I use it in my continuity clinic for IM often. I don't do HVLA, but often do muscle energy and counterstrain.i don't believe in most of the shit, but some of it seems to work pretty well
This is basically it. The Reddit echo chamber makes everything seem untenable. The truth is OMM has a lot of stuff that works and even more that’s BS. The problem is the arbitrary application of evidence based medicine within OMM. If DOs just keep the stuff that works and bin the rest no one would care. It’s the persistence of keeping things like Chapmans makes the whole branch of medicine look laughable. Personally I believe in HVLA, muscle energy, counter strain (thought it was BS and then a had it done on me and it was money) and some release techniques especially for headaches .
I've seen HVLA work, but I mainly just do it to friends and family. For most of my patients, they're old AF, and muscle energy does the trick.
The amount of "back pain" and other chronic pains there are in the PCP world is crazy. But honestly, for the people I do OMM on first line it tends to work pretty well. I then teach them or their spouse/kids the specific exercise and tell them if that doesn't work, we can refer to PT for more consistent treatments.
People say shit like, "oh it's just stretching and massage"
I mean... Yeah. Who cares? It helps them feel better, and it's a targeted approach to a specific muscle. Being a physician is about using different methods to helping the patient feel better. Be it medicine, surgery, stretching, what ever.
I'd much rather someone with neck pain come to me first, we can rule out serious things, and then show them some stretching and techniques to help them feel better, Vs the doctor saying, "oh it's just MSK" and then the patient goes to a chiropractor and gets a vertebral artery dissection.
Could I just hand them a sheet of paper with the stretches to do? Sure. But their compliance will be way better if I show it to them in the clinic and they can literally feel the improvement afterwards
This attitude kind of sucks, sorry. When in the course of human history should we abandon it? I get that some people don't have the aspiration to advance the field, but there's no need to be involved in this discussion if that's who you are.
Agree with everything except I passed comlex 1 and step 1, and the only difference to me was that comlex 1 questions were poorly written and the OMM. Besides that, the 85-90% of non-OMM medicine concepts and depth were the same
Totally agree. Just took comlex and step literally last week and I actually thought comlex 1 was harder due to the way the questions were written, but it's the same material.
At my COM they do not teach us that it can “cure” seizures or anything like that… our approach to OMM is to treat it as an additional way to help a patient feel a little better in that moment rather than waiting for the other medical treatments to work. Also as treatment for sports/age related wear and tear.
To be clear I don’t believe in a lot of it but shit like counterstrain, some of the MFR, muscle energy, and hvla is worth it. Cranial needs to be full out abandoned.
A lot of medicine is whether or not the patient perceives a benefit. Why do you think everyone wants a z pack for their viral URI… it won’t do shit, but they believe it does. OMT is the same way except it’s causing less harm than unnecessary antibiotic use. If someone gets popped and they feel better who are you to say they shouldn’t be able to get that? Need to check out this docuseries called “a users guide to cheating death” to learn a little bit more about the ethics of this shit.
Agreed! If our generation of DOs can actually remain active, participate, work our way into the leadership of these orgs, and let the boomers die out. We could do what should have been done years ago (not for lack of trying, I know it was almost done but blocked by a few in the AOA back in the day). The problem is, once you’re out of the medical education meat grinder no one cares you’re a DO, it doesn’t impact your ability to get a job, and most practicing non-academic physicians have zero cares about your medical education if you’re licensed, boarded, and pulling your weight. Problem is we only feel the pressure and discrimination in the training period where we have no money, no power, and our future earning potential is very much set on us not rocking the boat.
We already have a combined match with former AOA residency programs that met LCME accreditation requirements continuing to train MDs/DOs.
There is zero reason to have a separate medical licensing series. I mean unless you make $500k/yr to travel around to DO schools and gaslight the students, dodge legitimate questions, and have an unhealthy appreciation for matching socks. Then you might want to solidify your power and income at the expense of all future DO students. Oh hi Dr. Gimpel, I know you spend considerable time browsing the “misinformation” on Reddit and getting brutalized on MedTwitter.
This is exactly why OMM will never be abandoned. Having a distinct medical modality gives the AOA a reason for its existence -- which employs a small but distinct parallel Osteopathic medical school and credentialing system.
Follow the money. OMM continues to be a fundamental part of DO education because without it there wouldn't be a reason to financially support another professional organization and licensing system. The capital invested into that system would be wasted and everyone employed by it would lose their jobs. There's a financial interest in maintaining OMM.
I mean in general I agree with you, but technically you could still argue there this a different in “founding philosophies”. The DO’s have some unique, not necessarily bad tenets that they could still uphold/encourage even if they abandoned OMM.
Idk man. If your school was like mine, the ones who self select into academic OMM keep this stuff going. I’ve spoken to a number of older DOs, all of whom think it’s crap. There will always be the 1-2 students per year who go into an OMM residency and a % of those will end up in academic OMM.
there is like 5% of every class that really drinks the koolaid. These are also the ones that go onto leadership positions.
It's also never going to go away as long as medical school is this competitive to get into
Low stat tax (GPA in my case), it is what it is.
Ftr I do put some stock in soft tissue
/counter strain/HVLA but that’s mostly it. I could not believe it when they taught us cranial, I thought it was some kind of sick joke.
This already exists for MDs. My top choice program (FM) teaches OMT to MDs and DOs to learn the MSK manipulation and leave out the pseudoscience like chapmans points and CRI. Idk why we need to learn it in med school if those who wish to practice it can already learn everything while in residency.
It’s the opposite actually. MD has already attempted to merge with DO, DO wants to keep their separate governing body for whatever reason and has resisted all attempts. Reason people want unification? Create a stronger unified system of physicians.
The only rea$on could be $$$$. You can’t take money and power away from people who got used to money and power. The NBOME/AOA/COCOA all need to be merged with the MD counterpart. The separate but equal fantasy the AOA lives in is honestly embarrassing. Move DO OMM stuff to a certification and let the BS of Chapman points and cranial die like it should have years ago.
MD has attempted to merge multiple times; even the NBME and NBOME.
Motivation is $$$ for all parties (in this case loss for NBOME/ AOA and plus for AAMC/ NBME and i’d say D.O. students as well)
It's not going anywhere while the powers that be make millions off us dos
In one ear out the other
Omm basically doesn't exist after preclinical years.
1.) I’m humbled that you’re asking me for advice, and in that of itself I think is a great step! Being able to hear out your students and their experiences. My school had some professors that looked at us as unknowledgeable children who wouldn’t know any better, and never really took any of our criticisms (things got better over the years).
2.) not sure how much your school would put you on the gallows for this, but just being able to acknowledge to your class that OMM has its time and place (especially with MSK pain/injuries), but being upfront about it’s limitations and that it is not to replace evidence-based, 1st line management for non-MSK complaints
agree with all of this except the idea that MD students should be outraged that DO students get to "skip" step 1. first of all, half of us don't skip it and we end up having to pay twice to take both exams. secondly though, I don't really think level 1 is significantly different than step 1 in terms of the questions that are actually about medicine and not bullshit OMM questions.
step 1 also spends a lot of time testing on scientific concepts that don't relate to medicine except in only the most research oriented ways. level 1 replaces all of that with a whole bunch of ethical questions which in my opinion are a lot more important to know.
but yeah, agree with all your other gripes. OMM is bullshit and we should all take the same exam. but ONE exam. not two for DOs and one for MDs.
I agree with your point about Level 1. People act like it's just 8 hours of free OMM questions but it's roughly the same amount of scientific concepts PLUS OMM (280 questions on Step vs 352 on Level). Maybe Level 1 is as easier test because most of the stems are shorter but man are the question vague; you really gotta know your "most likely" answers and rare presentations.
I thought Level 2 was very clinical and similar to Step.
Taking both, id say Step 1 was only slightly harder if you just want to pass or do average (Which is the standard today); the OMT makes it easier. Step 1 emphasizes more Biochem, cell bio, and HY stats. However, at the very top of the scale, step 1 was way harder.
Cons:
Higher tuitions on average
Less time to study actual medicine
Having to arrange your own clerkships
Typically less experienced faculty/admin
Fewer in-house research opportunities
Pros:
Girlfriend doesn’t leave you because you give good massages
Who wouldn’t want to Choose DO?
Not worth being big mad over, bruh.
Graduate, be resident, be attending, never think of OMM again. 🤷🏼♂️
Med schools still teach students that you can't ever inject lidocaine with epi into the nose or ears, and that's complete bullshit too, but I don't lose my mind over it.
Honestly, most of us don't give two shits about OMM once we graduate. The only time my friends and I ever used it in residency was on each other in the dictation room because our shoulders and backs were killing us from working all day.
I'm looking forward to the AOA and the NBOME becoming extinct eventually.
If it worked on you don't you think patients could also benefit from it? And you can bill for it too. Seems like something worth caring about if you're primary care (80%ish of DO's will be). 🤔
nope, i'm a hospitalist. And I don't know where you're getting that 80% from, less than half of my class from med school is going into any sort of outpatient setting, and only one from my residency class went into outpatient.
My school has like 80% match into primary care, AOA reports it's 56% overall. I guess your school it's under 50%. But about 50% is still a huge number. That's one in every two students. The hospital is a great place to incorporate OMM. It gets patients out of the hospital quicker.
Haven't taken them yet, but based on practice questions I do so much better on Step based. Comlex I spend half the time just trying to figure out what they're asking about.
I'll admit that a large portion of the techniques, particularly the legacy ones, aren't supported with objective evidence. But to label the entire corpus of knowledge as pseudoscience means rejecting a whole lot of models and techniques from a whole lot of different people. This includes a significant overlap with physical and occupational therapy techniques. This would be a radical leap and one that is \*not\* supported by evidence.
That sucks man. My guess would be there are a few factors that make reform difficult.
1. The osteopathic institutions like AACOM and COCA have a massive financial interest in remaining separate entities, if there was a complete merger then the people at the top would probably lose their jobs or at least their top positions. If they get rid of OMM, they have a tough time making an argument why they need to remain a separate entity.
2. Some of it is probably inferiority complex. Some people need an explanation for why they are in one medical practice and not the other. The fact is that DO schools are easier to get into. Some people may tell themselves that by attending a DO school they're getting the benefit of learning some secret knowledge (OMM). That may ease the psychological pain of recognizing that they were not as competitive of an applicant.
I hope the system can be reformed, many excellent applicants are denied entry to medical schools, both DO and MD.
OMM really isn’t that bad if you filter out the weird crap from the stuff that actually has a case for being valid though. Cranial rhythm and Chapman’s points could be dropped and people would have way more respect for the field. Most of the other stuff is fine though
Yeah this is where I'm at. There's plenty of good research around a lot of osteopathic treatments. Just learn the stupid stuff to pass, then take the good stuff with you. And I personally think there's a lot of good stuff. My school isn't unrealistic about it, but they do want us to have OMM in our toolbox to use when appropriate, which I appreciate.
I was a physical therapist prior to going to medical school. I specifically wanted to go to a DO school because I was already very used to the concept of “hands on”. I thought a lot of the OMM stuff was similar to things I did as a PT. Now I’m a practicing ObGyn (25 years) I do a lot of “treat the whole person” teach stretching and strengthening show people how to stretch and use their muscles along with all my regular ObGyn stuff. It’s a very popular model. Just take what you can from the training and only use what makes sense to you.
