How to reconcile critical skepticicsm with OMM philosophy?

[paramed2premed]

I will be applying to an osteo school in June, but I am wondering how to handle a certain issue in the interview. I would appreciate any thoughts from current students.

Part of what attracts me to medicine is the critical attitude that successful physicians must evince. I am partial to reading studies, evaluating evidence, understanding the limits of research, etc. I am an ACLS instructor, and I enjoy teaching the part of the curriculum that involves the ranking of the quality of studies supporting various interventions.

I am concerned that my natural skepticism will not play well with the advocates of OMM, and my attitude while be viewed as a detriment in school, or, God help me, during an interview.

No flames; I work in an ED with DOs, I don't view them as any less of a doctor. I REALLY want to go to a certain osteo school, and I potentially have to turn down an MD school to go there. Hence my concern about this potential conflict.

How have other skeptical/critical personalities handled the potential conflict with "strong" OMM theory? Is there a conflict? Can tempers flare?

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[Fenrezz]

I wouldn't worry about it. Not everyone is in DO school because of OMT. In fact there are some people who have no plans on using it. OMT is one of those things that you cant really put hard numbers on. Much of it is objective. You'll just have to see that it works as you perform it on patients.

The only way to rid yourself of skepticism is to actually help real people with it. You'll probably still be skeptical when you're learning it in lab because the people you work with are your classmates, and very few of them have the kind of problems that OMT is designed to take care of.

So don't sweat it. You'll meet the full spectrum of DO students. Some excited about OMT, and others annoyed that they have to spend a few hours a week learning it. It's perfectly natural to be skeptical or to even dislike it. Despite what you may read in the pre-allo board, DO schools are not cults. We don't sit around wide-eyed like those Heaven's Gate peeps during OMT lab with a giant mural of A.T. Still in the background, on the lookout for any 'unbelievers'.

I wouldnt go arguing with the interviewers about this, though. If asked, do what everyone else does.... lie!

 

[drusso]

Skepticism is good. It's not that DO's who use OMT are not skeptical people. Quite the contrary, their personal experience has taught them that OMT is useful for whatever conditions they use it. The everyday practice of medicine is one giant, non-randomized, non-controlled experiment: You try something and the patient gets better of worse. Was it what you did? WJas it the natural course of the disease? What?

Just approach learning OMT with the same **DISCIPLINE** you would approach learning physiology, biochemistry, pharmacology, or anatomy. OMT is a psychomotor skill not a supernatural skill. Getting good at it requires practice, dedication, and more practice. It's like learning a surgical technique. The concept behind a heart-lung transplant is really simple enough for any third grader to understand. Cracking the chest and actually **DOING** one, well that requires years of advanced training and practice.

 

[DrMom]

I am naturally skeptical & haven't had a problem. So far I have been quite impressed with OMT, but we have some methods that we'll be introduced to that I'm not so sure about. We'll see how it goes when I get there.

Some instructors and students treat OMT almost as a "religion." They are the exception, not the rule. Also, after spending more time with some of them, I have found that they, too, are critically-minded & not as "religious" about OMT as I originally thought.

Some of my classmates are completely negative about OMT, but they are the ones that admittedly don't practice it. Some of them barely even try in class. They have set themselves up for failure as they won't be able to learn if it can work if they never learn how to do it decently.

My $0.02. Be open-minded, but think critically at the same time. Ask how some of these methods are thought to work. Do some background reading on the methods. And, finally, practice on your classmates, and then on some people with more significant problems. See for yourself what OMT can do.

 

[Vince]

OMT is what you make it, exactly like what Dr. Mom was talking about. I get skeptical sometimes...so what do I do? I ask questions to the instructors. I think its good to not be the type to just listen to people and believe whatever they say...its good to think critically and not just be spoon fed. They may ask you in the interview why you want to be a DO? Just be honest in that you work with some in the ED, and you are very interested in learning OMM...that OMM sounds like a great tool to have as a physician....blah blah blah.

As a Paramedic, they didn't ask me a whole lot about EMS, but they asked about my teaching experience(teaching EMT school, Paramedic CE, etc). They want to get to know you in the Interview. They won't be hammering you about OMM Theories, etc. Be confident and enthusiastic and you'll do fine.

I was interviewed by 2 clinicians(DO's) and a Pharmacy professor...and now that I know these clinicians better, I wouldn't say they are gung ho about their OMM skills, etc. Sometimes, students are interviewed by basic science faculty alone.....and most of them think that OMM is a sham(parts of it), or some don't know anything about it at all.

Good Luck!

 

[paramed2premed]

Thank you guys for understanding the question, knowing that I'm not out to slam DOs, etc. I am pretty open-minded; its a messy world out there, and its the rare patient that matchs those found in the studies.

I know that many things we do not do in the ED (e.g. reiki) are therapies that some people find to be healing (and you can't beat the side-effect profile). We also do many things (e.g. give lidocaine in v.fib arrest) because "we always have, and I saw it work once," despite tons of scientific evidence to the contrary. People argue over the benefits of "evidence-based medicine" precisely because it reflects poorly many elements that enter into clinical decision-making.

I don't mind being shown a therapy that could help, probably won't hurt. Hell, you can't say that about many medical therapies. I just don't want to proselytized at. Your responses have allayed many of my concerns.

Applying to UNECOM in 2 months!

 

[DireWolf]

Just keep your mouth shut and go home to b!tch about OMT. Works just fine for most people here.

 

[bones]

Originally posted by Fenrezz
We don't sit around wide-eyed like those Heaven's Gate peeps during OMT lab with a giant mural of A.T. Still in the background, on the lookout for any 'unbelievers'.

