COMAT Clinical – Family Medicine

Content Outline and Assessment Objectives

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

^{*10-20% patients under 18 years old on each form}

^{*10-20% patients under 18 years old on each form}

Selected Specific Learner-Centered Objectives for Family Medicine

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

1. Integrate didactic knowledge with clinical experiences to understand the unique practice of osteopathic family physicians and apply this understanding in patient care.
2. Apply approaches to evaluating and managing acute presentations in the office setting, utilizing osteopathic principles and practices.
3. Apply skills in managing chronic illnesses, focusing on creating individualized, evidence-based treatment plans that incorporate patient preferences and socioeconomic factors.
4. Perform focused wellness visits for patients of all ages and genders, emphasizing preventive health care and lifestyle modifications.
5. Collaborate effectively with a diverse healthcare team, including consultants, staff, and external agencies, to provide patient-centered care.
6. Apply osteopathic philosophy and manipulative techniques to diagnose and treat patients, ensuring the integration of these principles into routine family medicine practice.
7. Perform common diagnostic and therapeutic procedures in the family medicine setting, including those related to osteopathic manipulative medicine.
8. Interpret and apply findings from diagnostic tests and develop appropriate management plans considering patient-specific factors.

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

Community Health and Patient Wellness: Patients presenting for routine examinations and screenings, patients presenting for vaccinations/preventive care, and patients presenting with health care delivery concerns

Human Development, Reproduction, Breasts, and Sexuality: Asymptomatic patient with a reproductive disorder, symptomatic patient with undifferentiated symptoms related to development or reproduction, boy’s/men’s health, breast disorders, contraceptive management, developmental and sexuality, gender identity and evidence-based guidelines for gender affirming care, gynecologic and male hypogonadism and gynecomastia, menopause and hormone replacement therapy, pregnancy-related presentations, and sexually transmitted infections

Endocrine System and Metabolism: Asymptomatic patient with an endocrine disorder, symptomatic patient with undifferentiated symptoms related to the endocrine system, adrenal disease, diabetes-related issues, dyslipidemia, electrolyte and serum mineral disorders, growth/puberty and weight-related presentations, heat/cold intolerance or heat-related conditions, osteoporosis and other bone disorders, pituitary disease, and thyroid/parathyroid diseases

Nervous System and Mental Health: Asymptomatic patient with a psychiatric or neurologic disorder; symptomatic patient with undifferentiated symptoms related to the psychiatric or neurologic systems; abuse/substance use/eating disorders; anxiety disorders; cerebrovascular disease, transient ischemic attack, cerebrovascular accident, and syncope; chronic pain syndromes; demyelinating/degenerative and neuromuscular conditions; developmental/behavioral and neurologic problems in children and adolescents; headaches; meningitis and infectious disorders; mood and adjustment disorders; neurocognitive disorders; neuropathies and neuropathic disorders; personality disorders; schizophrenia and other psychotic disorders; seizure disorders; and sleep-related disorders and somatoform disorders

Musculoskeletal System: Asymptomatic patient with a musculoskeletal disorder; symptomatic patient with undifferentiated symptoms related to the musculoskeletal systems; arthritis/vasculitis/inflammatory conditions; head and neck disorders/somatic dysfunction; lower extremity disorders/somatic dysfunction; lumbar, pelvic, and sacral disorders/somatic dysfunction; upper extremity disorders/somatic dysfunction; soft tissue syndrome; and thoracic and rib disorders/somatic dysfunction

Genitourinary/Renal System: Asymptomatic patient with a genitourinary/renal disorder, symptomatic patient with undifferentiated symptoms related to the genitourinary/renal system, abnormal vaginal bleeding, incontinence, menstrual-related disorders, ovarian and uterine disorders, renal disease/disorders, testicular disorders, urinary tract infections, and vulvovaginal and cervical disorders

Gastrointestinal System and Nutritional Health: Asymptomatic patient with a gastrointestinal disorder; symptomatic patient with undifferentiated symptoms related to the gastrointestinal system; anorectal disorders/hernias; gastric disorders; hepatobiliary disorders; mouth, oropharynx, and esophageal disorders; nutritional and vitamin deficiencies and nutritional replacement; pancreatic disorders; poisonings, ingestions, and foreign bodies; and small and large bowel disorders

Cardiovascular and Circulatory Systems: Asymptomatic patient with a cardiovascular disorder, symptomatic patient with undifferentiated symptoms related to the cardiovascular system, arrhythmias, congenital heart disease, coronary artery disease, heart failure, hypertension/hypotension, left ventricular hypertrophy and cardiomyopathies, murmurs, pericarditis, valvular heart disease, and vascular (venous, arterial, lymph) disorders

Hematology, Oncology, and Immunology: Asymptomatic patient with a hematology, oncology, or immune disorder; symptomatic patient with undifferentiated symptoms related to these systems; anemias; autoimmune disorders; bleeding disorders; cancers including endocrine, gastrointestinal, genitourinary, gynecologic, respiratory, skin, bone, muscle, breast, and neuro/ophthalmologic; hereditary thrombophilias; HIV, AIDS, and immune deficiencies; hypercoagulability disorders; and proliferative disorders

Respiratory System: Asymptomatic patient with a respiratory disorder, symptomatic patient with undifferentiated symptoms related to the respiratory system, pulmonary edema, pulmonary infectious disorders, pulmonary obstructive disorders, pulmonary restrictive and occupational disorders, and pulmonary vascular disorders

Integumentary System: Benign and premalignant growths/lesions; hair, nail, sweat gland, and keratinization disorders; hypersensitivity, allergic, and autoimmune skin disorders; infectious skin disorders; infestations, bites, burns, and trauma; inflammatory skin disorders; pigmentation disorders; skin manifestations of systemic disease; and wounds and other skin injuries

HEENT: Ear disorders, eye disorders, neck and salivary gland disorders, nose and sinus disorders, and oral and pharynx disorders

Selected Student and Faculty Learning Resources for Family Medicine

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

• Society of Teachers of Family Medicine (STFM) – National Clerkship Curriculum
• American Association of Colleges of Osteopathic Medicine (AACOM) – Educational Council on Osteopathic Principles (ECOP)
• American Osteopathic Association (AOA) – Family Medicine
• American College of Osteopathic Family Physicians (ACOFP)