COMAT Clinical – Emergency Medicine

Content Outline and Assessment Objectives

The exam blueprint below contains the Emergency Medicine topics covered in two dimensions: Dimension 1 – Patient/Clinical Presentations and Dimension 2 – Physician Tasks.

Selected Specific Learner-Centered Objectives for Emergency Medicine

The osteopathic medical student examinee will be required to demonstrate the ability to:

1. Apply foundational knowledge in emergency medicine to manage common and life-threatening conditions
2. Apply knowledge of diagnostic testing (e.g., radiographs, laboratory study results) to assess and manage typical emergency department conditions
3. Apply knowledge of basic emergency procedures (e.g., wound care, suturing, splinting, basic ECG interpretation) as well as more advanced skills (e.g., fracture management, basic airway management, basic ultrasound)
4. Develop a structured approach to acute care clinical problem solving, focusing on rapid assessment and stabilization of acutely ill patients
5. Assist in managing patients from initial assessment to final disposition, including history taking, physical examinations, case presentations, diagnosis, and treatment planning
6. Demonstrate knowledge of EMTALA regulations and efficiently utilize consultations and referrals in patient management
7. Integrate osteopathic principles into emergency patient care, recognizing the benefits of osteopathic manipulative treatment (OMT) in appropriate scenarios

These objectives will include selected patient presentations and clinical situations involving but not limited to:

Public Health and Special Populations: Abuse, EMTALA, special populations, and public health issues, including reportable infectious diseases

Endocrine System and Metabolism: Adrenal insufficiency, diabetic ketoacidosis, hypoglycemia, pheochromocytoma, and thyroid storm

Nervous System and Mental Health: Brain tumor; delirium; dementia; depression; headache; meningitis; psychosis and thought disorders; seizure; stroke, including ischemic and hemorrhagic; substance use and addictive disorders; suicidal ideation or attempt; and syncope

Musculoskeletal System (non-traumatic): Ankylosing spondylitis; back pain, including herniated, degenerative, and bulging disks; inflammatory disorders, including arthritis; radiculopathy; septic joint; spinal epidural abscess; and spinal stenosis

Genitourinary/Renal System and Breasts: Abortion, including complete, incomplete, inevitable, and threatened; acute kidney injury; chronic renal failure; ectopic pregnancy; mastitis; nephrolithiasis; ovarian torsion; placental disorders, including placenta previa and placental abruption; pyelonephritis; sexual transmitted infections; testicular disorders, including testicular torsion; tubo-ovarian abscess; and urinary tract infections

Gastrointestinal System and Nutritional Health: Appendicitis, bowel obstruction, cholecystitis/cholelithiasis, diverticulitis, diverticulosis, hemorrhoids, pancreatitis, peptic ulcer disease, variceal bleeding, and vitamin deficiencies

Cardiovascular/Circulatory System: Acute coronary syndromes, including myocardial infarctions and chest pain; aortic aneurysm; aortic dissection; arrythmias; cardiopulmonary resuscitation; claudication; heart failure; and hypo/hypertension

Hematologic Systems (includes Oncology): Anemias, leukocytosis, malignancies (primary and metastatic), and thrombocytopenia

Respiratory System: Anaphylaxis, airway obstruction, asthma, basic airway management, bronchitis, chronic obstructive pulmonary disease, epiglottitis, pneumonia, and pulmonary embolism

Integumentary System: Cutaneous abscesses; infectious skin disorders, including scabies, impetigo, and herpes; necrotizing skin; noninfectious rashes; purulent and nonpurulent cellulitis; and wound care, including irrigation, local anesthesia, primary closure, and tetanus prophylaxis

HEENT: Conjunctivitis, epistaxis, glaucoma, otitis, periorbital cellulitis, peritonsillar abscess, pharyngitis, retinal detachment, sinusitis, and temporal arteritis

Trauma: Hypovolemic shock; abdominal injuries, including bowel, hepatic, and splenic injuries; chest injuries, including hemothorax, pneumothorax, and tension pneumothorax; extremity injuries, including dislocations, fractures, and splinting; head injuries, including epi-/subdural hematomas and concussions; and spinal injuries, including cervical fractures and spinal cord damage

Environmental, Toxicology, and Exposures: Anion gap acidosis; chemical and thermal burns; decontamination; envenomations, including bites; hypothermia/hyperthermia; overdoses of acetaminophen, opioids, salicylates, tricyclic antidepressants, and toxic alcohols; and toxicity, including carbon monoxide and cyanide poisoning

Selected Student and Faculty Learning Resources for Emergency Medicine

In addition to the aforementioned objectives, examples of supplementary resources used by the NBOME to inform the development of the Emergency Medicine exam are listed below:

• Society for Academic Emergency Medicine (SAEM) – Emergency Medicine Clerkship Curriculum: An Update and Revision
• American Osteopathic Association (AOA) and American College of Osteopathic Emergency Physicians – Basic Standards for Residency Training in Emergency Medicine