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What OMT techniques are needed for COMLEX PE?

Discussion in 'Medical Students - DO' started by ketafol, Mar 21, 2007.

  1. ketafol

    ketafol ASA Member
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    I am not a big OMT guru, in fact, I have forgotten most of it since I have used it very little since 2nd year. I am worried since I know some patients will require OMT during the PE examination.

    How many cases on average will you have to use OMT? What kind of level of OMT is expected? Can you get by with simple soft tissue and muscle energy techniques? Also, is all of the manipulation spinal in nature, or are you expected to use it on extremities as well (ie. a patient with knee/shoulder/etc. pain)? Can I just learn one technique for each of the spinal levels and be all good? Share your stories.

    Thanks so much guys. Cant wait to have this one done.
     
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  3. tcomboi07

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    I passed the COMLEX PE last fall and for the 2-3 instances where OMT was indicated, I just did soft tissue (on the neck, and the thoracic/lumbar spine). I might just review 7 Stages of Spencer for possible shoulder dysfunction, but other than that, I really wouldn't sweat it about the OMT on the COMLEX. It's **very obvious** which standardized patients are OMT cases and you can do just about any technique you want (except HVLA). Hope that helps!
     
  4. DeLaughterDO

    DeLaughterDO Ghost in the Machine
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    I had 2 cases where OMT was absolutely indicated and one where I'm fairly certain they were trying to get us to use it inappropriately.

    On the two cases I used it, I used soft tissue and stages of spencer. I've never heard of anyone else using any more than soft tissue or indirect techniques.

    best of luck,

    jd
     
  5. corpsmanUP

    corpsmanUP Senior Member
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    I just used a bunch of indirect "looking" techniques, where you have the patient breath deeply in and out, find the point of least resistance ([email protected]), and then hold it (and have them hold their breath). Of course don't forget to scrunch up your face and pretend to be doing micromillimeter motion changes to the affected area and then say "Ok, breaaaaattttthhhhhhe". Then return whatever body part back to the position of functio and ask them if they feel better. It won't matter what you do...they will say "Yes, thank you very much".

    I even threw in some OMT indirect stuff at the end of other non-OMT cases just to be thorough (OCD).

    I passed!!!!!!!!!!!!!!

    I am surprised though that the above poster DelaughterDO passed, because he was like the slowest guy in our med school......couldn't even break 260 on his USMLE!!! ;)
     
  6. DeLaughterDO

    DeLaughterDO Ghost in the Machine
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    yeah... pathetic isn't it? I'm surprised they even let me practice medicine.

    The standards are so low nowadays. They'll let just anyone into medical school (and residency).

    :D
     
  7. DeLaughterDO

    DeLaughterDO Ghost in the Machine
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    :laugh: at the indirect "looking" techniques, BTW... aren't all indirect techniques indirect "looking?"

    and who actually asks a patient if they feel better immediately - everyone knows it takes at least 24 hours and 3 doses of percocet for OMT to actually kick in!!

    :smuggrin:
     
  8. ketafol

    ketafol ASA Member
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    Are we supposed to present the assessment and plan to each patient at the conclusion of the encounter? Also, for patients with psychiatric complaints, do we perform an entire mini mental status exam?
     
  9. VALSALVA

    VALSALVA sh*t or get off the pot
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    In addition to indirect, I used muscle energy in one case. Seemed to be an okay choice.
     
  10. DeLaughterDO

    DeLaughterDO Ghost in the Machine
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    Yes - when you leave the room and have your 9 minutes or whatever to write your SOAP note, you write your A/P in the appropriate sections of the note.

    As for patients with Psychiatric complaints - I would think you should do whatever you think is appropriate. Depressed patients probably do not need a full MMSE (nor do most people, in my opinion). In this case, you should probably assess how long they have been depressed, what treatments/medications they have tried or are currently on, are they suicidal, have they ever tried to suicide, etc, etc. MMSE really isn't all that good of a test, in all actuality - just a very basic and nonspecific screener for dementia - and it takes waaaaaaay to long to perform for the time you are given in this test.

    My opinion - unless the person is obviously demented (in which case you wouldn't even need the MMSE), leave it at home and try to get the cases done in the alotted time.

    jd
     
  11. ketafol

    ketafol ASA Member
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    Anyone else have any tips? Thanks.
     
  12. Dr.Dicky

    Dr.Dicky Original P-I-M-P
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    Drink plenty of EtOH the night before....just relax, the cases are pretty straightforward.
     

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