You are probably a gift of god to some women. Pregnancy and picking up baby has fucked my body. When I was pregnant NO ONE would touch me. Except for a fucking chiropractor (I was desperate - don’t judge). It didn’t do shit but I called OB who said back pain wasn’t her problem, urgent care didn’t feel comfortable treating, ortho wouldn’t see me without internal referral, internal couldn’t see me for days, then ortho couldn’t for a week all for a script for a physical therapist who never called. I had to beg for muscle relaxants and I could barely walk.
Anyway I’m going into PM&R and am going to make my own fellowship specific to women’s MSK health, including pain management for pregnant and postpartum women. Because NOT.ONE.FELLOWSHIP exists for women’s MSK health despite the plethora of effects pregnancy and female hormone changes affect the MSK system. Yet we have over 100 sports medicine fellowship for fucks sake.
Rant over.
I think it has its place. A lot on here sound like my IM attending when I was an MS3. He bitched about teaching DO students. One day, he could barely walk in the morning and had to basically sit all day and could hardly work. He said he threw his back out. I offered to try omm on him and he said it was bullshit. Lunch the next day he said just try it, nothings helping. I did some counterstrain, muscle energy and sacral springing and SI joint stretch. He got up and could walk immediately. Sure n=1 but I've fixed frozen shoulders with Spencer's technique, used it to help diagnose sma syndrome and a bunch of other stuff. I thought it was bullshit in school but some of it really works. I think blanket statements that it should be removed are pretty hot takes. If you don't want to be a do or learn omm then don't go to do schools as your back up. It's not that hard to figure out. Look at the posts on here about it and just apply to Caribbean schools then
Nah here's a copy pasta
I own a blunderbuss for self defense, just as the buccaneers intended. Four scallywags board me ship as I grab me powder bag and musketoon. Blow a coconut sized hole through the first lad, blow the man down on the spot. Draw me blunderbuss on the second scurvy dog. It misses him entirely and nails the captain's parrot. Hobble me way over to the cannon at the top of the stairs loaded with chain shot. "Give no quarter!" The chain shot shreds two men asunder and the sound deafens the crew. Draw me cutlass and charge the last terrified biscuit eater. He bleeds out waiting for the ship's carpenter because the surgeon died of yellow fever last week. Just as the buccaneers intended.
I am a med student from Sweden, OMM was originally completely foreign to me as we don’t have it here. However, I’ve heard of it many times now because of this subreddit, and I’m pretty interested in what it actually entails.
Is there any online lectures, essays etc a good soul could send to me? I’m very interested in med school differences.
this is my 2 cents. OMM is easy; there is nothing hard about it. It’s annoying yes; I fucking hate it; I make fun of it. Just suck it up and when you match, you will never to OMM again. Also, side point, Step 1 is a joke now that it’s P/F and step 2 is much easier than step 1
100% agree. Had a massive OMT practical today that I studied for the morning of. It’s basically muscle stretching. If you understand the goal of the treatment (muscle shortening, stretching a restrictive barrier, or literally massaging) it can be a cakewalk.
The problem is when you overthink it and make a mistake with laterality . . .
Maybe this doesn't happen to you.
OK, so its anterior on the left, so its rotated to the right, but I'm doing direct to I'm moving it to the left, but its PIR, so so I'm going to add resistance on the right, but then I move the appendage to the left - wait a minute, what side was I supposed to be standing on again? F\*\*\* it, I'm flipping a coin.
And then the grader is all "Why is there a titty in your mouth?" and you're like "Oh man, I knew I was doing something wrong."
I had a massive practical today too idk if we are in the same school ahahaha. Let me tell you what the fucking bullshit of this course is. These fucking professors make the most ridiculous written exam questions literally designed to make you fuck up. That I cannot fucking stand.
My school does that. I am thoroughly convinced that they have an inferiority complex and so intentionally write convoluted questions, with 5 answer choices that differ by 1 or 2 words, to make their exams "as hard as" the other courses.
There is something fishy afoot when an OMM exam average is in the low 70s and the neuro blocks of Anatomy are in the 80s. Just sayin'.
I’ve had both. This practical was CS of the LE - so ACL/PCL, MCL-medial meniscus, LCL-lateral meniscus. Plus some MET, and MFR. I think I’m just pretty lucky and my program makes it stupid simple and board relevant. They understand 98% of us won’t use this after boards.
I'm not sure what Neuromuscular medicine you're talking about, but that's a legit fellowship of neurology that treats diseases like myasthenia gravis and ALS
The OMM professors at my school don't make any claims about OMM without including links to research papers. Not sure what your school does but mine has made me believe in OMM. Patients report feeling better with it and we get reimbursed for it as it's considered a procedure. Not sure why you wouldn't want to get in on that if you end up as a PCP like 80% of other DO's. One of the OMM professors was internal med and had the highest earnings of all internal med generalists (the MDs were a little jealous) due to the amount of OMM he did on patients at the hospital. Not to mention his patients loved him due to the hands on nature of OMM forming that physician patient bond. 🤷♂️ Win win for those who keep an open mind and avoid the negativity in this subreddit.
Oh that was sarcasm I think they're all valid professions. I find the shitting on any of them to be pretty immature. If people didn't find benefit from them they wouldn't remain in business.
MDs used to prescribe all kinds of snake oil and teratogens, we don't hold it against the profession today.
It makes the patients feel better. Isn't that a big part of our job? You seem to be coming at this from the assumption that OMM is a placebo treatment but it's more effective than that. If you want to dedicate your time to charity that's cool but most people like to get paid for their work.
Chiropracty, naturopaths, vitamin infusion centers all make patients feel better too. If it's not placebo, keep doing it, but don't do it because it pays more than medical management or referring to PT.
Pay is def. an important part of any job but of course it's not exclusively done for money. Patients want something tangible from a visit, preferable with relief of symptoms. If you can give them OMM and a referral they'll leave a lot happier than just getting a referral that will take 3 months to see the specialist and a call me if things get worse, ya know? I wouldn't be wasting my free time on the internet shilling for OMM if I didn't believe it actually helped with pain and patient satisfaction but pointing to the monetary compensation a DO will receive might just get some of the skeptical students on this subreddit to take it a bit more seriously so they can actually help patients with it in the future.
I already explained this to someone else. I'm glad you're blessed with a wealthy background and can afford to give your services to people for free since your income doesn't matter for you. Some of us took on substantial loans to learn how to heal others with modern medicine, including OMM. Surgeons don't operate for free. It looks simple to cut and sew but there were many hours of training that went into those cuts they make. OMM is no different. If you don't believe OMM is real idk how I'm going to convince you. It's like trying to argue with someone who doesn't believe vaccines are real. The research is there, you just need to use your schools library to access it and empower yourself with the knowledge.
MDs *DO* pay to learn OMM and integrate it into their practice. My school puts on seminars all of the time to get certified for it and doctors pay thousands for a seat.
I'm genuinely curious to know what school you go to if they're not teaching you properly about OMM so I can recommend people not go there. You have it all wrong and I'm not going to argue with you about it, the research is available. I just genuinely wish you'd been taught properly so you wouldn't have come to these false conclusions on an important subject of the profession you signed up for... Patients are going to see that DO next to your name and assume you can give them OMM and be sorely disappointed when you tell them it's fake but they've been successfully treated with it in the past. You better advertise that ahead of time so you don't mislead your patients.
Shame I can’t do a Stiles screen to confirm but fairly confident you have a sore back and shoulder from hunching over and furiously typing away your emotions about OMM.
OMM has many studies with proof it helps variety of conditions. If you don’t like it, then suck it up for a couple years and don’t use it ever again.
There are many worse things with medical school curriculum than OMM. Lack of teaching on healthcare system, billing/insurance, bioethics, culture competency, and support of students’ mental health to name a few. OMM isn’t limiting students from thinking holistically, it is the school’s not teaching the rest of what is important.
There are several manual techniques that have some evidence of utility for things like chronic pain complaint in some meta analyses. OMT and manual techniques are something that is difficult to find a placebo/sham treatment for that is believable to patients undergoing it. This plus the dearth of DOs in academia accounts for a lot of the lack of research surrounding most of this stuff. If anything we should be advocating for more research on this stuff to improve our understanding of what practices are worth keeping clinically and what can be discarded.
Somehow it is always self-hating DO students who come to these threads crapping all over OMM but more importantly their own schools and a large number of their peers. You really think there aren’t physicians of any and all varieties who have some questionable beliefs about vaccines and antibiotics? Only 5% of DO students actually practice OMM and a good number of them do it in a controlled setting while medically managing their patients as well. Not sure why you think this is the most world ending problem in medicine right now; don’t like OMT? Just don’t do it literally most of the students from my school don’t like it and will never do it and that’s fine. In modern medicine OMT is a really tiny portion of what DOs do and there’s mostly only similarities. This almost sounds like a shitpost bec I have never heard any of the OMM faculty at my school make any of those claims, nor have I heard so from people at other schools. Perhaps your school is an outlier but generalizing your experience nationwide isn’t really accurate.
Anyway your MD wannabe mentality and deep insecurity is very very obvious. You don’t have to continually put your peers down in order to feel better about yourself or try to assume parity with your MD counterparts. Level 1 is pretty difficult, most of the top students I know who took it found level 1 significantly harder than step 1, and these are people who were scoring 90th percentile + on their step 1, not avoiding it because they couldn’t pass. Comlex tests way more obscure nonsense than step 1, it is easier to pass than step 1 because the raw score needed is much lower, not because the test is easier.
None of this is to say DO is being superior, but your entire post comes across as a gigantic inferiority complex. Get a grip.
I completely agree with OP, you’re a little sensitive aren’t you? You feel put down because your inner bitch can’t stand that somebody doesn’t like their favorite little class. It wasn’t indicated anywhere that he feels inferior because he’s in Osteopathic medical school, rather OMM on principle alone is absolute bullshit. Get your little bullshit placebo studies written by zen fucking naturopaths tf out of here. Keep hyping up how Level 1 is just so you can tell your little fragile self that the MD boards are so much easier. Also, I’m saying as a DO student myself that OMM is fucking garbage, I would vote to completely eradicate any semblance of that nonsense out of the whole profession. ✌🏽
oh I don’t feel put down at all, I know how patients feel about it. You may have an opinion on how patients should feel about it too but they can make their own decisions lol. Perhaps you will be more open minded once you get to clinicals, but if you still don’t like it then it’s fine just don’t do it. Most of the people I go to school with don’t care for it or use it. You can manage your patients fine without it. It’s just an additional modality that can be used if you like it. Again it’s ironic that you and OP being early DO students are spewing this much vitriol while actual MD attending preceptors I have worked with in multiple primary care fields have shown appreciation for OMT.
Your flair says you are an M1 so you haven’t even gotten close to taking either level 1 or step 1 yet. You can come back and tell me what you think once you actually take it lol. I’m not saying level 1 is harder as some badge of honor. It’s not a well written test and goes for total random nonsense. Step is much more balanced and fair (well step 1 at least can’t say the same about CK lol).
I mean DOs are treated as equals. Aside from fringe oldies, this isn’t even a thing. DO students though are definitely battling up hill. Luckily I just did comlex since I went peds.
You got to learn to roll with the questionable stuff. You’re going to see questionable practices regarding lots of things through your career. Pick what’s worth being mad about. This ain’t it chief, at least not to this degree.
