COMAT Clinical – Osteopathic Principles & Practice

Content Outline and Assessment Objectives

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

Selected Specific Learner-Centered Objectives for Osteopathic Principles and Practice

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

1. Identify and apply the basic principles of the osteopathic philosophy.
2. Identify the impact of osteopathic principles on health care delivery.
3. Apply scientific knowledge supporting the utilization of osteopathic principles and practice and osteopathic manipulative treatment (OMT), including the basic science of the mechanisms of OMT and somatic dysfunction.
4. Identify the current evidence base for the clinical application of OMT.
5. Define the types of physical examination findings consistent with somatic dysfunction.
6. Define and describe the types of somatic dysfunction found within the ten body regions, including the head, cervical, thoracic, rib, lumbar, pelvic, sacral, abdominal, upper extremity, and lower extremity body regions.
7. Identify the symptoms and physical findings consistent with viscerosomatic, somatovisceral, and somatosomatic reflexes.
8. Define, differentiate, and describe indirect and direct types of OMT, including articulatory, balanced ligamentous tension (BLT), counterstrain, osteopathic cranial manipulative medicine (OCMM), muscle energy, high velocity low amplitude (HVLA), visceral, lymphatic, exercise therapy, soft tissue, myofascial release technique (MFR), and Still technique.
9. Describe the basic principles of treatment of facilitated positional release and ligamentous articular strain.
10. Identify the indications and contraindications of different types of OMT.
11. Describe the relative value, advantages, and disadvantages of different types of OMT.
12. Correctly diagnose somatic dysfunction within the ten body regions, prioritize a differential diagnosis, and develop an appropriate care plan.
13. Effectively communicate with patients and their families regarding risks, benefits, and alternatives associated with the use of OMT.
14. Identify how to maintain the safety and dignity of the patient while administering OMT.
15. Identify viscerosomatic relationships and the role of the musculoskeletal system in health and disease by performing a structural examination and documenting findings reflective of this relationship.
16. Demonstrate cultural and ethnic awareness and sensitivity, as it may impact the patient’s presentation.

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

Human Development, Reproduction, and Sexuality: Growth, development, and lifestyle recommendations; menstrual disorders/conditions; normal pregnancy and somatic dysfunction in pregnancy; OMT during labor; perimenopause and menopause; and postpartum conditions

Endocrine System and Metabolism: Adrenal disorders, diabetes, osteoporosis, pituitary disorders, polycystic ovary syndrome, and thyroid/parathyroid disorders

HEENT, Nervous System, and Mental Health: Allergic and sinus disorders; anxiety disorders; cerebrovascular incidents/conditions; cervical somatic dysfunction; concussion, headache, and migraine; cranial somatic dysfunction; ear, jaw, and facial pain; mood disorders; neuropathies, plexopathies, and radiculopathies; seizure disorders; and vertigo, Meniere disease, and tinnitus

Musculoskeletal System: Acute and chronic somatic dysfunction (cranial, axial, and appendicular); adhesive capsulitis; coccydynia; degenerative joint diseases; exercise prescription; inflammatory musculoskeletal disorders, including costochondritis; leg length and gait disorders; musculoskeletal trauma, including fractures, compartment syndrome, whiplash, tears, and sprain/strain; overuse syndromes, including carpal tunnel syndrome, tendinopathies, and plantar fasciitis; rheumatologic conditions; and spinal disorders, including spondylolisthesis and scoliosis

Genitourinary/Renal System and Breasts: Breast masses/conditions, erectile dysfunction and testicular disorders, incontinence and pelvic floor conditions/disorders, pelvic pain/masses, prostate disorders, renal calculi/conditions, urinary tract infections/disorders

Gastrointestinal System and Nutritional Health: Abdominal pain, constipation, diseases and disorders of the hepatobiliary system, gastroesophageal reflux disease and esophageal conditions, hemorrhoids, hyperemesis and nausea, inflammatory and irritable bowel conditions, and spleen conditions

Circulatory, Hematologic, and Integumentary Systems: Cellulitis; edema and peripheral vascular disease; heart conditions/diseases; inflammatory skin diseases, including atopic dermatitis and psoriasis; lymphedema and lymphatic conditions; thoracic outlet syndrome; and vascular disease, including aortic dissection

Respiratory System: Asthma; atelectasis; chest pain; chronic obstructive pulmonary disease; cough; lung conditions/disorders, including pneumothorax, tuberculosis, and pleurisy; pneumonia; pulmonary embolism; and upper respiratory infections

Selected Student and Faculty Learning Resources for Osteopathic Principles and Practice

In addition to the aforementioned objectives, examples of supplementary resources used by the NBOME to inform the development of the Osteopathic Principles and Practice exam are listed below:

• American Association of Colleges of Osteopathic Medicine (AACOM) – Educational Council on Osteopathic Principles (ECOP)

COMAT-SE

COMAT-SE is designed to provide exposure to COMAT style questions and resources for additional learning, prior to taking the COMAT Osteopathic Principles and Practice (OPP) exam.