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Summary: Fake it 'til you make it.

Depending on your school, you'll be forced to sit in OMM lab for 2-4 hours per week while you are pounded with sketchy pseudoscience about OMM and all the "benefits." The worst part for me was cranial. I never felt the fused cranial bones move, but got tired of telling the OMM doctors I didn't feel anything so I finally said yes so they would leave me alone. Some of my classmates sat in the OMM lab for 45-60 minutes after some labs while the instructor tried to get them to feel the movement. I find cranial osteopathy to be embarrassing to the profession and believe it needs to be abolished. There is no proven benefit. More insane, there exists "The Osteopathic Cranial Academy."

If you're sitting in lab like I and many of my classmates were while "not feeling" what you are supposed to, fear not, just act like you do. Much of what you are supposed to feel doesn't exist. Does your lab partner have plenty of excess adipose? If yes, then that is why you can't feel the transverse process or maybe even the spinous process.

Did the instructor or assistant always seem to get the exact opposite diagnosis, N RlSr instead of N RrSl? If so, don't worry, because the next instructor who comes along will likely not agree with the one before him.

Point being, much of this stuff isn't real. Don't lose any sleep over this.

My suggestion to help you fake it. Learn how to fake it early (early meaning during first semester). Practice your OMM skills with the thought in mind of going through the motions to get your points, not actually arriving at an accurate diagnosis, if such a thing exists. For example, during practicals you should look competent in making a diagnosis even if you have no idea what you are actually feeling. I had classmates who had their diagnosis scripted and planned the exact treatment planned ahead of time. Sacral is a perfect example, that is about like cranial IMO and rarely will two instructors back to back arrive at the same diagnosis. Make something up and treat. Pass practical. Pass pre-clinical years. Retire from using OMM aside from spinal or cervical manipulation, I know how to do those well, but don't believe there is much therapeutic about them. Doctors and clinical staff just like having their back "popped."

Add any other suggestions for the new osteopathic students.

Add some stories about two instructors having conflicting diagnosis.

Add some stories about how you felt about cranial.
 

Drrrrrr. Celty

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Aside from the cranial bit, it just seems like you're really bad with your hands or something. Like I'm not a big fan of a lot of OMM and honestly I'm not really good at it. But the diagnostic bit is probably the easy part.
 
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Mad Jack

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It's pretty easy to diagnose. Most people aren't symmetrical, so you're basically just noting what way in which they aren't.
 

IslandStyle808

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LOL Scripting my @ss. If your school uses one practical instructor, they determine your grade. In the end it is luck of the draw as to who you get as an "easy" grader. You can "pretend" to be as good as you want, but if the instructor disagrees with your diagnosis, its like the 12 year olds put it "your @ss is grass."
 

TTPpentad

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You can't script your diagnoses if your practical instructor checks your diagnosis (worth points on the practical) and makes you treat what they find...

For anyone who is not a huge OMM fan, just show up to lectures and labs as required and cram before practicals/exams. I despised OMM first semester but after having to do various treatments many times over the past year, I've found it's actually pretty simple; just memorize the diagnostic and treatment techniques and you're golden.
 
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12glaucoma34

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Aside from the cranial bit, it just seems like you're really bad with your hands or something. Like I'm not a big fan of a lot of OMM and honestly I'm not really good at it. But the diagnostic bit is probably the easy part.
Really bad with my hands? No. Average? Probably

I just can't help notice the very high frequency in which the following occurs. I diagnosis rotated left. OMM faculty #1 disagrees and says rotated right. OMM faculty #2 says rotated left to correct my now corrected diagnosis based on faculty #1. I could go on a much longer rant about sacral, RR vs LL vs RL vs RL. Most can't actually feel anything.

The inter-rater reliability is incredibly low, this fact alone discredits much of OMM in my opinion. Even if the manipulations help, the initial diagnosis isn't really all that important. And the evidence in regards to the effectiveness of OMT is sparse and sketchy at best.

And yes, the diagnostic part is the easiest. Just be confident and make sure your diagnosis make sense in relation to findings.
 
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12glaucoma34

12glaucoma34

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You can't script your diagnoses if your practical instructor checks your diagnosis (worth points on the practical) and makes you treat what they find...