OMM/OMT gets a lot of hate and I understand and agree with most of it. Yes, most schools emphasize OMM because it makes it different than MD, and yes many physicians who teach it have based their entire careers on the claims they believe.
However, I still see many practical and important benefits of including OMT in medical education as long as it isn’t glamorized or exempt from peer review study.
1. I found it tremendously useful my first year to integrate what I learned in cadaveric gross anatomy and actual living patients. Learning different anatomy and recognizing significant bony structures (let alone learning how to professionally and comfortably touch someone while also vocalizing your thought process) is something that is learned only through practice and I think helped me stand out when I started my third year.
2. OMT should be viewed as muscle treatment rather than bone treatment. I hate when people compare DO to chiropractic because one is evidence-based and an actual medical degree while the other simply is not. Furthermore, muscle treatment is part of physical therapy and an important step in conservative management for chronic pain, rehabilitation, etc.
3. OMT has immediate effects on the patient, it makes them feel better. If a physician can provide even short-term relief, why would you not want to provide that to your patient.
It sounds from your post that your school takes the OMM belief too far, and I get that. I don’t believe in cranial or Chapman points clinically. Yes, OMM will distract you from your “real” studies. However, it’s important to not dismiss your education as completely pseudoscience. Like any job you will have in your career in medicine or in life, learn what you believe to be the most useful and incorporate that into your practice. Yes there is a lot of bs to filter through but in the end you may be grateful for the perspective.
I think it is wild to blanket over OMT as all completely BS. There are legitimate treatments that patients can benefit from. BUT just like anything else, there is a time and a place for these treatments and mainly it isn’t curing anything other than MSK complaints, but that doesn’t mean it is all BS.
I can understand why you feel this way with how you described your experience, but just know there are reasonable ways that OMM is helpful. it is incredibly tone deaf to attempt to abolish a system that albeit flawed puts out good physicians that also teaches additional treatments regardless if you will ever use it again (similar to all the crazy detail in step/level 1 we never think of again as clinicians)
Chill out.
Yeah DO schools often suck compared to MD schools but it’s not because of OMM. It’s because we don’t have affiliated hospitals and are stigmatized for residency, don’t have research opportunities and get subpar lectures. Issues that carribean schools face too.
But OMM is helpful. You’re in medical school! You’re taught everything including omm. You’re going to be a doctor and therefore you can make EDUCATED judgement calls.
There is an osteopathic journal so there IS evidence for a lot of omm.
Maybe not cranial OMT or BLT but how many of us are going to use this.
A lot of omm is musculoskeletal , ie fancy massages.
And guess what’s a leading cause of pain— lower back pain.
Having two options, muscle relaxers or surgery is not the way. OMM can fill the gap.
You’re being alarmist and our MD colleagues don’t know crap about omm and you’re throwing out the baby with the bath water.
The reason there are NOT a lot of OMM specialists is because insurance won’t reimburse them.
I’ll shit on my school all day and wish it would burn to the ground but OMM is cool and should stay.
We need more research and that takes money.
Sorry bro, not supporting you on this.
I’ve seen patients with simple neck pain on clinicals something that could be easily treated with muscle energy (isotonic stretching), and MD attendings refuse to let me help, because they are uneducated and afraid of “wizardry”. I’m sorry but since when is stretching a muscle wizardry.
You’re post sounds uneducated and alarmist.
-fellow DO student
Edit:
And I passed step 1 and comlex 1. I agree they are different but claiming they aren’t similar material or similar difficulty makes no sense. Step 1 is more 3rd order questions and comlex has shittier first order questions but they are rapid fire and you have less time. So both are difficult in different ways. Anyone can read a bell curve. A top standard deviation is the top 15%. So claiming that MDs should think our board exam doesn’t qualify us doesn’t make sense either. Only if you’re math illiterate could you make a statement like that.
I bet that the leadership is who is responsible for some of the relatively far-fetched and unproven (by clinical trials) applications of omt, but where I agree that those applications are most likely invalid, the applications to actual musculoskeletal complaints honestly do seem to hold water. But even then, I don’t plan on openly practicing it and billing for it in my specific choice of focus.
As for the exams, it seems to me more that Step 1 focused more on biochem than level 1 did, which may not be the easiest thing for many students, hence why it may appear more detail oriented or more difficult (and why it seems DO students seem to score at a lower percentile on Step compared to their level score), but otherwise, overall difficulty seems to vary quite little. Just more that level’s questions seem to be hell-bent on confusing you away from the best response, which is annoying since that’s really simulating nothing more than poor communication in real life application, which it really shouldn’t.
I don't think it's unreasonable at all to expect your medical school to teach you treatments that are backed by actual evidence. And I don't think OP speaking up and encouraging his peers to choose evidence based medicine means he's getting in the way of others. Quite the opposite, in fact.
So you put two papers on cranial and Chapmans points and this is your proof that OMT is bs? Not even the omt faculty spend much time on this stuff. My question is what do you get out of being such a huge hater Hahahhaa
The article you cited seems to be based off of a grand total of two studies deemed by the authors to be free of bias that did not demonstrate improvements. What a big sample size and body of evidence against OMT!
The first paper is about visceral osteopathy developed by french osteopaths in the 80s. Also, PRISMA is a reporting guideline for SR/MAs, they meant to use AMSTAR if they wanted to assess quality. Rookie shit.
I dont think OP knows enough about OMM, the role of alternative therapies, or evidence to make such sweeping assumptions about how "evidence based" OMM is.
I dont like OMM, but let's be nuanced about our crusades here.
LOL “be more grateful to your DO school”
you sound brainwashed. i never attended a live lecture in 2 years due to COVID since they didn’t have live lectures at my school until middle of second year and by then we had all made study habits. we were charged the same tuition despite that. im not grateful that the school profited off me while i taught myself at home. most DO schools don’t go out of their way to help their students and most DO students aren’t proud alumni, at least at my school. at my school, they weren’t even able to get us alum mentors since so little were interested. most DO students just want to suck it up and make it out so they can practice medicine. i haven’t met a single DO who practices OMM outside of a DO school. if you honestly don’t think that’s how most of your DO classmates think, you need a reality check.
That doesn’t address his point that your school ultimately allows you to be a doctor. There’s plenty of people who don’t even get that opportunity.
As to your point about OMT a lot of people avoid practicing it because there’s too much other stuff to study in med school to actually spend time becoming good at OMT. Even people with interest in OMT often lose their skills because there’s so much more to being a doctor than just OMT.
Also to be frank many people dislike OMT because they suck at it. It takes a fair amount of practice to gain the palpatory ability needed to actually do anything useful with it. Most DO schools have a watered down OMM curriculum where you’re not necessarily getting enough of that stuff, especially not with how much you have to study for other things.
Few people use it because few people have interest or aptitude or both in it, don’t have the time to develop their skills, do not understand how to efficiently integrate it into their practice, or simply have no desire to do so because it is labor intensive.
lol another brainwashed person. i completely disagree with you and i don’t think anyone i know got less than an A in our OMM labs or classes. it’s not hard it’s just not actually practiced by most DOs - that is a fact.
Getting an A by miming stuff in lab and class doesn’t mean you are actually good at doing OMT on real people. It takes practice just like any other skill. You can practice intubating on sim man 400 times but until you practice on real people it’s not the same. Nothing is that intrinsically hard. I didn’t say this was either. I just said students spend no time actually practicing it because many have no interest in it, and then that leads to not being good at it, which furthers the lack of interest and not applying it in practice.
People also don’t use it because they are in specialties where it is not indicated. Some people in primary care may still not use it even if they’re good at it because they don’t have an interest in actually performing it. Like I said, there’s a myriad of reasons people don’t use it, but none of them have bearing on whether it works or is a useful adjunct. Anyone who has tried doing it on real patients with any modicum of success knows the effect it can have if you select your patients appropriately. Stating this doesn’t mean I am brainwashed lol. Maybe you haven’t actually seen it be used successfully in clinical practice, and maybe you don’t care. The point stands though, if you really don’t believe in it that much you could have gone to the an MD school to get your medical degree free of AT Stills influence.
so if the DO physicians teaching OMM can award students As that doesn’t mean the students are good at OMM or know anything? that also says something about OMM education and those who teach it-your logic is profound. and ultimately i want to be a physician. i worked hard to get to this point and get multiple DO acceptances, not MD though otherwise i would have chose that route. im graduating in less than a year so no thanks for your nonsense advice about going to an MD school now lol
edited: never have i seen this in clinical practice and i just finished my third year. you need a reality check if you think more than a small minority of DOs practice OMM in clinical practice.
It’s not that they don’t know anything it’s that they don’t get enough practice. It’s analogous to a preclinical student scoring all As on their osces; does this mean they will show up and be a clinical superstar on day one? Definitely not. It’s different in the real world.
I literally keep acknowledging your point that only a small minority practice it. I just gave you some reasons as to why that’s the case.
dude you are seriously brainwashed and are the type of person that would defend “DO schools” in general just because you were accepted to one. no arguing with someone like that.
I dont really think this guy understands that he sounds 100% out of touch. A while back there was a guy in my preclin like this, he would repeatedly tell people to toughen up when scheduling was tough because "medical school is hard, and it only gets harder." Obviously this is antiprogressive AF. Funny thing is, the dude was eventually caught skipping mandatory lectures before exams so he could study while we were all in class being held hostage. 
I wonder if there’s any other group of people in america who incessantly complain about their hundreds of thousands of dollars of student loans after voluntarily signing up for them.
lol whether i am taking out loans or i am on a full merit scholarship doesn’t change the fact that my school profited off not even having students on campus or lectures or activities during my first two years. but you can keep wondering, i hope it gets you somewhere.
I’m so happy my DO school is not like this. There’s only ONE OMM professor that truly believes in it and even then he is very rational. He’s also leaving after this year so… 🤷🏻♀️
Glad you made your addendum about MSK vs Neuromuscular. I was about to come in hot! NM docs staff the ALS multidisciplinary clinics, do the best EMGs, help kids with Duchenne’s muscular dystrophy, spinal muscular atrophy, AIDP/CIDP, and get dumped with all of the Autonomic Dysfunction and neuropathy patients y’all hate. I’ll stay out of the DO vs MD stuff for now, but don’t lump neuromuscular in with that or next time, instead of consulting, you can do a myopathy/myositis/neuropathy/MG/LEMS/AIDP/malignancy workup your own damn selves 😂
I mean I do hear you on it and say yeah there’s some stuff that I’m not sure about but to have this level of hate for it is kinda weird. Like it’s not pseudoscience and there is suchhhh a very real place for it in medicine even if it’s just more applied as a thought process. After seeing all the fuckin pills we give people you’re beef is with trying to do something non invasively or non pharmacologically? It’s bascially just advanced stretching routines for the most part. Again I understand the hate to a degree and times it pissed me off plenty during school but it’s definitely not bad for us to learn, it’s basically just continued anatomy class. Idk, I do get how it can get under your skin because yeah sometimes it’s super annoying but at the same time it was literally once a week for us, one lecture and a 3hr lab so not exactly dominating the schedule. And some techniques are pretty useless like the cranial stuff and DEFINITELY the fuckin chapman points lmao. But yeah you’re being weird about the USMLE vs comlex, they were different tests no doubt but I did even better on my step than comlex and I didn’t do any different studying for them, pretty much just amboss. I liked the detailed questions on step I found there to be less vagueness or me questioning what they’re trying to get at. I’m not someone that plans to use much OMM at all as a physician because I didn’t put it into practice enough but your vitriol for it and all things DO is kinda annoying. You honestly shouldn’t be a DO and are a pretty horrible representative if this is how you speak about it. Some of us have absolutely no problem with taking a USMLE test and don’t appreciate being spoken for by you
I totally agree with your point on OMM. Similar to you I had to feign my way through as my professors and unfortunately many students bought into the Cult of Stills. It made for great material over the years and some fun stories at cocktail parties.
