As a medical student participating in clinical observations, Alice Chen, DO, witnessed something that would change her life. Through osteopathic manipulative treatment (OMT), a patient in her late 30s with an abnormal walking pattern began to walk normally.
Seeing the effectiveness of manual medicine with her own eyes led to Dr. Chen pursuing—and landing—a residency in neuromusculoskeletal medicine/osteopathic manipulative medicine.
“I could see how OMT, in an acute care setting, could provide treatment for a patient and instant relief from their symptoms,” she says. “It became evident that there was more to OMT than just musculoskeletal complaints.”
Dr. Chen and other DOs in osteopathic manipulative medicine (OMM) share their advice for students thinking about pursuing this specialty, including what to do to prepare for a residency in this field, which ACGME and ERAS list as osteopathic neuromusculoskeletal medicine (ONMM).
How to prepare in medical school
For medical students interested in OMM, Matthew Barker, DO suggests the following:
- Start to prepare early.
- Do as many OMM rotations as you can.
- Take as many OMM courses as possible.
- Find professional mentors and look to treat patients with OMM.
- Maintain other medical skill sets, as you’ll need to look at patients through a holistic lens.
Mark Thai, DO, program director for the OMM/NMM fellowship at Oklahoma State University Center for Health Sciences (OSUHS), says that program directors often select candidates with a sustained interest in OMM. According to Dr. Thai, this can often be done by participating in research and demonstrating an interest in patient care and engagement.
Finding the right residency program
DOs practicing OMM recommend that medical students evaluate programs and assess if they align with their long-term career goals. Additionally, students should consider the type of clinical setting where they are most interested in practicing.
“OMM is a skill that takes time to develop. We modify our fellowship to the individual fellows’ interests,” Dr. Thai says. “We give them the freedom to develop their skills, trust their intuition and challenge them to provide care at a next level.”
OSUHS’ fellowship trains DOs who have completed a primary residency program. In addition to the outpatient clinic and inpatient hospital training, Dr. Thai’s fellowship offers opportunities to teach in the first and second-year medical school OMM lectures and labs. “The strengths of our fellowship are hospital training and pediatric OMM exposure,” he says.
Dr. Barker sought an OMM residency that included a focus on family medicine (FM). At the University of North Texas Health Science Center Texas College of Osteopathic Medicine (UNTHSC/TCOM), he found a combined FM/ONMM residency program that allowed him to train in both fields simultaneously. “I was very impressed with the diversity in their faculty and the resources for research,” says Dr. Barker, who was named 2018 OMM Resident of the Year by The American Academy of Osteopathy and the American Osteopathic Foundation.
For Dr. Chen, the OMM residency at St. Barnabus Hospital in New York provided the opportunity to develop meaningful relationships with faculty, which was a priority for her.
“I was looking for quality mentorship to help me become the doctor I wanted to be. It was also important to have the ability to treat and learn from a variety of patients, with differences in age, pathology, and illness,” she says.
Life after residency
Physicians who are trained in OMM pursue a variety of career paths following residency. Whether in an acute care setting or an academic environment, DOs have the opportunity to use manual medicine in myriad ways to help patients.
Dr. Chen launched an inpatient OMM consult service at her first job following residency. At the University of California San Diego Health, she assesses patients to determine if they’ll benefit from OMT.
“There is so much that OMT can offer patients, and there are simply not enough doctors who are providing it,” she says.
Following the completion of his FM/ONMM residency, Dr. Barker launched into several different career options. He provides in-home OMT through his mobile practice and also treats patients onsite at a clinic in Southlake, Texas. This year, he’ll also begin to practice two days per week in several dental offices to perform guided release procedures and treat patients with ankyloglossia and other oral problems.
After completing a family medicine residency at Binghamton General Hospital in Binghamton, New York, and an OMM/NMM fellowship at OSUHS, Dr. Thai went into academia.
The future of OMM
“One of the most exciting aspects of osteopathic medicine is all the research that is ongoing,” Dr. Thai says. “This may help provide a bridge for collaboration between the allopathic and osteopathic worlds.”
New research on OMM’s effectiveness is helping to raise awareness of its benefits, says Dr. Chen, who personally has seen the demand for OMT increasing.
“There are a lot of sick people and we’re starting to see limits regarding how we can manage chronic pain,” she says. “There is a gap, which has created a place for integrative medicine, and that has helped elevate the role and importance of OMT.”
The American Academy of Osteopathy has more info about residency programs, opportunities and training standards here.