you think for yourself. I'm not convinced.

 

[Nate]

First, some schools require more than 2.5 hours a week. CCOM required (requires?) 4. And that is the minimum. Second, OMM can serve as a review for anatomy, but anatomy composes only a portion of what is covered in OMM. The OMM I learned covered technique and osteopathic principle in detail. I really had no desire to learn those things because I knew I'd never use them. Third, if you are required to know cranial techniques and lymphatic pump techniques to pass your practicals and written exams, there is no "dissecting" out of information. You need to know it all - whether you think it is relevant or not. Finally, look at the studies on OMM carefully if you are going to research it yourself. Anyone with a basic background in science will quickly see that the majority of "OMM research" is not scientifically valid. We know that OMM can help some people. The studies that I've read in JAOA (which I receive at my house) have not been impressive. I'm not saying that there aren't any studies that support the theories of OM. I am saying that if there was REALLY a large body of valid research to support OM, it would be more respected in the medical community.

Having said all this, I don't think there is anything wrong with DO students having some healthy skepticism about OMT. After all, we aren't expected to prescribe drugs based on anecdotal evidence and poorly controlled research. It is hypocritical to not apply that same skepticism to OMT. But read up on the studies and see what you think for yourself. I'm not convinced.

It is good that we present different perspectives on this issue; my perspective is obviously from a different school where we have fewer hours and less hardcore OMM exams than other schools. At the same time there is extracurricular OMM stuff for the enthusiast so no those who want more can get more. Perhaps that is what has kept me happy with my education in it; I do the minimum and am happy with it. I know it is impossible to have double blind randomized trials with OMM but that does not make the research invalid, after all we are not shoving some foreign chemical down people's throats but rather simply manipulating their musculoskeletal system back to its natural form. Validity can be determined from relevancy and bias and not all research has to be double blind randomized trials to be relevant and unbiased. Believe me, I am not in the OMM “cult” and as I mentioned I do not plan to practice it professionally, however I choose to see the positive aspects of learning it which I have already listed. Of course it does not encompass what anatomy does but it sure did help me understand how facets articulate and glide and how fascia and lymphatic work when those topics were jammed down my throat at medical school pace. As for the comment I made about dissecting out the irrelevant, yes you may be responsible for cranial stuff on exams and even the COMLEX but that does not mean it has to be the highlight of your studies. I store some information in my brain to pass tests, like most of biochem, I need to know it to pass the exams but who cares about most of it beyond that? Other stuff like Cardiology and Anatomy I store in another area of my brain for stuff I need to know for the rest of my life.

 

[the1doc]

Believe me, I am not in the OMM “cult”

LOL...I've never heard it put quite that way, but it rings true. I can appreciate your perspective more now...I think a lot of it is dependent on what school you go to. CCOM takes its OMM very seriously...way too seriously.

Best of luck with finishing up your first year.

 

[Taus]

1.5 hours a week lab + 1 of lecture seems to be a good amount here at PCOM...just enough/not too much to keep a happy medium...

on a side note...
One of my favorite things about being in DO school so far is that during the long hours of studying, its not so inappropriate to ask another student for a massage.....as long as you call it soft tissue/omm....I would usually never ask another man for a massage....but under these circumstances.....sure...why not.... its educational....

 

[OSUdoc08]

1.5 hours a week lab + 1 of lecture seems to be a good amount here at PCOM...just enough/not too much to keep a happy medium...

on a side note...
One of my favorite things about being in DO school so far is that during the long hours of studying, its not so inappropriate to ask another student for a massage.....as long as you call it soft tissue/omm....I would usually never ask another man for a massage....but under these circumstances.....sure...why not.... its educational....

Ummm....ever consider studying with female classmates?

I do.

 

[Taus]

yeah but only for counterstrain on anterior L5 dysfunction.....

 

[OSUdoc08]

yeah but only for counterstrain on anterior L5 dysfunction.....

Don't forget about upsheared pubes.

(and don't forget to "adjust.")

 

[dude11]

dude11,

maybe you should try to meet with a DO that practices OMT. I think you live in the NY/NJ area so it should not be too difficult. Read up some more before you meet your DO.

You have a lot of concern with going the DO route and you need to be sure it is something you can live with if you decide to matriculate.

Yeah, I emailed a DO. I am also going to talk to another DO to see what he has to say. There is a lot of materials on the internet about this. There was this article by an MD talking about validity of omt and then there are others by DOs who said that they use it all the time and that the new generation of DOs don't use it as much anymore.

 

[FrogE7]

Have you guys gone over to the osteopathic thread? I have been looking into their discussions and they talk about OMT and have a lot of opinions about it. The DO students basically talk about how they have to study OMT but that it's not really evidence based or there is little scientific research to back it up. Also, they said they have hard time in lab doing OMT because some people are good at it while others are not and produce different results.

dud11 here is an interesting thread where experienced med students are discussing OMM. It might alleviate your worries.

http://forums.studentdoctor.net/showthread.php?t=184466

 

[Dr JPH]

The DO students basically talk about how they have to study OMT but that it's not really evidence based or there is little scientific research to back it up.