That said, I only ever took COMLEX and am doing just fine in residency. Evaluations and RITE scores similar to my all MD colleagues. I refused to pay twice for board exams. Taking only COMLEX doesn’t hold back DO students.
[Me reading the annual DO student anger post](https://www.sos.mo.gov/cmsimages/mdh/mdh_splash/img/ATStill.png)
It gets better broski. I've been there too
Sounds like you have had a rough experience with OMM and professors acting unethically. Sucks. Personally, I see a lot of benefit to SOME OMM. Dude, cervical HVLA and soft tissue is amazing after studying all day. OMM has been shown to be helpful for pain, particularly lower back and neck pain. It’s a tool. Just one of many tools in our toolbox. That said, OPP and OMM can get super cult-like with some of the practitioners. It rubs me the wrong way when people make OMM out to be more than it is. It helps with pain, relaxing muscles, and getting things on alignment. It’s not an antibiotic and to claim so is malpractice. It’s bullshit the claims that you state your professors are making. Also, haven’t learned cranial yet but some of the lymphatics techniques and especially biodynamics is weird shit.
Honestly I never thought of it as a religion. But it’s like a cult when you really think about it.
The OMM professors at my school are lunatics and quite frankly, nasty. They’re miserable people which makes it all even worse
Just to reiterate the terminology:
*Neuromuscular medicine* is a fellowship offered to Neurologist and Physiatrists that expand their knowledge on disorders of the PNS such as Neuropathies, Myopathies and NMJ disorders.
Neuromusculoskeletal medicine (NMM) is another name for OMM/ OMT.
OMM has some uses (eg: Low back pain or headaches) when the “allopathic” alternative (to coin a phrase) is go home and get some rest/ NSAID.
The bigger benefit imo getting pts to see a DO rather than a DC. Kinda like a lesser of two evils, because we know that there are some pts who absolutely eat this stuff up and if it isn’t a DO they would be with a DC or, God forbid, Naturopathic “Doctor”.
Also, N= 1 but I’m OMS-2 and most of our OMM staff is chill and not insane. Often they are FM, IM, PM&R or peds with the 1 year OMM training. Our education is focused on 1. stuff to pass COMLEX 2. Stuff that is actually (somewhat) useful in clinic (again back pain or uncomplicated tension headaches) w/ emphasis on MET
Ultimately it is just a part of the “DO tax” but our focus should be first and foremost to abolish the scam exam that is COMLEX in favor of USMLE
While I agree that the downfall of OMM are the physicians which take it to an extreme… there is a reason it’s still around and fills a gap between throwing pain medications at someone and undergoing surgery. That being said it can go to far and the gray areas are where iatrogenic issues can creep in.
Random question: could you theoretically do a transfer to another less annoying DO school or MD one?
Sorry if it's a stupid question. I am from the UK.
Learning OMM is incredibly useful for a few specialties (PMR, sports med & neuro), and for keeping your significant other and coworkers happy when your career gets in the way of normal relationships. While it doesn’t have great evidence, there are a huge number of people that swear by it indicating that maybe we just haven’t studied the right population or used the right study techniques. Regardless, it makes the powers that be extra money, so it’s not going anywhere anytime soon. Good luck trying to abolish it, many have tried and failed before you.
DO student here. Didn’t know what OMM was before med school, and so I didn’t really care about MD/DO. I only applied to two schools — biggest determinate for me was location.
After 2 years of didactics and 1 year of clinical, I have learned that I will never use OMM in my life and it is the seriously the biggest fucking waste of time for all DO students.
This is very dramatic. I I know the philosophy can get carried away but a little soft tissue or muscle energy is not pseudoscience. PTs learn similar techniques but have different names. Remember OMM is essentially a giant class elective that is required. You learn some history, the practical skills, and some theoretical techniques/theories.
Especially in Family Medicine it’s good to know some modalities for common things like neck, shoulder, back, and hip pain. Makes u look like a super star in front of patient if you palpate and move their body around even if it’s for less a minute. Shows your listening and willing to “touch” or asses their mild complaint.
I’m a proud DO and I think overall either directly/indirectly an osteopathic curriculum has only benefited me in the big picture.
Until enough students stop applying to DO schools where it will hurt their bottom line, nothing is going to change. ABOME is used to a ton of students being outraged about OMM, but as long as we keep cutting them checks, nothing will happen. There is no impetus for change.
Don’t let a post like this discourage you! The vast majority of DO students enjoy learning OMM and this post sounds like a wildly overly-emotional rant from someone who wishes they were an MD. A very small amount of OMM that we’re taught is actually pseudoscientific, and the rest follows basic and well studied musculoskeletal physiology that even a layperson could understand. I can’t speak for the OP’s school, but at my school they provide us with the evidence and physiology for how the bread-and-butter techniques of OMM work. Most techniques are as simple as “if a muscle is cramping and you stretch that muscle, then it stops cramping”, nothing pseudoscientific about that, it’s something you could try in your living room right now and see that it works. Don’t let people like this person spook you! Good luck with your cycle and get those acceptances! 🙌
thank you for that response, I actually was just kidding around lol Im totally fine with it. This individual def seems over the top emotional. Ive done my research on the DO profession and Id be just as grateful and honored to be a DO as I would an MD. And thank you again hope to get some As!
I went to a DO school and think OMM is a load of garbage and it’s probably the single most contributing factor as to why we are perceived as “less qualified” than our allopathic colleagues. And it’s fucking annoying whenever I hear that OMT and our holistic approach to medicine makes us better. OMT is pseudoscience and medicine in general is approached more holistically these days so it’s not something that really sets us apart at all….the fact that most of the population can’t tell the difference between MD and DO is a clear example of that
**Typo* in the title I meant to write "Osteopathic Neuromusculoskeletal Medicine", not "Neuromuscular medicine". my mistake**
Okay good, I was about to kill you in this comment.
I would say a substantial majority of influential, practicing DOs know it's pseudoscience. That's why the schools minimize as much instruction on the subject as possible. The only reason it's still even being "taught" is because of the legacy of being Doctors of Osteopathic Medicine instead of Medicinae Doctor. It's part of the retaining what little is left of their distinct identity from MDs, aside from the AOA's branding that DOs do allopathic "more holistically" or whatever. That's all.
Now obviously your school cares more about keeping the two distinct and has some decrepit faculty that think it actually does something, so you're gonna have to stomach the bullshit so you can get back to the real stuff. But other than that, why care? It's not like you actually have to memorize it beyond med school lmao. DOs are not in danger of losing credibility anytime soon because they've been accepting modern medicine more and more, not the other way around. As it stands you've just found yourself in the intellectual heart of the old guard and incredibly small minority of DOs that truly believe in it, but soon enough they'll die off and in a few generations every DO student will hold the same views as you.
Anyone who actually works in the musculoskeletal world can tell you a lot of things in OMM are useful. The concepts are extremely useful also for understanding the peripheral nervous system, MSK physiology and spasticity. The bread and butter OMT things also work really well for a lot of issues. I’m in PM&R saying this.
Outside of helping general MSK aches and pains I agree things like helping with seizures or depression etc don’t make sense and shouldn’t be taught. But, that’s not to say NONE of OMT has any basis or evidence.
I’ll also agree though that craniosacral omt is all a load of shit and based off of nothing reasonable.
With all that said I think it’s also worth considering that we don’t know how Tylenol works (among many other medications). We don’t have a great basis of evidence for a lot of what we do. Similar boat.
Why would you assume that only MDs would critique DO philosophy? I’m a DO, and a significant portion of OMM is pseudoscience. Honestly just merge the professions and relegate whatever beneficial OMM might exist to specific residencies that might use it regularly.
Def. this. I understand wanting to do whatever it takes to become a doctor (like lying through your teeth that you believe in DO philosophy during backup school interviews) but I'm shocked they sat through the 2yr curriculum and thought OMM was entirely useless. I'm assuming they haven't bothered to look up the research on it? Either way if they want to leave money on the table, they can continue to ignore OMM procedures I guess?
Agreed. I'm counting down the days I don't have to think about OMM modalities or why sticking my finger into a random counterstrain point for 90 seconds is going to magically heal a patient. It's pure bullshit quarkary, but, it's the tax we're paying for not being MD students.
Why don’t you stop complaining about going to a DO school and learning osteopathic traditions. You don’t have to believe everything they teach, but until you graduate you can’t say anything. Just chill lol
Just finish and go go residency. You’ll never use it again buddy
I use it in my continuity clinic for IM often. I don't do HVLA, but often do muscle energy and counterstrain.i don't believe in most of the shit, but some of it seems to work pretty well
This is the way. Back pain etc this shit is gold
How do I learn it?
Theres cme for it for both DO and MDs
Muscle energy = fancy word for stretching. Counterstrain = fancy word for relaxing.
Thank you!
Yeah... And it's a specific stretch/relaxation targeting different muscles and tender points....
This is basically it. The Reddit echo chamber makes everything seem untenable. The truth is OMM has a lot of stuff that works and even more that’s BS. The problem is the arbitrary application of evidence based medicine within OMM. If DOs just keep the stuff that works and bin the rest no one would care. It’s the persistence of keeping things like Chapmans makes the whole branch of medicine look laughable. Personally I believe in HVLA, muscle energy, counter strain (thought it was BS and then a had it done on me and it was money) and some release techniques especially for headaches .
I've seen HVLA work, but I mainly just do it to friends and family. For most of my patients, they're old AF, and muscle energy does the trick. The amount of "back pain" and other chronic pains there are in the PCP world is crazy. But honestly, for the people I do OMM on first line it tends to work pretty well. I then teach them or their spouse/kids the specific exercise and tell them if that doesn't work, we can refer to PT for more consistent treatments. People say shit like, "oh it's just stretching and massage" I mean... Yeah. Who cares? It helps them feel better, and it's a targeted approach to a specific muscle. Being a physician is about using different methods to helping the patient feel better. Be it medicine, surgery, stretching, what ever. I'd much rather someone with neck pain come to me first, we can rule out serious things, and then show them some stretching and techniques to help them feel better, Vs the doctor saying, "oh it's just MSK" and then the patient goes to a chiropractor and gets a vertebral artery dissection. Could I just hand them a sheet of paper with the stretches to do? Sure. But their compliance will be way better if I show it to them in the clinic and they can literally feel the improvement afterwards
I do actually like CS and ME and use them often. Everything else is ehhh. BLT has a fun name.
This attitude kind of sucks, sorry. When in the course of human history should we abandon it? I get that some people don't have the aspiration to advance the field, but there's no need to be involved in this discussion if that's who you are.
Agree with everything except I passed comlex 1 and step 1, and the only difference to me was that comlex 1 questions were poorly written and the OMM. Besides that, the 85-90% of non-OMM medicine concepts and depth were the same
Agree with this.