For anyone who is not a huge OMM fan, just show up to lectures and labs as required and cram before practicals/exams. I despised OMM first semester but after having to do various treatments many times over the past year, I've found it's actually pretty simple; just memorize the diagnostic and treatment techniques and you're golden.
Even if the instructor checks the diagnosis, usually there is a 50% chance you'll be right. On our practicals, at most, 20% of the grade was based on correct diagnosis. Basically, there was a 50% chance you would lose 20% of your grade.

With respect to treatment, yes, you better know more than one treatment because the risk is too high IMO that the grader will make you treat a different diagnosis. However, if they don't disagree with your diagnosis, then you'll look like a pro with your scripted diagnosis and quick treatment in which you didn't even have to think about what to do because you obviously must practice several hours per day.
 
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Any tips for OMM lab for those of us with excess adipose? Dieting and exercise aside (which I've been doing, but I have a long way to go)...I feel kinda bad that my partners can't feel anything.
 

TTPpentad

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Any tips for OMM lab for those of us with excess adipose? Dieting and exercise aside (which I've been doing, but I have a long way to go)...I feel kinda bad that my partners can't feel anything.
Don't fret over it if possible. All of the patients I've seen to date in OMM clinic have been overweight and you and your classmates will need to learn to work with all body types.

While it is harder to learn to feel things on someone with a bit more adipose (or even just a lot of muscle), it is what it is and you'll adapt. At my school, most of us don't have perfect bodies and everyone has been extremely professional toward each other in OMM labs, even those people who act like jerks outside of class.
 
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IslandStyle808

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Even if the instructor checks the diagnosis, usually there is a 50% chance you'll be right. On our practicals, at most, 20% of the grade was based on correct diagnosis. Basically, there was a 50% chance you would lose 20% of your grade.

With respect to treatment, yes, you better know more than one treatment because the risk is too high IMO that the grader will make you treat a different diagnosis. However, if they don't disagree with your diagnosis, then you'll look like a pro with your scripted diagnosis and quick treatment in which you didn't even have to think about what to do because you obviously must practice several hours per day.
Correct

While there are situations where your chances are even less than 50% (ex. I diagnosed cervical neck and got rotation and sidebending correct but not the flexion, extension, neutral part); you can only practice so much. After that point, it is in faiths hands as to how you do on practical day.

And as a friendly reminder, don't be surprised if a proctor marks you off for a diagnosis or treatment that another proctor would have given you full points for. All proctors have their own slight differences in techniques (s*** like this should not happen but does) and they will try to see if you include those differences. So not only do I remember the 'general' techniques I even remember techniques specific for each proctor. Welcome to OMM...
 
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BorntobeDO?

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Really bad with my hands? No. Average? Probably

I just can't help notice the very high frequency in which the following occurs. I diagnosis rotated left. OMM faculty #1 disagrees and says rotated right. OMM faculty #2 says rotated left to correct my now corrected diagnosis based on faculty #1. I could go on a much longer rant about sacral, RR vs LL vs RL vs RL. Most can't actually feel anything.

The inter-rater reliability is incredibly low, this fact alone discredits much of OMM in my opinion. Even if the manipulations help, the initial diagnosis isn't really all that important. And the evidence in regards to the effectiveness of OMT is sparse and sketchy at best.

And yes, the diagnostic part is the easiest. Just be confident and make sure your diagnosis make sense in relation to findings.
I have heard faculty say this pretty much verbatim (red). They just move stuff where they think it wants to go, and the patients usually like it, especially if there's cracks or pops.
 
M

MrWonderful

Suggestions:

(1) Learn to fake it. As mentioned above, make up a diagnosis and treat it based on your understanding of direct vs. indirect treatment.

(2) Be gentle. If you're trying to flex the cervical spine, it's probably only going to take ~5 degrees of flexion to engage those cervical segments. Students who Flex the cervical spine of their patient forward to 45 degrees are actually engaging the Thoracic spine (for example) and proctors are like jesus christ...

(3) Verbalize what you're doing. If you know nothing else, say what you know. The proctor will see you have a clear understanding of the concept despite your inability to do it by the books. Most proctors just want to pass you.