Quite false.

The students who you talk to who have this idea of OMT probably never took the time to read journal articles or inquire about what happens in the research labs at the osteopathic schools.

There is mounds of research regarding OMT. Right now at PCOM there are 3 major studies going on right now, at least one of them being funded by the Dept. of Defense.

Don't let people tell you that OMT doesn't work because "there isnt research".

In 2 years of teaching OMT to students I find that the students who feel that it doesn't work are the students who don't put the effort into it and quite honestly aren't very good at it.

Just like any skill, it takes practice and some sense of coordination.

"I didn't believe that chest tubes were a worthy therapeutic option until I saw the reversal of a pneumothorax."

 

[Dr JPH]

\its not so inappropriate to ask another student for a massage.....as long as you call it soft tissue/omm....I would usually never ask another man for a massage....but under these circumstances.....sure...why not.... its educational....

FWIW I don't think this person is in MY lab group!

 

[Taus]

of course not jp.... my fellow would never refer to breasts as the "boobage" either....

 

[Dr JPH]

of course not jp.... my fellow would never refer to breasts as the "boobage" either....

 

[Jamers]

Have you guys gone over to the osteopathic thread? I have been looking into their discussions and they talk about OMT and have a lot of opinions about it. The DO students basically talk about how they have to study OMT but that it's not really evidence based or there is little scientific research to back it up. Also, they said they have hard time in lab doing OMT because some people are good at it while others are not and produce different results.

A good majority of the reason I chose the Osteopathic pathway was because of OMM. I do not believe that spending hours in a lab would be a waste of my time. However, I am not yet in medical school so, please, take what I take as opinion only.

 

[the1doc]

A good majority of the reason I chose the Osteopathic pathway was because of OMM. I do not believe that spending hours in a lab would be a waste of my time. However, I am not yet in medical school so, please, take what I take as opinion only.

Hmmm...I think you'll be surprised how things that used to be a perfectly acceptable use of time become a "waste" of time when you have 24-30 credit hours crammed into a quarter. Suddenly, you'll realize you are sacrificing the couple hours of spare time you DO have to screw around in the OMM lab. Just my experience.

 

[Dr JPH]

Hmmm...I think you'll be surprised how things that used to be a perfectly acceptable use of time become a "waste" of time when you have 24-30 credit hours crammed into a quarter. Suddenly, you'll realize you are sacrificing the couple hours of spare time you DO have to screw around in the OMM lab. Just my experience.

This is a common complaint among some first and second year students in OMM lab. But again, the people who seem to have the most frustration and most feel that this part of their education is "a waste of time" are the students who typically aren't skilled in OMM and have no interest in learning it.

An hour and a half per week in OMM lab won't cut into your study schedule, and if it does your have some serious issues with your time management skills and you should strongly consider re-evaluating this before you get to rotations and internship...it doesn't get easier.

Just remember...18 - 20% of your COMLEX is strongly related to osteopathic concepts or straight out OMM questions.

 

[DragonWell]

of course not jp.... my fellow would never refer to breasts as the "boobage" either....

Hi Y'all. At the risk of hijacking the deeply meaningful discourse on this thread , I've got a few OMM questions to ask.

I specifically chose the DO route to learn OMM, coming from a career as an massage therapist.

Can anybody point me to some info or briefly summarize what my options are for advanced OMM training?

JP, you're an OMM fellow. What does that mean exactly, do all the schools have them? Do you basically spend an extra year studying/teaching OMM?

I have read a bit about board cert in OMM and/or NMM (Neuromuscularskeletal medicine), but the DOs I shadowed who used OMM were all family practice docs, so I don't really have a sense of what OMM/NMM docs do. The AAO site is a bit dense on all this.

Any info appreciated. Thanks.

 

[Dr JPH]

Hi Y'all. At the risk of hijacking the deeply meaningful discourse on this thread , I've got a few OMM questions to ask.

I specifically chose the DO route to learn OMM, coming from a career as an massage therapist.

Can anybody point me to some info or briefly summarize what my options are for advanced OMM training?

There are OMM residencies and there are "+1" years...an additional year after a traditional residency (usually family medicine) that will allow the doctor to become dually board certified in both the residency they completed as well as in OMT. You do not need to complete any additional training in OMT to practice as this specialty...I know many docs who only see patients for manipulative treatment but who only completed a family medicine residency.

JP, you're an OMM fellow. What does that mean exactly, do all the schools have them? Do you basically spend an extra year studying/teaching OMM?