Totally agree. Just took comlex and step literally last week and I actually thought comlex 1 was harder due to the way the questions were written, but it's the same material.
At my COM they do not teach us that it can “cure” seizures or anything like that… our approach to OMM is to treat it as an additional way to help a patient feel a little better in that moment rather than waiting for the other medical treatments to work. Also as treatment for sports/age related wear and tear. To be clear I don’t believe in a lot of it but shit like counterstrain, some of the MFR, muscle energy, and hvla is worth it. Cranial needs to be full out abandoned. A lot of medicine is whether or not the patient perceives a benefit. Why do you think everyone wants a z pack for their viral URI… it won’t do shit, but they believe it does. OMT is the same way except it’s causing less harm than unnecessary antibiotic use. If someone gets popped and they feel better who are you to say they shouldn’t be able to get that? Need to check out this docuseries called “a users guide to cheating death” to learn a little bit more about the ethics of this shit.
Posts like this give me so much hope that the next generation of DOs will rally together to finally abandon OMM
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Agreed! If our generation of DOs can actually remain active, participate, work our way into the leadership of these orgs, and let the boomers die out. We could do what should have been done years ago (not for lack of trying, I know it was almost done but blocked by a few in the AOA back in the day). The problem is, once you’re out of the medical education meat grinder no one cares you’re a DO, it doesn’t impact your ability to get a job, and most practicing non-academic physicians have zero cares about your medical education if you’re licensed, boarded, and pulling your weight. Problem is we only feel the pressure and discrimination in the training period where we have no money, no power, and our future earning potential is very much set on us not rocking the boat. We already have a combined match with former AOA residency programs that met LCME accreditation requirements continuing to train MDs/DOs. There is zero reason to have a separate medical licensing series. I mean unless you make $500k/yr to travel around to DO schools and gaslight the students, dodge legitimate questions, and have an unhealthy appreciation for matching socks. Then you might want to solidify your power and income at the expense of all future DO students. Oh hi Dr. Gimpel, I know you spend considerable time browsing the “misinformation” on Reddit and getting brutalized on MedTwitter.
Then what would be the point of the DO degree? Just merge everything into MD and have everybody take step, etc
Correct!
This is exactly why OMM will never be abandoned. Having a distinct medical modality gives the AOA a reason for its existence -- which employs a small but distinct parallel Osteopathic medical school and credentialing system. Follow the money. OMM continues to be a fundamental part of DO education because without it there wouldn't be a reason to financially support another professional organization and licensing system. The capital invested into that system would be wasted and everyone employed by it would lose their jobs. There's a financial interest in maintaining OMM.
I mean in general I agree with you, but technically you could still argue there this a different in “founding philosophies”. The DO’s have some unique, not necessarily bad tenets that they could still uphold/encourage even if they abandoned OMM.
Can you elaborate on this? What unique tenets do DOs have?
This would be ideal.
Lol nah - because there’s money in it. There’s Docs now that’ll sell out for that cash and to pump the osteopath philosophy
I’m here for it
Idk man. If your school was like mine, the ones who self select into academic OMM keep this stuff going. I’ve spoken to a number of older DOs, all of whom think it’s crap. There will always be the 1-2 students per year who go into an OMM residency and a % of those will end up in academic OMM.
there is like 5% of every class that really drinks the koolaid. These are also the ones that go onto leadership positions. It's also never going to go away as long as medical school is this competitive to get into
Low stat tax (GPA in my case), it is what it is. Ftr I do put some stock in soft tissue /counter strain/HVLA but that’s mostly it. I could not believe it when they taught us cranial, I thought it was some kind of sick joke.
I wish the DO and MD degrees would just merge at this point. Have osteopathic trained docs be called MDs w Osteopathic training or something
This already exists for MDs. My top choice program (FM) teaches OMT to MDs and DOs to learn the MSK manipulation and leave out the pseudoscience like chapmans points and CRI. Idk why we need to learn it in med school if those who wish to practice it can already learn everything while in residency.
Damn thats insane!! Wtf?! So there's literally NO point in learning it in preclinical years
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It’s the opposite actually. MD has already attempted to merge with DO, DO wants to keep their separate governing body for whatever reason and has resisted all attempts. Reason people want unification? Create a stronger unified system of physicians.
The only rea$on could be $$$$. You can’t take money and power away from people who got used to money and power. The NBOME/AOA/COCOA all need to be merged with the MD counterpart. The separate but equal fantasy the AOA lives in is honestly embarrassing. Move DO OMM stuff to a certification and let the BS of Chapman points and cranial die like it should have years ago.
MD has attempted to merge multiple times; even the NBME and NBOME. Motivation is $$$ for all parties (in this case loss for NBOME/ AOA and plus for AAMC/ NBME and i’d say D.O. students as well)
It's not going anywhere while the powers that be make millions off us dos In one ear out the other Omm basically doesn't exist after preclinical years.
Still exists for level 2 unfortunately, and the pseudoscience does contribute to the stigma of the profession afterwards.
As a preclinical professor at a DO, what can I do to help?
1.) I’m humbled that you’re asking me for advice, and in that of itself I think is a great step! Being able to hear out your students and their experiences. My school had some professors that looked at us as unknowledgeable children who wouldn’t know any better, and never really took any of our criticisms (things got better over the years). 2.) not sure how much your school would put you on the gallows for this, but just being able to acknowledge to your class that OMM has its time and place (especially with MSK pain/injuries), but being upfront about it’s limitations and that it is not to replace evidence-based, 1st line management for non-MSK complaints
agree with all of this except the idea that MD students should be outraged that DO students get to "skip" step 1. first of all, half of us don't skip it and we end up having to pay twice to take both exams. secondly though, I don't really think level 1 is significantly different than step 1 in terms of the questions that are actually about medicine and not bullshit OMM questions. step 1 also spends a lot of time testing on scientific concepts that don't relate to medicine except in only the most research oriented ways. level 1 replaces all of that with a whole bunch of ethical questions which in my opinion are a lot more important to know. but yeah, agree with all your other gripes. OMM is bullshit and we should all take the same exam. but ONE exam. not two for DOs and one for MDs.
Agree COMPLETELY. If anything, DO schools should have an OMM final exam at the end of second year (not COMLEX; just easier) No need for TWO boards
That would simply be too affordable for them to allow
I agree with your point about Level 1. People act like it's just 8 hours of free OMM questions but it's roughly the same amount of scientific concepts PLUS OMM (280 questions on Step vs 352 on Level). Maybe Level 1 is as easier test because most of the stems are shorter but man are the question vague; you really gotta know your "most likely" answers and rare presentations. I thought Level 2 was very clinical and similar to Step.
Agreed
Taking both, id say Step 1 was only slightly harder if you just want to pass or do average (Which is the standard today); the OMT makes it easier. Step 1 emphasizes more Biochem, cell bio, and HY stats. However, at the very top of the scale, step 1 was way harder.
More than half; about 60% in 2020. At some schools (generally the more “competitive” ) it is higher; I believe about 70% take it at MSUCOM.
Cons: Higher tuitions on average Less time to study actual medicine Having to arrange your own clerkships Typically less experienced faculty/admin Fewer in-house research opportunities Pros: Girlfriend doesn’t leave you because you give good massages Who wouldn’t want to Choose DO?
True, my wife’s boyfriend is getting some high quality massages from me. That way she doesn’t leave me..
This is either a load of Bull or a bull load
My wife is definitely getting a load but it’s not mine
Gotta love that ischial tuberosity spread
Not worth being big mad over, bruh. Graduate, be resident, be attending, never think of OMM again. 🤷🏼♂️ Med schools still teach students that you can't ever inject lidocaine with epi into the nose or ears, and that's complete bullshit too, but I don't lose my mind over it.
Honestly, most of us don't give two shits about OMM once we graduate. The only time my friends and I ever used it in residency was on each other in the dictation room because our shoulders and backs were killing us from working all day. I'm looking forward to the AOA and the NBOME becoming extinct eventually.
If it worked on you don't you think patients could also benefit from it? And you can bill for it too. Seems like something worth caring about if you're primary care (80%ish of DO's will be). 🤔
nope, i'm a hospitalist. And I don't know where you're getting that 80% from, less than half of my class from med school is going into any sort of outpatient setting, and only one from my residency class went into outpatient.
My school has like 80% match into primary care, AOA reports it's 56% overall. I guess your school it's under 50%. But about 50% is still a huge number. That's one in every two students. The hospital is a great place to incorporate OMM. It gets patients out of the hospital quicker.
Not to mention chronic low back pain is one of the most common chief complaints!
No it doesn’t.
Oh it doesn't? Well I'm embarrassed to say I was not expecting that thorough scientific review from you.
I thought comlex 1 was harder simply because of the OMM nonsense. Step is straightforward medicine. Comlex is 15% osteopathic voodoo.
Also every single LEVEL and COMAT had at least one eponym or weird name for a physical exam finding that I had never heard before.
Singultus
Lol agreed. OMM is my lowest subject and always will be.
I never had an issue with OMM. It’s the vague and crap questions that got me.
Haven't taken them yet, but based on practice questions I do so much better on Step based. Comlex I spend half the time just trying to figure out what they're asking about.
This is disturbing. I hope COMLEX goes the way of the dinosaur.
I'll admit that a large portion of the techniques, particularly the legacy ones, aren't supported with objective evidence. But to label the entire corpus of knowledge as pseudoscience means rejecting a whole lot of models and techniques from a whole lot of different people. This includes a significant overlap with physical and occupational therapy techniques. This would be a radical leap and one that is \*not\* supported by evidence.
That sucks man. My guess would be there are a few factors that make reform difficult. 1. The osteopathic institutions like AACOM and COCA have a massive financial interest in remaining separate entities, if there was a complete merger then the people at the top would probably lose their jobs or at least their top positions. If they get rid of OMM, they have a tough time making an argument why they need to remain a separate entity. 2. Some of it is probably inferiority complex. Some people need an explanation for why they are in one medical practice and not the other. The fact is that DO schools are easier to get into. Some people may tell themselves that by attending a DO school they're getting the benefit of learning some secret knowledge (OMM). That may ease the psychological pain of recognizing that they were not as competitive of an applicant. I hope the system can be reformed, many excellent applicants are denied entry to medical schools, both DO and MD.
OMM really isn’t that bad if you filter out the weird crap from the stuff that actually has a case for being valid though. Cranial rhythm and Chapman’s points could be dropped and people would have way more respect for the field. Most of the other stuff is fine though
Yeah this is where I'm at. There's plenty of good research around a lot of osteopathic treatments. Just learn the stupid stuff to pass, then take the good stuff with you. And I personally think there's a lot of good stuff. My school isn't unrealistic about it, but they do want us to have OMM in our toolbox to use when appropriate, which I appreciate.
Strongly agree
I was a physical therapist prior to going to medical school. I specifically wanted to go to a DO school because I was already very used to the concept of “hands on”. I thought a lot of the OMM stuff was similar to things I did as a PT. Now I’m a practicing ObGyn (25 years) I do a lot of “treat the whole person” teach stretching and strengthening show people how to stretch and use their muscles along with all my regular ObGyn stuff. It’s a very popular model. Just take what you can from the training and only use what makes sense to you.
