NBOME

Emergency Medicine

Core Knowledge & Elements of Osteopathic Principles in the Discipline of Emergency Medicine

Content Outline and Assessment Objectives

The Emergency Medicine examination is designed for end-of-course or end-of-clinical rotation/clerkship assessment for students enrolled at a college of osteopathic medicine (COM). Individual COMs may also administer the examination at other times in accordance with their curriculum goals and mission. This examination emphasizes core knowledge and elements of osteopathic principles and practice in the discipline of Emergency Medicine that are essential for the pre-doctoral osteopathic medical student.

The exam blueprint below contains the Emergency Medicine topics covered in two dimensions: Dimension 1 – Patient Presentation and Dimension 2 –Physician Tasks.

Dimension 1: Patient Presentation

Topic%
Abdominal Pain6–11%
Chest Pain6–11%
Environmental/Travel Disorders2–5%
Gastrointestinal Bleeding3–6%
Genitourinary4–7%
HEENT (Head, Eyes, Ears, Nose, and Throat) Disorders4–7%
Mental Status Change/Weakness6–11%
Musculoskeletal Disorders6–11%
OB/GYN4–7%
Poisoning/Overdose/Withdrawal4–7%
Psychiatric/Behavioral2–5%
Rashes/Disease of the Skin2–5%
Resuscitation/Shock5–8%
Shortness of Breath6–11%
Special Populations4–7%
Traumatic Injuries4–7%

Dimension 2: Physician Tasks

Topic%
History & Physical Examination20–28%
Differential Diagnosis & Diagnostic Technologies15–25%
Management15–25%
Scientific Understanding of Health & Disease Mechanisms5–15%
Health Care Delivery Issues4–8%
Understanding of Procedural Skills (Indications/Performance Description/Contraindications)10–20%
Health Promotion & Disease Prevention2–4%

General Learner-Centered Objectives

Based on the general learner-centered objectives outlined in the Emergency Medicine Examination Blueprint, the examinee will be required to demonstrate the ability to apply:

  1. Foundational content knowledge to situations and patient presentations encountered in clinical settings and important to Emergency Medicine.
  2. Foundational content knowledge and clinical problem-solving ability related to physician tasks critical to Emergency Medicine.
  3. Knowledge and clinical problem-solving as related to the Fundamental Osteopathic Medical Competency Domains, including osteopathic principles and practice and osteopathic manipulative treatment (OMT), osteopathic medical knowledge, interpersonal and communication skills, practice-based learning and improvement, systems-based practice, professionalism and patient care.
  4. Osteopathic principles and practice in commonly encountered patient care scenarios.

Selected Specific Learner-Centered Objectives for Emergency Medicine

For Emergency Medicine, the examinee will be required to demonstrate the ability to diagnose and manage selected patient presentations and clinical situations involving, but not limited to:

  1. Abdominal Pain: Aortic aneurysm, appendicitis, bowel obstruction, cholecystitis/cholelithiasis and diverticulitis
  2. Mental Status Change/Weakness: Cerebrovascular disease, hypoglycemia, infection, seizure, syncope and metabolic disorders
  3. Chest Pain: Acute coronary syndromes, aortic dissection, pneumothorax and pulmonary embolism
  4. Environmental/Travel Disorders: Chemical and thermal burns, envenomations and hypothermia/hyperthermia
  5. HEENT Disorders: Infection, headache including migraine and subarachnoid hemorrhage, glaucoma, epistaxis and trauma
  6. Gastrointestinal Bleeding: Upper including peptic ulcer disease and variceal, and lower including diverticulosis, hemorrhoids and malignancy
  7. Poisoning/Overdose: Anion gap acidosis, decontamination, and overdoses of acetaminophen, carbon monoxide, opioids, salicylates, tricyclic antidepressants and toxic alcohols
  8. Psychiatric/Behavioral: Psychosis, depression, substance abuse and suicidal ideation or attempt
  9. Resuscitation/Shock: Basic airway management, cardiopulmonary resuscitation, dysrhythmia identification and treatment and first minute of a code, treatment of shock states including anaphylaxis, cardiogenic, hypovolemic and septic
  10. Shortness of Breath: Airway obstruction, asthma/COPD, heart failure, pulmonary embolism, and infections including pneumonia, bronchitis, and epiglottitis
  11. Traumatic Injuries: Abdomen including bowel, hepatic, and splenic injuries, chest including hemothorax, pneumothorax, and tension pneumothorax, extremities including dislocations, fractures and splinting, head injuries including epi-/subdural hematomas, neck including cervical fractures and spinal cord damage, and pediatric non-accidental trauma/domestic violence
  12. OB/GYN: Abortion including complete, incomplete, inevitable and threatened, ectopic pregnancy, placenta previa and placental abruption. Infections including pelvic inflammatory disease and sexual transmitted infections
  13. Wound Care: Irrigation, local anesthesia, primary closure and tetanus prophylaxis

Selected Student and Faculty Learning Resources for Emergency Medicine

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

Practice Examination

The Emergency Medicine Practice Exam is 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 actually perform on the examination. When an answer choice is selected, it will not be recorded for scoring and the selection will not be saved once another item is viewed. If you wish to track your answer choices, you must record them on your own. A special function is provided that allows you to view the correct answer for each item by clicking on the “Show Answer” button located below the answer choices. The “Show Answer” button will not appear on the actual examination.

Launch the Emergency Medicine Practice Exam

Additional References

Following is a select number of resources related to the discipline of Emergency Medicine:

TitleAuthorEditionYear
Tintinalli's Emergency Medicine: A Comprehensive Study GuideTintinalli et al.8th Edition2016
Rosen's Emergency Medicine: Concepts and Clinical PracticeMarx8th Edition2013
Clinical Procedures in Emergency MedicineRoberts and Hedges6th Edition2013
Tintinalli's Emergency Medicine ManualCline and Ma7th Edition2012
An Osteopathic Approach to Diagnosis and TreatmentDi Giovanna3rd Edition2004
Foundations of Osteopathic MedicineAOA3rd Edition2010
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