An undergraduate OMM fellow: basically means I complete an additional year of training here on campus, in the clinics and teaching in lab to become more proficient in OMT. I go to school for 5 years rather than 4. There are multiple benefits ranging from research experience, more patient time, teaching experience as well as very nice financial benefits. The training & details are different at each school. I would contact the DO schools you are interested in to see what schools have an OMM fellowship program.

I have read a bit about board cert in OMM and/or NMM (Neuromuscularskeletal medicine), but the DOs I shadowed who used OMM were all family practice docs, so I don't really have a sense of what OMM/NMM docs do. The AAO site is a bit dense on all this.

OMM/NMM docs simply see only those patients who are to be treated with osteopathic manipulation. Many of the docs who only see these types of patients no longer manage the medical aspect of their patients and are, in fact, specialists in this area. As I said above, however, many are family board certified and still may perform these duties as well.

Any info appreciated. Thanks.

No problem. Any futher questions, please feel free to PM me.

 

[DragonWell]

Thanks so much. That's extremely helpful.

 

[the1doc]

This is a common complaint among some first and second year students in OMM lab. But again, the people who seem to have the most frustration and most feel that this part of their education is "a waste of time" are the students who typically aren't skilled in OMM and have no interest in learning it.

An hour and a half per week in OMM lab won't cut into your study schedule, and if it does your have some serious issues with your time management skills and you should strongly consider re-evaluating this before you get to rotations and internship...it doesn't get easier.

Just remember...18 - 20% of your COMLEX is strongly related to osteopathic concepts or straight out OMM questions.

This is also a "common complaint" among some third and fourth year students who wondered why they spent so much time learning something that they wouldn't use. Obviously, skill and interest are interrelated - whether it is with OMM, basketball, or playing the flute. Pointing that out is just saying the obvious.

"An hour and a half per week" isn't what I remember with my OMM experience. "Four hours of class and lab plus studying and practicing techniques" was closer to what I had to endure. As I've stated more than once on this thread, some schools go heavier on the OM than others.

People who know how to manage their time will naturally have a problem with wasting their time. 4-6 hours per week was a waste of my time. That has nothing to do with time management skills. And the "18-20 %" of the COMLEX relating to OM? I could have learned that material in one tenth the time I spent giving massages and in the OM lab.

 

[Jamers]

This is also a "common complaint" among some third and fourth year students who wondered why they spent so much time learning something that they wouldn't use. Obviously, skill and interest are interrelated - whether it is with OMM, basketball, or playing the flute. Pointing that out is just saying the obvious.

"An hour and a half per week" isn't what I remember with my OMM experience. "Four hours of class and lab plus studying and practicing techniques" was closer to what I had to endure. As I've stated more than once on this thread, some schools go heavier on the OM than others.

People who know how to manage their time will naturally have a problem with wasting their time. 4-6 hours per week was a waste of my time. That has nothing to do with time management skills. And the "18-20 %" of the COMLEX relating to OM? I could have learned that material in one tenth the time I spent giving massages and in the OM lab.

I am sorry, maybe I missed this but; why did you choose to follow the Osteopathic tradition if you knew you were going to hate OMM so much? Also, the 1.5 hours that JP is talking about is actually found in a few schools. PCOM and DMU, two that I can think of right now, only require 1.5 hours per week but for two years. I think these schools get just as "heavy" into OMM as a school that requires 4 hours per week. Also, I think this helps to reduce the apathy that some students, such as yourself, may experience.

 

[the1doc]

I am sorry, maybe I missed this but; why did you choose to follow the Osteopathic tradition if you knew you were going to hate OMM so much? Also, the 1.5 hours that JP is talking about is actually found in a few schools. PCOM and DMU, two that I can think of right now, only require 1.5 hours per week but for two years. I think these schools get just as "heavy" into OMM as a school that requires 4 hours per week. Also, I think this helps to reduce the apathy that some students, such as yourself, may experience.

First, I didn't realize that I would be spending as much time doing OMM as I did (4+ hours per week for 2 years - CCOM). Second, I spoke with several DOs before I matriculated, and none of them used OMM. Most of them, however, thought that it had been at least slightly helpful in exposing them to certain aspects of medicine. Third, I thought then (and I still think now) that OMM has its place and it can be useful in some circumstances. So I really had no problem with going DO before I started school. I burned out with OMM during my education, not before it.

 

[Dr JPH]

the1doc

Sounds like you would have been better off at an MD school.

 

[the1doc]

the1doc

Sounds like you would have been better off at an MD school.

maybe. but the medical education i've received has been good, and i do appreciate the humanistic emphasis in an DO education. in the long run, i think it will work out well for me. not every DO and DO student has a completely positive attitude about omm....and IMO, that isn't a bad thing. it's good to have different points of view within our profession to keep it moving forward. the bottom line is that we all want to be good doctors and help people out - regardless of how much we use omm in practice. wouldn't you agree?