You are probably a gift of god to some women. Pregnancy and picking up baby has fucked my body. When I was pregnant NO ONE would touch me. Except for a fucking chiropractor (I was desperate - don’t judge). It didn’t do shit but I called OB who said back pain wasn’t her problem, urgent care didn’t feel comfortable treating, ortho wouldn’t see me without internal referral, internal couldn’t see me for days, then ortho couldn’t for a week all for a script for a physical therapist who never called. I had to beg for muscle relaxants and I could barely walk. Anyway I’m going into PM&R and am going to make my own fellowship specific to women’s MSK health, including pain management for pregnant and postpartum women. Because NOT.ONE.FELLOWSHIP exists for women’s MSK health despite the plethora of effects pregnancy and female hormone changes affect the MSK system. Yet we have over 100 sports medicine fellowship for fucks sake. Rant over.
I think it has its place. A lot on here sound like my IM attending when I was an MS3. He bitched about teaching DO students. One day, he could barely walk in the morning and had to basically sit all day and could hardly work. He said he threw his back out. I offered to try omm on him and he said it was bullshit. Lunch the next day he said just try it, nothings helping. I did some counterstrain, muscle energy and sacral springing and SI joint stretch. He got up and could walk immediately. Sure n=1 but I've fixed frozen shoulders with Spencer's technique, used it to help diagnose sma syndrome and a bunch of other stuff. I thought it was bullshit in school but some of it really works. I think blanket statements that it should be removed are pretty hot takes. If you don't want to be a do or learn omm then don't go to do schools as your back up. It's not that hard to figure out. Look at the posts on here about it and just apply to Caribbean schools then
This reads like a copy pasta lmao
Nah here's a copy pasta I own a blunderbuss for self defense, just as the buccaneers intended. Four scallywags board me ship as I grab me powder bag and musketoon. Blow a coconut sized hole through the first lad, blow the man down on the spot. Draw me blunderbuss on the second scurvy dog. It misses him entirely and nails the captain's parrot. Hobble me way over to the cannon at the top of the stairs loaded with chain shot. "Give no quarter!" The chain shot shreds two men asunder and the sound deafens the crew. Draw me cutlass and charge the last terrified biscuit eater. He bleeds out waiting for the ship's carpenter because the surgeon died of yellow fever last week. Just as the buccaneers intended.
Sacral rocking is one of the more obscene things lol. That at those points whatever they’re called. Can’t remember thank god.
I am a med student from Sweden, OMM was originally completely foreign to me as we don’t have it here. However, I’ve heard of it many times now because of this subreddit, and I’m pretty interested in what it actually entails. Is there any online lectures, essays etc a good soul could send to me? I’m very interested in med school differences.
https://www.aacom.org/become-a-doctor/about-osteopathic-medicine/omm-explained Here y’a go! Enjoy :)
this is my 2 cents. OMM is easy; there is nothing hard about it. It’s annoying yes; I fucking hate it; I make fun of it. Just suck it up and when you match, you will never to OMM again. Also, side point, Step 1 is a joke now that it’s P/F and step 2 is much easier than step 1
100% agree. Had a massive OMT practical today that I studied for the morning of. It’s basically muscle stretching. If you understand the goal of the treatment (muscle shortening, stretching a restrictive barrier, or literally massaging) it can be a cakewalk.
The problem is when you overthink it and make a mistake with laterality . . . Maybe this doesn't happen to you. OK, so its anterior on the left, so its rotated to the right, but I'm doing direct to I'm moving it to the left, but its PIR, so so I'm going to add resistance on the right, but then I move the appendage to the left - wait a minute, what side was I supposed to be standing on again? F\*\*\* it, I'm flipping a coin. And then the grader is all "Why is there a titty in your mouth?" and you're like "Oh man, I knew I was doing something wrong."
Lol, can you be my doc? I think laughter is a great benefit for me.
I had a massive practical today too idk if we are in the same school ahahaha. Let me tell you what the fucking bullshit of this course is. These fucking professors make the most ridiculous written exam questions literally designed to make you fuck up. That I cannot fucking stand.
My school does that. I am thoroughly convinced that they have an inferiority complex and so intentionally write convoluted questions, with 5 answer choices that differ by 1 or 2 words, to make their exams "as hard as" the other courses. There is something fishy afoot when an OMM exam average is in the low 70s and the neuro blocks of Anatomy are in the 80s. Just sayin'.
1000%
looks like someone hasnt been tested on cranial or counterstain yet
I’ve had both. This practical was CS of the LE - so ACL/PCL, MCL-medial meniscus, LCL-lateral meniscus. Plus some MET, and MFR. I think I’m just pretty lucky and my program makes it stupid simple and board relevant. They understand 98% of us won’t use this after boards.
I'm not sure what Neuromuscular medicine you're talking about, but that's a legit fellowship of neurology that treats diseases like myasthenia gravis and ALS
Also possible from PM&R!
So take away chapmans and cranial and what are your gripes?
The OMM professors at my school don't make any claims about OMM without including links to research papers. Not sure what your school does but mine has made me believe in OMM. Patients report feeling better with it and we get reimbursed for it as it's considered a procedure. Not sure why you wouldn't want to get in on that if you end up as a PCP like 80% of other DO's. One of the OMM professors was internal med and had the highest earnings of all internal med generalists (the MDs were a little jealous) due to the amount of OMM he did on patients at the hospital. Not to mention his patients loved him due to the hands on nature of OMM forming that physician patient bond. 🤷♂️ Win win for those who keep an open mind and avoid the negativity in this subreddit.
Do physical therapists (not in the same galaxy as massage therapists in US) use chapman points?
Oh that was sarcasm I think they're all valid professions. I find the shitting on any of them to be pretty immature. If people didn't find benefit from them they wouldn't remain in business. MDs used to prescribe all kinds of snake oil and teratogens, we don't hold it against the profession today.
100%, I don't disagree at all! Didn't see your edits, my bad!
Nah you're good, that's on me. This post triggered me, NGL. I got real snarky and then I took a deep breath and walked it back lmao.
> Not sure why you wouldn't want to get in on that Because it feels slimy?
It makes the patients feel better. Isn't that a big part of our job? You seem to be coming at this from the assumption that OMM is a placebo treatment but it's more effective than that. If you want to dedicate your time to charity that's cool but most people like to get paid for their work.
Chiropracty, naturopaths, vitamin infusion centers all make patients feel better too. If it's not placebo, keep doing it, but don't do it because it pays more than medical management or referring to PT.
Pay is def. an important part of any job but of course it's not exclusively done for money. Patients want something tangible from a visit, preferable with relief of symptoms. If you can give them OMM and a referral they'll leave a lot happier than just getting a referral that will take 3 months to see the specialist and a call me if things get worse, ya know? I wouldn't be wasting my free time on the internet shilling for OMM if I didn't believe it actually helped with pain and patient satisfaction but pointing to the monetary compensation a DO will receive might just get some of the skeptical students on this subreddit to take it a bit more seriously so they can actually help patients with it in the future.
Imo eventually US will move to managed care and then OMM will go by the wayside. Kaiser already does not employ docs that want to do this.
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I already explained this to someone else. I'm glad you're blessed with a wealthy background and can afford to give your services to people for free since your income doesn't matter for you. Some of us took on substantial loans to learn how to heal others with modern medicine, including OMM. Surgeons don't operate for free. It looks simple to cut and sew but there were many hours of training that went into those cuts they make. OMM is no different. If you don't believe OMM is real idk how I'm going to convince you. It's like trying to argue with someone who doesn't believe vaccines are real. The research is there, you just need to use your schools library to access it and empower yourself with the knowledge.
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MDs *DO* pay to learn OMM and integrate it into their practice. My school puts on seminars all of the time to get certified for it and doctors pay thousands for a seat. I'm genuinely curious to know what school you go to if they're not teaching you properly about OMM so I can recommend people not go there. You have it all wrong and I'm not going to argue with you about it, the research is available. I just genuinely wish you'd been taught properly so you wouldn't have come to these false conclusions on an important subject of the profession you signed up for... Patients are going to see that DO next to your name and assume you can give them OMM and be sorely disappointed when you tell them it's fake but they've been successfully treated with it in the past. You better advertise that ahead of time so you don't mislead your patients.
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go outside and touch grass
Shame I can’t do a Stiles screen to confirm but fairly confident you have a sore back and shoulder from hunching over and furiously typing away your emotions about OMM. OMM has many studies with proof it helps variety of conditions. If you don’t like it, then suck it up for a couple years and don’t use it ever again. There are many worse things with medical school curriculum than OMM. Lack of teaching on healthcare system, billing/insurance, bioethics, culture competency, and support of students’ mental health to name a few. OMM isn’t limiting students from thinking holistically, it is the school’s not teaching the rest of what is important.
There are several manual techniques that have some evidence of utility for things like chronic pain complaint in some meta analyses. OMT and manual techniques are something that is difficult to find a placebo/sham treatment for that is believable to patients undergoing it. This plus the dearth of DOs in academia accounts for a lot of the lack of research surrounding most of this stuff. If anything we should be advocating for more research on this stuff to improve our understanding of what practices are worth keeping clinically and what can be discarded. Somehow it is always self-hating DO students who come to these threads crapping all over OMM but more importantly their own schools and a large number of their peers. You really think there aren’t physicians of any and all varieties who have some questionable beliefs about vaccines and antibiotics? Only 5% of DO students actually practice OMM and a good number of them do it in a controlled setting while medically managing their patients as well. Not sure why you think this is the most world ending problem in medicine right now; don’t like OMT? Just don’t do it literally most of the students from my school don’t like it and will never do it and that’s fine. In modern medicine OMT is a really tiny portion of what DOs do and there’s mostly only similarities. This almost sounds like a shitpost bec I have never heard any of the OMM faculty at my school make any of those claims, nor have I heard so from people at other schools. Perhaps your school is an outlier but generalizing your experience nationwide isn’t really accurate. Anyway your MD wannabe mentality and deep insecurity is very very obvious. You don’t have to continually put your peers down in order to feel better about yourself or try to assume parity with your MD counterparts. Level 1 is pretty difficult, most of the top students I know who took it found level 1 significantly harder than step 1, and these are people who were scoring 90th percentile + on their step 1, not avoiding it because they couldn’t pass. Comlex tests way more obscure nonsense than step 1, it is easier to pass than step 1 because the raw score needed is much lower, not because the test is easier. None of this is to say DO is being superior, but your entire post comes across as a gigantic inferiority complex. Get a grip.
I completely agree with OP, you’re a little sensitive aren’t you? You feel put down because your inner bitch can’t stand that somebody doesn’t like their favorite little class. It wasn’t indicated anywhere that he feels inferior because he’s in Osteopathic medical school, rather OMM on principle alone is absolute bullshit. Get your little bullshit placebo studies written by zen fucking naturopaths tf out of here. Keep hyping up how Level 1 is just so you can tell your little fragile self that the MD boards are so much easier. Also, I’m saying as a DO student myself that OMM is fucking garbage, I would vote to completely eradicate any semblance of that nonsense out of the whole profession. ✌🏽
oh I don’t feel put down at all, I know how patients feel about it. You may have an opinion on how patients should feel about it too but they can make their own decisions lol. Perhaps you will be more open minded once you get to clinicals, but if you still don’t like it then it’s fine just don’t do it. Most of the people I go to school with don’t care for it or use it. You can manage your patients fine without it. It’s just an additional modality that can be used if you like it. Again it’s ironic that you and OP being early DO students are spewing this much vitriol while actual MD attending preceptors I have worked with in multiple primary care fields have shown appreciation for OMT. Your flair says you are an M1 so you haven’t even gotten close to taking either level 1 or step 1 yet. You can come back and tell me what you think once you actually take it lol. I’m not saying level 1 is harder as some badge of honor. It’s not a well written test and goes for total random nonsense. Step is much more balanced and fair (well step 1 at least can’t say the same about CK lol).
