COMAT Clinical – Osteopathic Principles & Practice
Core Knowledge & Elements of Osteopathic Principles
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.
Dimension 1 – Patient/Clinical Presentations
Topic | Percentage |
---|---|
1. Human Development, Reproduction and Sexuality | 5-10% |
2. Endocrine System and Metabolism | 9-12% |
3. HEENT, Nervous System, and Mental Health | 18-25% |
4. Musculoskeletal System | 18-25% |
5. Genitourinary/Renal System and Breasts | 9-14% |
6. Gastrointestinal System and Nutritional Health | 9-14% |
7. Circulatory, Hematologic, and Integumentary Systems | 9-12% |
8. Respiratory System | 13-18% |
Dimension 2 – Physician Tasks
Topic | Percentage |
---|---|
Osteopathic Concept and Philosophy | |
1.1 Osteopathic Tenets and Treatment Models | 5-7% |
1.2 Musculoskeletal Structure and Function | 5-7% |
1.3 Structure and Function of Somatic Nerve, Autonomic Nervous System, and Vascular/Lymphatic Organization and Drainage | 5-7% |
Osteopathic Diagnosis | |
2.1 Cranium and Cervical Spine | 10-15% |
2.2 Chapmans Reflexes and Abdomen | 5-7% |
2.3 Ribs and Thoracic and Lumbar Spine | 10-15% |
2.4 Pelvis and Sacrum | 10-15% |
2.5 Lower Extremities and Upper Extremities | 5-7% |
Osteopathic Treatment Methods | |
3.1 Articulatory, Facilitated Positional Release, Still Technique, Balance Ligamentous Tension, Functional Technique, Indirect, Exercise Therapy, Soft Tissue, and Myofascial Release | 10-15% |
3.2 Muscle Energy, HVLA Manipulation, Countertsrain, and Cranial | 10-15% |
3.3 Somatovisceral (Autonomic Oriented Techniques), Visceral, Lymphatic | 10-15% |
Selected Specific Learner-Centered Objectives for Osteopathic Principles and Practice
The osteopathic medical student examinee will be required to demonstrate the ability to:
- Identify and apply the basic principles of the osteopathic philosophy.
- Identify the impact of osteopathic principles on health care delivery.
- 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.
- Identify the current evidence base for the clinical application of OMT.
- Define the types of physical examination findings consistent with somatic dysfunction.
- 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.
- Identify the symptoms and physical findings consistent with viscerosomatic, somatovisceral, and somatosomatic reflexes.
- 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.
- Describe the basic principles of treatment of facilitated positional release and ligamentous articular strain.
- Identify the indications and contraindications of different types of OMT.
- Describe the relative value, advantages, and disadvantages of different types of OMT.
- Correctly diagnose somatic dysfunction within the ten body regions, prioritize a differential diagnosis, and develop an appropriate care plan.
- Effectively communicate with patients and their families regarding risks, benefits, and alternatives associated with the use of OMT.
- Identify how to maintain the safety and dignity of the patient while administering OMT.
- 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.
- 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:
Sample Questions
The sample questions for Osteopathic Principles and Practice 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.
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.
Additional Resources
An Osteopathic Approach to Diagnosis and Treatment
Author: DiGiovanna, Amen, & Burns, 4th Edition, 2020
Atlas of Osteopathic Techniques
Author: Nicholas, 3rd Edition, 2015
Foundations of Osteopathic Medicine
Author: Seffinger, 4th Edition, 2019
Greenman’s Principles of Manual Medicine
Author: DeStefano, 5th Edition, 2016
Somatic Dysfunction in Osteopathic Family Medicine
Author: Nelson, 2nd Edition, 2014