I guess that all depends on where you go.

seriously though, you can make your skepticism a very GOOD thing in your application. DO schools are full of folks with little research experience- so if you have good critical thinking skills and an interest in research, play it up big. They'll love you for it. you might just want to do some OMM research yourself if there are things you are curious about, and if you find it isn't helpful for a certain condition, tell the world.

 

[PublicHealth]

I don't think pre-DOs and DOs are skeptical enough! If more osteopathic medical students and practicing DOs were more skeptical about OMM, maybe they'd undertake more research in this area.

Skepticism leads to testable hypotheses which lead to clinical investigations. Unfortunately, the osteopathic field has a ways to go before the mainstream public -- and incoming osteopathic medical students for that matter -- are convinced that OMM is a viable clinical technique.

PH

 

[bones]

Originally posted by PublicHealth
I don't think pre-DOs and DOs are skeptical enough! If more osteopathic medical students and practicing DOs were more skeptical about OMM, maybe they'd undertake more research in this area.

Skepticism leads to testable hypotheses which lead to clinical investigations. Unfortunately, the osteopathic field has a ways to go before the mainstream public -- and incoming osteopathic medical students for that matter -- are convinced that OMM is a viable clinical technique.

PH

agreed that there isn't enough skepticism, but I think the lack of research of more due to a lack of research skill by those who use OMM rather than any lack of desire test its veracity. Well, every DO I know that uses OMM wishes there was more research out there (more to prove to the world that it works, rather than to ask whether it works, but those are details...). Who is going to do it? Research is minimized in the curriculum of most schools, and to be quite honest most DO's know very little about it. Sad really. it falls on folks like us that did a lot of research in undergrad and are willing to carry it over. Thats why you gotta talk it up on your app- they LOVE research experience. If you were part of Sigma Xi- big bonus. if you have published or have done formal research presentations at conferences- huge.

 

[PublicHealth]

Great point, bones.

Here are some people evaluating the efficacy of OMM:

http://nccam.nih.gov/clinicaltrials/osteopathicmanipulation.htm

AACOM is rubbing their sticks, too:

http://www.aacom.org/om/research/index.html

I concur wholeheartedly with you that incoming osteopathic medical students have to want to apply their research skills toward evaluating the clinical efficacy and effectiveness of OMM. Of course, one must be careful not to overemphasize his or her interest in research during an interview at an osteopathic medical school that does not have the resources needed to conduct research.

I've done some research as an undergrad and grad (MPH). Which schools do you think value research experience?

PH

 

[bones]

Originally posted by PublicHealth
Great point, bones.

Here are some people evaluating the efficacy of OMM:

http://nccam.nih.gov/clinicaltrials/osteopathicmanipulation.htm

AACOM is rubbing their sticks, too:

http://www.aacom.org/om/research/index.html

I concur wholeheartedly with you that incoming osteopathic medical students have to want to apply their research skills toward evaluating the clinical efficacy and effectiveness of OMM. Of course, one must be careful not to overemphasize his or her interest in research during an interview at an osteopathic medical school that does not have the resources needed to conduct research.

I've done some research as an undergrad and grad (MPH). Which schools do you think value research experience?

PH

well, if you actually want to DO research, Texas and Michigan schools probably have the best facilities for it. but, they are both state schools so your chances of acceptance will be lower from out of state even if you have strong numbers. Virtually any DO school, however, will be interested in incoming students with research experience.

Don't make that the whole of your application, but certainly don't try to hide it or brush it off in favor of some health-related volunteer job where you didn't actually do anything. If you can devote maybe a quarter of your interview to talking intelligently about research that you've done you will look very strong, no matter where you apply. If you make it out to be a hobby rather than a life's mission, you might be able to sidestep questions about why on earth you'd want to go to a place with poor research facilities if you love it so much. Just let them know you have experience and you'd be interested in research once you got there- thats what will give you the points.

 

[paramed2premed]

Uh, thanks Direwolf; I'm not quite sure how you meant that...

To everyone else; these sorts of viewpoints, on the state of OMM research, and the attitude of students and faculty regarding the evidence regarding its efficacy, have been illuminating. I was somewhat concerned that the paucity of evidence would be glossed over, rather than a topic of discussion.

With regards to doing research myself: I'm a clinical grunt. I've been a paramedic in the field and in the ED for 5 years, and I want nothing more than to punch a clock as an EM physician. I put a lot of energy into evaluating the literature, especially in EMS and EM, but I have little interest in actually generating literature.

Personally, I am more worried about "Big Pharm" shoving unsubstantiated claims down our throats than with the equivocal efficacy of OMM.
( Check out www.Nofreelunch.org for more on that topic!

 

[DireWolf]

Originally posted by paramed2premed
Uh, thanks Direwolf; I'm not quite sure how you meant that...

Umm... what I meant is: work hard in lab, nod your head yes, and go home to complain.

 

[paramed2premed]

Direwolf, this topic seems to have provoked some sort of reaction with you, but your comment came off as glib.

I will assume that you are trying to make a trenchant point about the attitudes of your classmates. Explain more! Do you have any specific concerns with the curriculum? The philosophy? The other students? Did you go in as a "Still-head," and have now come to rue your choices?

Believe it or not, your perspective is of value to some people.

Of course, if you were just blowing off steam, then never mind.

 

[Homunculus]

Originally posted by Fenrezz
We don't sit around wide-eyed like those Heaven's Gate peeps during OMT lab with a giant mural of A.T. Still in the background, on the lookout for any 'unbelievers'.

*cough* KCOM *cough*



seriously though. i interviewed up there and i swear you can't go anywhere without ol' AT watching you from a nearby portrait. i even think the eyes follow you Columbus doesn't get much press there though, poor guy.

i'm glad i chose OSU You won't really notice it until you do your elective rotations with students from other schools (allopathic & osteopathic), but we get a great education. and i didn't even go to most of second year. mwahahaha