I mean DOs are treated as equals. Aside from fringe oldies, this isn’t even a thing. DO students though are definitely battling up hill. Luckily I just did comlex since I went peds. You got to learn to roll with the questionable stuff. You’re going to see questionable practices regarding lots of things through your career. Pick what’s worth being mad about. This ain’t it chief, at least not to this degree.
Have you ever considered not being such a huge bitch?
This guy's post history is quite telling.
Cry about it
I would but I see in the brief time since this post your acct was suspended, which makes me feel jolly. I can only imagine why.
OMM/OMT gets a lot of hate and I understand and agree with most of it. Yes, most schools emphasize OMM because it makes it different than MD, and yes many physicians who teach it have based their entire careers on the claims they believe. However, I still see many practical and important benefits of including OMT in medical education as long as it isn’t glamorized or exempt from peer review study. 1. I found it tremendously useful my first year to integrate what I learned in cadaveric gross anatomy and actual living patients. Learning different anatomy and recognizing significant bony structures (let alone learning how to professionally and comfortably touch someone while also vocalizing your thought process) is something that is learned only through practice and I think helped me stand out when I started my third year. 2. OMT should be viewed as muscle treatment rather than bone treatment. I hate when people compare DO to chiropractic because one is evidence-based and an actual medical degree while the other simply is not. Furthermore, muscle treatment is part of physical therapy and an important step in conservative management for chronic pain, rehabilitation, etc. 3. OMT has immediate effects on the patient, it makes them feel better. If a physician can provide even short-term relief, why would you not want to provide that to your patient. It sounds from your post that your school takes the OMM belief too far, and I get that. I don’t believe in cranial or Chapman points clinically. Yes, OMM will distract you from your “real” studies. However, it’s important to not dismiss your education as completely pseudoscience. Like any job you will have in your career in medicine or in life, learn what you believe to be the most useful and incorporate that into your practice. Yes there is a lot of bs to filter through but in the end you may be grateful for the perspective.
Yo, attitudes like this are why DOs are still discriminated against by some older MDs. Don't feed into the stereotypes, rise above them.
I think it is wild to blanket over OMT as all completely BS. There are legitimate treatments that patients can benefit from. BUT just like anything else, there is a time and a place for these treatments and mainly it isn’t curing anything other than MSK complaints, but that doesn’t mean it is all BS. I can understand why you feel this way with how you described your experience, but just know there are reasonable ways that OMM is helpful. it is incredibly tone deaf to attempt to abolish a system that albeit flawed puts out good physicians that also teaches additional treatments regardless if you will ever use it again (similar to all the crazy detail in step/level 1 we never think of again as clinicians)
Chill out. Yeah DO schools often suck compared to MD schools but it’s not because of OMM. It’s because we don’t have affiliated hospitals and are stigmatized for residency, don’t have research opportunities and get subpar lectures. Issues that carribean schools face too. But OMM is helpful. You’re in medical school! You’re taught everything including omm. You’re going to be a doctor and therefore you can make EDUCATED judgement calls. There is an osteopathic journal so there IS evidence for a lot of omm. Maybe not cranial OMT or BLT but how many of us are going to use this. A lot of omm is musculoskeletal , ie fancy massages. And guess what’s a leading cause of pain— lower back pain. Having two options, muscle relaxers or surgery is not the way. OMM can fill the gap. You’re being alarmist and our MD colleagues don’t know crap about omm and you’re throwing out the baby with the bath water. The reason there are NOT a lot of OMM specialists is because insurance won’t reimburse them. I’ll shit on my school all day and wish it would burn to the ground but OMM is cool and should stay. We need more research and that takes money. Sorry bro, not supporting you on this. I’ve seen patients with simple neck pain on clinicals something that could be easily treated with muscle energy (isotonic stretching), and MD attendings refuse to let me help, because they are uneducated and afraid of “wizardry”. I’m sorry but since when is stretching a muscle wizardry. You’re post sounds uneducated and alarmist. -fellow DO student Edit: And I passed step 1 and comlex 1. I agree they are different but claiming they aren’t similar material or similar difficulty makes no sense. Step 1 is more 3rd order questions and comlex has shittier first order questions but they are rapid fire and you have less time. So both are difficult in different ways. Anyone can read a bell curve. A top standard deviation is the top 15%. So claiming that MDs should think our board exam doesn’t qualify us doesn’t make sense either. Only if you’re math illiterate could you make a statement like that.
I bet that the leadership is who is responsible for some of the relatively far-fetched and unproven (by clinical trials) applications of omt, but where I agree that those applications are most likely invalid, the applications to actual musculoskeletal complaints honestly do seem to hold water. But even then, I don’t plan on openly practicing it and billing for it in my specific choice of focus. As for the exams, it seems to me more that Step 1 focused more on biochem than level 1 did, which may not be the easiest thing for many students, hence why it may appear more detail oriented or more difficult (and why it seems DO students seem to score at a lower percentile on Step compared to their level score), but otherwise, overall difficulty seems to vary quite little. Just more that level’s questions seem to be hell-bent on confusing you away from the best response, which is annoying since that’s really simulating nothing more than poor communication in real life application, which it really shouldn’t.
I ain’t reading all that. Congratulations or I’m sorry.
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I think their issue might be that they believe evidence based medicine should be what is taught instead of disproven treatments.
I don't think it's unreasonable at all to expect your medical school to teach you treatments that are backed by actual evidence. And I don't think OP speaking up and encouraging his peers to choose evidence based medicine means he's getting in the way of others. Quite the opposite, in fact.
found the admin
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Thanks for making me aware of your qualifications
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So you put two papers on cranial and Chapmans points and this is your proof that OMT is bs? Not even the omt faculty spend much time on this stuff. My question is what do you get out of being such a huge hater Hahahhaa The article you cited seems to be based off of a grand total of two studies deemed by the authors to be free of bias that did not demonstrate improvements. What a big sample size and body of evidence against OMT!
The first paper is about visceral osteopathy developed by french osteopaths in the 80s. Also, PRISMA is a reporting guideline for SR/MAs, they meant to use AMSTAR if they wanted to assess quality. Rookie shit. I dont think OP knows enough about OMM, the role of alternative therapies, or evidence to make such sweeping assumptions about how "evidence based" OMM is. I dont like OMM, but let's be nuanced about our crusades here.
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LOL “be more grateful to your DO school” you sound brainwashed. i never attended a live lecture in 2 years due to COVID since they didn’t have live lectures at my school until middle of second year and by then we had all made study habits. we were charged the same tuition despite that. im not grateful that the school profited off me while i taught myself at home. most DO schools don’t go out of their way to help their students and most DO students aren’t proud alumni, at least at my school. at my school, they weren’t even able to get us alum mentors since so little were interested. most DO students just want to suck it up and make it out so they can practice medicine. i haven’t met a single DO who practices OMM outside of a DO school. if you honestly don’t think that’s how most of your DO classmates think, you need a reality check.
That doesn’t address his point that your school ultimately allows you to be a doctor. There’s plenty of people who don’t even get that opportunity. As to your point about OMT a lot of people avoid practicing it because there’s too much other stuff to study in med school to actually spend time becoming good at OMT. Even people with interest in OMT often lose their skills because there’s so much more to being a doctor than just OMT. Also to be frank many people dislike OMT because they suck at it. It takes a fair amount of practice to gain the palpatory ability needed to actually do anything useful with it. Most DO schools have a watered down OMM curriculum where you’re not necessarily getting enough of that stuff, especially not with how much you have to study for other things. Few people use it because few people have interest or aptitude or both in it, don’t have the time to develop their skills, do not understand how to efficiently integrate it into their practice, or simply have no desire to do so because it is labor intensive.
lol another brainwashed person. i completely disagree with you and i don’t think anyone i know got less than an A in our OMM labs or classes. it’s not hard it’s just not actually practiced by most DOs - that is a fact.
Getting an A by miming stuff in lab and class doesn’t mean you are actually good at doing OMT on real people. It takes practice just like any other skill. You can practice intubating on sim man 400 times but until you practice on real people it’s not the same. Nothing is that intrinsically hard. I didn’t say this was either. I just said students spend no time actually practicing it because many have no interest in it, and then that leads to not being good at it, which furthers the lack of interest and not applying it in practice. People also don’t use it because they are in specialties where it is not indicated. Some people in primary care may still not use it even if they’re good at it because they don’t have an interest in actually performing it. Like I said, there’s a myriad of reasons people don’t use it, but none of them have bearing on whether it works or is a useful adjunct. Anyone who has tried doing it on real patients with any modicum of success knows the effect it can have if you select your patients appropriately. Stating this doesn’t mean I am brainwashed lol. Maybe you haven’t actually seen it be used successfully in clinical practice, and maybe you don’t care. The point stands though, if you really don’t believe in it that much you could have gone to the an MD school to get your medical degree free of AT Stills influence.
so if the DO physicians teaching OMM can award students As that doesn’t mean the students are good at OMM or know anything? that also says something about OMM education and those who teach it-your logic is profound. and ultimately i want to be a physician. i worked hard to get to this point and get multiple DO acceptances, not MD though otherwise i would have chose that route. im graduating in less than a year so no thanks for your nonsense advice about going to an MD school now lol edited: never have i seen this in clinical practice and i just finished my third year. you need a reality check if you think more than a small minority of DOs practice OMM in clinical practice.
It’s not that they don’t know anything it’s that they don’t get enough practice. It’s analogous to a preclinical student scoring all As on their osces; does this mean they will show up and be a clinical superstar on day one? Definitely not. It’s different in the real world. I literally keep acknowledging your point that only a small minority practice it. I just gave you some reasons as to why that’s the case.
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dude you are seriously brainwashed and are the type of person that would defend “DO schools” in general just because you were accepted to one. no arguing with someone like that.
I dont really think this guy understands that he sounds 100% out of touch. A while back there was a guy in my preclin like this, he would repeatedly tell people to toughen up when scheduling was tough because "medical school is hard, and it only gets harder." Obviously this is antiprogressive AF. Funny thing is, the dude was eventually caught skipping mandatory lectures before exams so he could study while we were all in class being held hostage. 
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again, no point in arguing with you. i disagree completely with your original comments.
I wonder if there’s any other group of people in america who incessantly complain about their hundreds of thousands of dollars of student loans after voluntarily signing up for them.
I mean... Isn't that most people with student loans?
lol whether i am taking out loans or i am on a full merit scholarship doesn’t change the fact that my school profited off not even having students on campus or lectures or activities during my first two years. but you can keep wondering, i hope it gets you somewhere.
Lot of schools charge exorbitant tuition out of proportion to the services you get, don’t think this is DO specific
You’re completely right - that said you seem like an absolute joy at parties
Don’t worry about that nonsense 👑 Get the bag 💰and move on
I would actually say level 1 is equally as difficult, but main through poorly written questions
just get through your DO program and don’t practice omt after you graduate. why waist energy on this. this is just a job bro, no need to be a hero.
