Originally posted by FutrFPDO
David, you were recently at TCOM right? Except for the manip course, which is only 2-3 hours per week (compared to KCOM where it is like 8 hours per week), there is really no emphasis placed on osteopathic principles. And why? Because I believe that osteopathic principles have become general medical principles that all schools learn now, and are no longer solely owned by us. Tell me one Texas medical school that doesn't teach and strongly emphasize preventive med topics these days. None of our courses outside manip offer anything different than courses you would get at any other medical school. Our Anatomy, Physio, Clin Med, Histo, Patho is exactly like any other school. And our manip course is so disconnected from these other courses in terms of terminology, anatomy overlap, and it is so short in time respect, that it has little overall influence. I agree that the manip we get gives us a cursory view of OMM, but if you really want to be good at it, you will have to do either a one year, 3 year residency in it, or be a PDF. Which is what you did right Dave? Your name still shows up in the powerpoint presentations because some have never been changed since you left. And in reality Dave, our administration all trained in allopathic residency programs, and most are tight with allopathic professional organizations. I think our program has smartly embraced the allopathic world because they know here in Texas we have a much stronger allopathic residency system for the graduates from here. Our higher ups are smart enough to know that there are more similarities among our program and the rest in Texas than there are differences. This is a very smart political move, and one that is already paying off. We became ranked 20th in primary care because many of the other medical school Deans put us there.
I'm not sure that the situation you're describing is a good one. If you leave an osteopathic medical school feeling like you have not received a distinctive kind of medical education then either the institution has failed you or you have failed yourself. TCOM, and in fact all of the the DO schools, offer quality medical educations. When you graduate or begin clinical rotations and interact with MD graduates and DO graduates from other programs you will appreciate the excellent medical preparation you received. Still, as Norman Gevitz (look him up, reference below) and other leaders in the osteopathic profession have said many times over, unless the osteopathic profession demonstrates that it has something UNIQUE to contribute to the health care of the citizens of the United States, then there is no compelling reason for us to exist. We are redundant: Chiropractors are more widely recognized as manual medicine providers, physical therapists have co-opted and profited from osteopathic techniques (Jones Strain-Counterstrain, myofascial release, soft tissue mobilization), and while DO schools may still lead the nation in primary care and rural medicine there is nothing really "osteopathic" in this mission. Some welcome this dissolution, but in reality it amounts to a defeat---not to the "allopathic enemy" but to ourselves. We were given an opportunity to create a reform movement in medicine by organizing not only a parallel educational system but also a parallel health delivery system...and failed. We only have ourselves to blame.
There do exist unique osteopathic principles that you won't find in Harrison's, Robinson's, Cecil's, Bates, or other standard medical texts. It's ashame that these ideas aren't more manifest in the wider curriculum. Part of the effort to create an "integrated" curriculum at TCOM was to make these ideas more prominent. You're at an osteopathic medical school and shouldn't have to fight for an osteopathic education. Osteopathic principles don't replace any of the ideas in standard medical texts, but contextualize them and offer heuristics for their clinical application.
**THAT** should be the difference between an osteopathic and allopathic education. When pimped on pulmonology rounds at UT Tyler your answers regarding the pathophysiology of pulmonary diseases should be more complete compared to the students from UT Houston, Southwestern, or TAMU and include discussions of the anatomical structure and function of the thoracic cage upon pulmonary compliance, the role of the autonomic nervous system on bronchoconstriction, and the mechanisms underlying lymphatic congestion in pulmonary edema. Why? Not because your MCAT was higher or your GPA better but because you attended OMM classes three days per week where you were taught to seriously consider three fundamental influences in *ANY* disease process---structural, autonomic, and fluid-based influences---and they didn't. Just as Felix Rogers, an osteopathic cardiologist as MSU-COM, has developed a model of congestive heart failure the incorporates current medical thinking and osteopathic principles in a manner that offers a more complete understanding of the pathophysiology of CHF.
The muscle hypothesis: a model of chronic heart failure appropriate for osteopathic medicine.
Just as Van Buskirk has developed a model bridging research in psychoneuroimmunology and somatic pain which has been corroborated by other "allopathic" investigators who have stumbled upon similar findings that support basic osteopathic precepts. Compare the two abstracts and if you removed the author affiliation could you guess which one was "osteopathic?":
Nociceptive reflexes and the somatic dysfunction: a model.
Neural mechanisms of autonomic responses elicited by somatic sensory stimulation.
These are examples of how osteopathic graduates should think differently (apply anatomical, physiological, and therapeutic principles more completely) as a consequence of their education. Just as those who have attended small liberal arts colleges tend to be "more well rounded" so to speak compared to graduates of large public universities, osteopathic graduates ought to have a richer understanding of anatomy and physiology than their allopathic colleagues. The underlying medical principles taught at both allopathic and osteopathic institutions are the same, but how they are applied is different. If this is the first time you've encountered these ideas, then I would print out this thread and bring it to Dean Hahn and Dr. Stoll and tell them that your school is failing you by not offering you a complete osteopathic education. At the very least, osteopathic graduates ought to feel more comfortable treating a variety of common musculoskeletal disorders (which has been a long-standing identified educational weakness in primary care curricula), should have a better appreciation of biopsychosocial aspects of disease, and have internalized the distinction between "abscence of disease" versus "health."
Proposed tenets of osteopathic medicine and principles for patient care.
'Parallel and distinctive': the philosophic pathway for reform in osteopathic medical education.