COMAT Clinical – Internal Medicine

Content Outline and Assessment Objectives

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

Selected Specific Learner-Centered Objectives for Internal Medicine

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

1. Perform thorough history taking and physical examinations that incorporate osteopathic principles and consider biopsychosocial aspects.
2. Formulate prioritized differential diagnoses for common and complex conditions by integrating clinical information with evidence-based resources.
3. Understand underlying etiologies of common internal medicine conditions.
4. Define and implement evidence-based therapeutic interventions for common internal medicine conditions.
5. Create patient-centered treatment plans that incorporate pharmacological, non-pharmacological, and osteopathic manipulative treatments (OMT) as appropriate
6. Demonstrate proficiency in initial management and escalation protocols for emergent conditions.
7. Incorporate preventive care and health promotion into patient management plans.
8. Educate patients on disease prevention and health maintenance, tailoring advice to individual risk factors and lifestyle considerations.

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

Community Health and Patient Presentation Related to Wellness: Disease prevention and prophylaxis, screening tests, and vaccinations

Endocrine System and Metabolism: Adrenal disorders, fluid and electrolyte disorders, diabetes, parathyroid and thyroid disturbances, pituitary disorders, and weight gain/loss

Nervous System and Mental Health: Brain anatomy and function, disorders of cerebral function, disorders of the spinal cord and peripheral nerves, neurodegenerative disorders, and stroke

Musculoskeletal System (includes Rheumatology): Disorders of bone and muscle, inflammatory and noninflammatory rheumatic diseases, osteoporosis, somatic dysfunction, vasculitis, and viscerosomatic relationships

Genitourinary/Renal System: Acute renal injury, chronic kidney disease, disorders of the testes, glomerular and tubulointerstitial disorders, infectious urinary system disorders, obstructive uropathy, renal calculi, urinary control disorders, and women’s health

Gastrointestinal System and Nutritional Health: Diseases of the upper and lower gastrointestinal tract, liver, gallbladder and pancreas; gastroesophageal disorders; gastrointestinal disease prevention; and nutritional deficiencies

Cardiovascular and Circulatory Systems: Acute coronary syndromes, aortic dissection, arrhythmias, arterial hypertension, chronic ischemic disease of the heart, congenital heart disease, congestive heart failure, endocarditis, hyperlipidemia, pericarditis, peripheral vascular disease, and valvular heart disease

Hematology, Oncology, and Immunology: Anaphylaxis, anemias and hemoglobinopathies, cancers of the gastrointestinal and respiratory tracts, coagulation disorders, drug allergies, hematologic malignancies, HIV, neoplasms, and solid tumors

Respiratory System: Asthma, chronic obstructive pulmonary disease, critical care medicine and respiratory failure, environmental and occupational exposures, pneumonia, and pulmonary embolism

Integumentary System: Atopic diseases, chemical exposure, and common dermatological conditions and skin lesions

Selected Student and Faculty Learning Resources for Internal Medicine

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

• American Osteopathic Association (AOA) and American College of Osteopathic Internists (ACOI) – Basic Standards for Residency Training in Internal Medicine

COMAT-SE

COMAT-SE is designed to provide exposure to COMAT style questions and resources for additional learning, prior to taking the COMAT Internal Medicine exam.