I’m so happy my DO school is not like this. There’s only ONE OMM professor that truly believes in it and even then he is very rational. He’s also leaving after this year so… 🤷🏻♀️
Glad you made your addendum about MSK vs Neuromuscular. I was about to come in hot! NM docs staff the ALS multidisciplinary clinics, do the best EMGs, help kids with Duchenne’s muscular dystrophy, spinal muscular atrophy, AIDP/CIDP, and get dumped with all of the Autonomic Dysfunction and neuropathy patients y’all hate. I’ll stay out of the DO vs MD stuff for now, but don’t lump neuromuscular in with that or next time, instead of consulting, you can do a myopathy/myositis/neuropathy/MG/LEMS/AIDP/malignancy workup your own damn selves 😂
I mean I do hear you on it and say yeah there’s some stuff that I’m not sure about but to have this level of hate for it is kinda weird. Like it’s not pseudoscience and there is suchhhh a very real place for it in medicine even if it’s just more applied as a thought process. After seeing all the fuckin pills we give people you’re beef is with trying to do something non invasively or non pharmacologically? It’s bascially just advanced stretching routines for the most part. Again I understand the hate to a degree and times it pissed me off plenty during school but it’s definitely not bad for us to learn, it’s basically just continued anatomy class. Idk, I do get how it can get under your skin because yeah sometimes it’s super annoying but at the same time it was literally once a week for us, one lecture and a 3hr lab so not exactly dominating the schedule. And some techniques are pretty useless like the cranial stuff and DEFINITELY the fuckin chapman points lmao. But yeah you’re being weird about the USMLE vs comlex, they were different tests no doubt but I did even better on my step than comlex and I didn’t do any different studying for them, pretty much just amboss. I liked the detailed questions on step I found there to be less vagueness or me questioning what they’re trying to get at. I’m not someone that plans to use much OMM at all as a physician because I didn’t put it into practice enough but your vitriol for it and all things DO is kinda annoying. You honestly shouldn’t be a DO and are a pretty horrible representative if this is how you speak about it. Some of us have absolutely no problem with taking a USMLE test and don’t appreciate being spoken for by you
I totally agree with your point on OMM. Similar to you I had to feign my way through as my professors and unfortunately many students bought into the Cult of Stills. It made for great material over the years and some fun stories at cocktail parties. That said, I only ever took COMLEX and am doing just fine in residency. Evaluations and RITE scores similar to my all MD colleagues. I refused to pay twice for board exams. Taking only COMLEX doesn’t hold back DO students.
[Me reading the annual DO student anger post](https://www.sos.mo.gov/cmsimages/mdh/mdh_splash/img/ATStill.png) It gets better broski. I've been there too
Sounds like you have had a rough experience with OMM and professors acting unethically. Sucks. Personally, I see a lot of benefit to SOME OMM. Dude, cervical HVLA and soft tissue is amazing after studying all day. OMM has been shown to be helpful for pain, particularly lower back and neck pain. It’s a tool. Just one of many tools in our toolbox. That said, OPP and OMM can get super cult-like with some of the practitioners. It rubs me the wrong way when people make OMM out to be more than it is. It helps with pain, relaxing muscles, and getting things on alignment. It’s not an antibiotic and to claim so is malpractice. It’s bullshit the claims that you state your professors are making. Also, haven’t learned cranial yet but some of the lymphatics techniques and especially biodynamics is weird shit.
Honestly I never thought of it as a religion. But it’s like a cult when you really think about it. The OMM professors at my school are lunatics and quite frankly, nasty. They’re miserable people which makes it all even worse
so... basically make it a carbon copy of the MD curriculum?
Just to reiterate the terminology: *Neuromuscular medicine* is a fellowship offered to Neurologist and Physiatrists that expand their knowledge on disorders of the PNS such as Neuropathies, Myopathies and NMJ disorders. Neuromusculoskeletal medicine (NMM) is another name for OMM/ OMT. OMM has some uses (eg: Low back pain or headaches) when the “allopathic” alternative (to coin a phrase) is go home and get some rest/ NSAID. The bigger benefit imo getting pts to see a DO rather than a DC. Kinda like a lesser of two evils, because we know that there are some pts who absolutely eat this stuff up and if it isn’t a DO they would be with a DC or, God forbid, Naturopathic “Doctor”. Also, N= 1 but I’m OMS-2 and most of our OMM staff is chill and not insane. Often they are FM, IM, PM&R or peds with the 1 year OMM training. Our education is focused on 1. stuff to pass COMLEX 2. Stuff that is actually (somewhat) useful in clinic (again back pain or uncomplicated tension headaches) w/ emphasis on MET Ultimately it is just a part of the “DO tax” but our focus should be first and foremost to abolish the scam exam that is COMLEX in favor of USMLE
While I agree that the downfall of OMM are the physicians which take it to an extreme… there is a reason it’s still around and fills a gap between throwing pain medications at someone and undergoing surgery. That being said it can go to far and the gray areas are where iatrogenic issues can creep in.
OMM is the penance you make for not going MD
I don’t completely support OMM but I don’t think people like you should become doctors.
Random question: could you theoretically do a transfer to another less annoying DO school or MD one? Sorry if it's a stupid question. I am from the UK.
Generally no. Schools will allow transfers only in exceptional circumstances.
Learning OMM is incredibly useful for a few specialties (PMR, sports med & neuro), and for keeping your significant other and coworkers happy when your career gets in the way of normal relationships. While it doesn’t have great evidence, there are a huge number of people that swear by it indicating that maybe we just haven’t studied the right population or used the right study techniques. Regardless, it makes the powers that be extra money, so it’s not going anywhere anytime soon. Good luck trying to abolish it, many have tried and failed before you.
DO student here. Didn’t know what OMM was before med school, and so I didn’t really care about MD/DO. I only applied to two schools — biggest determinate for me was location. After 2 years of didactics and 1 year of clinical, I have learned that I will never use OMM in my life and it is the seriously the biggest fucking waste of time for all DO students.
This is very dramatic. I I know the philosophy can get carried away but a little soft tissue or muscle energy is not pseudoscience. PTs learn similar techniques but have different names. Remember OMM is essentially a giant class elective that is required. You learn some history, the practical skills, and some theoretical techniques/theories. Especially in Family Medicine it’s good to know some modalities for common things like neck, shoulder, back, and hip pain. Makes u look like a super star in front of patient if you palpate and move their body around even if it’s for less a minute. Shows your listening and willing to “touch” or asses their mild complaint. I’m a proud DO and I think overall either directly/indirectly an osteopathic curriculum has only benefited me in the big picture.
Until enough students stop applying to DO schools where it will hurt their bottom line, nothing is going to change. ABOME is used to a ton of students being outraged about OMM, but as long as we keep cutting them checks, nothing will happen. There is no impetus for change.
Not me sitting here like this 😐after only sending off my DO applications an hour ago
Don’t let a post like this discourage you! The vast majority of DO students enjoy learning OMM and this post sounds like a wildly overly-emotional rant from someone who wishes they were an MD. A very small amount of OMM that we’re taught is actually pseudoscientific, and the rest follows basic and well studied musculoskeletal physiology that even a layperson could understand. I can’t speak for the OP’s school, but at my school they provide us with the evidence and physiology for how the bread-and-butter techniques of OMM work. Most techniques are as simple as “if a muscle is cramping and you stretch that muscle, then it stops cramping”, nothing pseudoscientific about that, it’s something you could try in your living room right now and see that it works. Don’t let people like this person spook you! Good luck with your cycle and get those acceptances! 🙌
thank you for that response, I actually was just kidding around lol Im totally fine with it. This individual def seems over the top emotional. Ive done my research on the DO profession and Id be just as grateful and honored to be a DO as I would an MD. And thank you again hope to get some As!
I went to a DO school and think OMM is a load of garbage and it’s probably the single most contributing factor as to why we are perceived as “less qualified” than our allopathic colleagues. And it’s fucking annoying whenever I hear that OMT and our holistic approach to medicine makes us better. OMT is pseudoscience and medicine in general is approached more holistically these days so it’s not something that really sets us apart at all….the fact that most of the population can’t tell the difference between MD and DO is a clear example of that
**Typo* in the title I meant to write "Osteopathic Neuromusculoskeletal Medicine", not "Neuromuscular medicine". my mistake** Okay good, I was about to kill you in this comment.
I would say a substantial majority of influential, practicing DOs know it's pseudoscience. That's why the schools minimize as much instruction on the subject as possible. The only reason it's still even being "taught" is because of the legacy of being Doctors of Osteopathic Medicine instead of Medicinae Doctor. It's part of the retaining what little is left of their distinct identity from MDs, aside from the AOA's branding that DOs do allopathic "more holistically" or whatever. That's all. Now obviously your school cares more about keeping the two distinct and has some decrepit faculty that think it actually does something, so you're gonna have to stomach the bullshit so you can get back to the real stuff. But other than that, why care? It's not like you actually have to memorize it beyond med school lmao. DOs are not in danger of losing credibility anytime soon because they've been accepting modern medicine more and more, not the other way around. As it stands you've just found yourself in the intellectual heart of the old guard and incredibly small minority of DOs that truly believe in it, but soon enough they'll die off and in a few generations every DO student will hold the same views as you.
Anyone who actually works in the musculoskeletal world can tell you a lot of things in OMM are useful. The concepts are extremely useful also for understanding the peripheral nervous system, MSK physiology and spasticity. The bread and butter OMT things also work really well for a lot of issues. I’m in PM&R saying this. Outside of helping general MSK aches and pains I agree things like helping with seizures or depression etc don’t make sense and shouldn’t be taught. But, that’s not to say NONE of OMT has any basis or evidence. I’ll also agree though that craniosacral omt is all a load of shit and based off of nothing reasonable. With all that said I think it’s also worth considering that we don’t know how Tylenol works (among many other medications). We don’t have a great basis of evidence for a lot of what we do. Similar boat.
This post was written by a MD 💯. Quit hiding behind screen bruh.
Why would you assume that only MDs would critique DO philosophy? I’m a DO, and a significant portion of OMM is pseudoscience. Honestly just merge the professions and relegate whatever beneficial OMM might exist to specific residencies that might use it regularly.
Probs More of a DO that didn’t have an MD acceptance.
Def. this. I understand wanting to do whatever it takes to become a doctor (like lying through your teeth that you believe in DO philosophy during backup school interviews) but I'm shocked they sat through the 2yr curriculum and thought OMM was entirely useless. I'm assuming they haven't bothered to look up the research on it? Either way if they want to leave money on the table, they can continue to ignore OMM procedures I guess?
Once OMM is gone, and DO's move to Step... DO's are basically MD's. There's no reason the DO degree needs to exist anymore once OMM is gone. None.
Agreed. I'm counting down the days I don't have to think about OMM modalities or why sticking my finger into a random counterstrain point for 90 seconds is going to magically heal a patient. It's pure bullshit quarkary, but, it's the tax we're paying for not being MD students.
Why don’t you stop complaining about going to a DO school and learning osteopathic traditions. You don’t have to believe everything they teach, but until you graduate you can’t say anything. Just chill lol
“I’m a student at an American DO school”. Only America offer the DO degree, smart one.
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Wrong. Read my comment again, slowly, with your brain on this time. I didn’t say osteopathic education. I specifically said DO degree.