COMAT Clinical – Surgery

Content Outline and Assessment Objectives

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

Selected Specific Learner-Centered Objectives for Surgery

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

1. Apply knowledge of fundamental surgical skills including laparoscopic techniques, suturing, gowning, gloving, Foley and nasogastric tube insertion, ultrasound application, and wound management.
2. Conduct thorough patient evaluations, including obtaining comprehensive histories and conducting physical examinations, to develop and implement appropriate differential diagnoses for common surgical diseases and management plans based on a solid understanding of osteopathic surgical principles.
3. Manage surgical emergencies and complications by recognizing life-threatening situations, performing immediate interventions, and providing comprehensive postoperative care.
4. Integrate osteopathic principles into the surgical care of patients by applying osteopathic manipulative treatment (OMT) and considering the holistic needs of patients, including their emotional and spiritual well-being.
5. Engage effectively with a multidisciplinary surgical team to enhance patient outcomes and ensure comprehensive care through collaborative decision-making and communication.

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

Breast: Benign breast masses and cysts, breast cancer, and disorders of the breast including gynecomastia

Hernias: Abdominal, femoral, incarcerated, inguinal, and umbilical

Endocrine System: Adrenal and pituitary glands and thyroid and parathyroid

Gastrointestinal System and Nutritional Health: Disorders of the appendix, diaphragm, duodenum, esophagus, rectum, small and large intestines, and stomach

Hepato/Biliary: Disorders of the biliary tract, liver, pancreas, and spleen

Integumentary and Musculoskeletal Systems: Somatic dysfunction, skin and subcutaneous tissues, and viscerosomatic relationships

Perioperative Care: Airway management complications, anesthesia-related syndromes, operative and postoperative complications, operative and postoperative fluids, and preoperative prophylaxis of common postoperative side effects

Trauma: Blood and fluid replacement strategies, blunt and penetrating chest and abdominal injuries, musculoskeletal injury and fractures, transfusion reactions, and ultrasound and imaging diagnosis of hemorrhage (FAST exams)

Selected Student and Faculty Learning Resources for Surgery

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

• Association for Surgical Education (ASE) – The Manual of Surgical Objectives, 4th Edition
• American Association of Colleges of Osteopathic Medicine (AACOM) – Educational Council on Osteopathic Principles (ECOP)
• American Osteopathic Association (AOA) – Surgery
• American Osteopathic Association (AOA) and the American College of Osteopathic Surgeons (ACOS) – Basic Standards for Residency Training in Surgery and the Surgical Subspecialties

Sample Questions

The Surgery sample questions are primarily designed to assist the candidate in navigating through the examination, and it is provided to facilitate the actual testing experience. It is not designed to give the candidate a score or provide information about how a candidate might perform on the examination.