(4) Get good resources. I highly recommend OMG OMT (www.OMGOMT.com) for focused board review while you go through your didactics in school. Understand that OMT is a very limited pool of (mostly) non-evidenced based medicine, so there is only so much you can learn/be tested on. Your teachers will overwhelm you with fluff that is NOT tested on COMLEX; you must be able to sit aside the bull**** and pass what you need to pass for class, but tunnel vision yourself into mastering the OMT on COMLEX. Master this stuff early. It comes back time and time again. Exams, finals, OMM-Comat, COMLEX I, II, and III. Just get it down now by using the aforementioned resource (or others, but this is better) and you will be absolutely fine. Lastly, remember that OMM accounts for ~20% of COMLEX. It's HUGGGEEEE to master it because it can really inflate an otherwise average score, which is looked upon favorably by residency programs.
 
G

grapefruit17

Suggestions:

(1) Learn to fake it. As mentioned above, make up a diagnosis and treat it based on your understanding of direct vs. indirect treatment.

(2) Be gentle. If you're trying to flex the cervical spine, it's probably only going to take ~5 degrees of flexion to engage those cervical segments. Students who Flex the cervical spine of their patient forward to 45 degrees are actually engaging the Thoracic spine (for example) and proctors are like jesus christ...

(3) Verbalize what you're doing. If you know nothing else, say what you know. The proctor will see you have a clear understanding of the concept despite your inability to do it by the books. Most proctors just want to pass you.

(4) Get good resources. I highly recommend OMG OMT (www.OMGOMT.com) for focused board review while you go through your didactics in school. Understand that OMT is a very limited pool of (mostly) non-evidenced based medicine, so there is only so much you can learn/be tested on. Your teachers will overwhelm you with fluff that is NOT tested on COMLEX; you must be able to sit aside the bull**** and pass what you need to pass for class, but tunnel vision yourself into mastering the OMT on COMLEX. Master this stuff early. It comes back time and time again. Exams, finals, OMM-Comat, COMLEX I, II, and III. Just get it down now by using the aforementioned resource (or others, but this is better) and you will be absolutely fine. Lastly, remember that OMM accounts for ~20% of COMLEX. It's HUGGGEEEE to master it because it can really inflate an otherwise average score, which is looked upon favorably by residency programs.
At my school I just put "no dysfunction" for every diagnosis station and usually made it out ok. It's a gamble, but on the practical if you put a diagnosis you have a .0001 percent chance of getting it right. If you put no dysfunction your odds improve to 50 percent
 
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I have heard faculty say this pretty much verbatim (red). They just move stuff where they think it wants to go, and the patients usually like it, especially if there's cracks or pops.
It seems illogical to me, but the general OMM doctrine is that OMM is good for anything and everything. And the patient is always better after the treatment..........................................yeah right.
 
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12glaucoma34

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At my school I just put "no dysfunction" for every diagnosis station and usually made it out ok. It's a gamble, but on the practical if you put a diagnosis you have a .0001 percent chance of getting it right. If you put no dysfunction your odds improve to 50 percent
Nothing like OMM lab where 90% of the class has no real somatic dysfunction, but you spend hours "diagnosing" each other.
 

Misrepresenting Reality

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Suggestions:

(1) Learn to fake it. As mentioned above, make up a diagnosis and treat it based on your understanding of direct vs. indirect treatment.

(2) Be gentle. If you're trying to flex the cervical spine, it's probably only going to take ~5 degrees of flexion to engage those cervical segments. Students who Flex the cervical spine of their patient forward to 45 degrees are actually engaging the Thoracic spine (for example) and proctors are like jesus christ...

(3) Verbalize what you're doing. If you know nothing else, say what you know. The proctor will see you have a clear understanding of the concept despite your inability to do it by the books. Most proctors just want to pass you.

(4) Get good resources. I highly recommend OMG OMT (www.OMGOMT.com) for focused board review while you go through your didactics in school. Understand that OMT is a very limited pool of (mostly) non-evidenced based medicine, so there is only so much you can learn/be tested on. Your teachers will overwhelm you with fluff that is NOT tested on COMLEX; you must be able to sit aside the bull**** and pass what you need to pass for class, but tunnel vision yourself into mastering the OMT on COMLEX. Master this stuff early. It comes back time and time again. Exams, finals, OMM-Comat, COMLEX I, II, and III. Just get it down now by using the aforementioned resource (or others, but this is better) and you will be absolutely fine. Lastly, remember that OMM accounts for ~20% of COMLEX. It's HUGGGEEEE to master it because it can really inflate an otherwise average score, which is looked upon favorably by residency programs.
Well written with easy readability and accurate and useful suggestions.
 
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