Osteopathic Schools: What is Osteopathy?
Updated: Dec 14, 2021
Osteopathic Schools: Is it right for you?
Over the past several years, medical school admissions have grown to be one of the most competitive things a graduating student can participate in. On average 6% of overall applicants in each cycle are given a seat in medical school. Though, I think if you have done your research and prepped properly, then this number shouldn’t worry you as much.
There are two sets of medical degrees in the United States: Allopathic (M.D.) and Osteopathic (D.O.) medical schools. Many advisors and pre-meds alike will talk along the lines of applying allopathic first and then osteopathic as a backup. But over the past many years, any medical school is extremely competitive to get into and no one should be considered one degree a backup to another. The purpose of this article is to tell you about more about the profession of osteopathic medicine and to inform if it is the right choice for you.
Long story short, both M.D.’s and D.O.’s serves as practicing physicians who specialize and practice in the same fields with the same practicing rights. In the hospital, the two degrees might seem indistinguishable. This does not mean that there is no difference, Osteopathic physicians get extra training in their 4 years of medical school in diagnosing and treating the Musculo-skeletal system. This specific training is osteopathic manipulative medicine/therapy (OMM/OMT). This training is to help students and physicians palpate, observe, and move musculoskeletal system to treat and diagnose complaints. Many of the same techniques used in treating and diagnosis are found in physical therapy, occupational therapy, orthopedics, and chiropractic’s.
Before beginning to talk about what OMM/OMT is, lets first quickly discuss the history of osteopathic medicine. Founded by Andrew Taylor Still (M.D.), he realized after losing his whole family to infectious diseases and seeing the horrors of medicine during the civil war that something had to change with medicine. Medicine during the mid to late 1800’s was often more harmful than useful (bloodletting and non-sterile procedures), these led to many unnecessary deaths. Thus A.T. Still created the first osteopathic school (AT Still University) in Kirksville, Missouri. He wanted students to discover and try out new techniques and to use their knowledge of human anatomy to create effective therapies that were not as detrimental to the patients. Since then many more schools have opened and have continued to pass on his way of thinking. D.O.’s first were allowed full practicing rights in the mid 1900’s. Most of them first being recognized to practice in the military and then by the public. Since then osteopathic physicians have gone on to become presidential physicians, bronze star recipients and social media icons.
OMM/OMT is an adjunctive therapy to what is already mainstay and first line. Osteopathic physicians are to diagnose and treat all ailments by standards set by the medical community. After mainstay treatment and diagnosis have been made, then an osteopathic physician can use OMM/OMT to aid in the recovery and treatment of various disease processes. Common joint/muscle injuries can be diagnosed and treated with just OMM/OMT treatments and can potentially save patients from needing to take more ibuprofen or acetaminophen than necessary. There is OMT for patient who might be recovering from upper respiratory infections and allergies. This includes drainage techniques to help the sinuses clear out mucus, improve breathing, and aid in the drainage of lymph.
However, OMM/OMT is more than just treatment. It includes how you diagnose and interact with patients. With the hundreds of hours of training, osteopathic students learn the details of how bodies react to diagnostic palpation and how to get comfortable with using a student’s eyes, ears, and hands to create a differential even before considering getting lab work. The art of an effective and therapeutic physical exam can make a huge difference in how a physician’s assessment and plan are formed. In addition, a thorough and well thought out physical exam can be therapeutic for the patient. This physical exam, diagnosis and treatment modality can create a greater therapeutic bond and can lead to confidence and trust that might not otherwise be given.
Sports medicine can offer great examples of the benefits of OMM. Knowing how the musculoskeletal system moves and works requires a great understanding of anatomy. When doing any activity people commonly fracture bones and injure soft tissues. Not having access to portable ultrasound, x-ray or CT can make it difficult to assess the severity of injuries. However, using, OMM and other physical diagnostic methods on the field can help with making fast and effective clinical diagnosis in the setting of minimal resources. Same can be applied to athletes (and even patients in emergency room’s) have cramping muscles, knowing how to stretch and apply the correct force can save time, money, and energy in trying to resolve simple issues.
You might be surprised but using your palpation skills can be incredibly important even in the ICU. When placing central lines that go into the jugular vein (to help maintain patients who might be in shock), one must palpate the carotid artery, clavicles and surrounding tissue. While doing this, you must ensure no superficial infections or other contra-indications to the procedure. Then you must turn the head to expose the jugular vein to insert a needle. The palpation, visual inspection and movement IS a part of OMM. Before being in the clinics in 3rd year, you will have already spent many hours and days knowing what normal and abnormal anatomy looks like and how to appropriately move your patient’s anatomy for procedures and treatments. Another example is inserting a chest tube, it must be done at a very specific part of the lungs through the ribs. You must be careful to not sever any nerve, arteries and veins that are below every rib. This is to be done through palpation and visual assessment. This is where OMM has already taught you how to assess for ribs and understand where a needle must go to avoid vital structures.
Seeing each patient with specific diseases as a culmination of many different factors is at the root of the osteopathic profession. This includes seeing patients’ outcomes and diseases as a part of their environment and their life outside of the clinic. There are 5 distinct models in osteopathic medicine to that is used to guide our treatment and diagnosis: Biomechanical, Respiratory/Circulatory, Neurological, Metabolic/Energy, and Behavioral. Through these lenses we can better address patient complaints in an all-encompassing solution that must be adjusted as treatment continues. A great example is fatigue, an extremely common problem but an often-elusive workup. Patients who are in medical school are often anxiety ridden (Behavioral) and thus don’t sleep. Decrease sleep and increased stress leads to increased appetite and weight gain (Metabolic). Weight gain can lead to obstructive sleep apnea (Respiratory/Circulatory). However, in attempts to lose weight the patient is having knee pain (Biomechanical) due to their weight gain. Due to this they must use a bike at the gym with uncomfortable seats and cause compression of their sciatic nerve and is causing extreme pain down one leg (Neurological). This is just one example, and there are many more out there of how viewing patients in this model can help start to unpack the complex lives of people who are in need.
All this to say osteopathic medicine goes beyond just treatment but is involved in every part of the interaction with patients. It involves getting in tune with the human body and using medicine and skills to create an effective therapeutic bond with patients. If these aspects of medicine resonate with your thinking, then osteopathic medicine is a great choice. Also, this does not mean that allopathic schools don’t emphasize and learn some of the things. It just means Osteopathic students have an extra emphasis on it and will have an extra tool in their toolbox in addressing patient concerns.
In the end, average GPA and MCAT of matriculants are becoming extremely similar between M.D.’s and D.O.’s. The choice is not between wanting an M.D. first then a D.O. but it’s between if you want to become a physician or not. If so, does the osteopathic profession align with your values and what you want to become.
If you want to learn more about just DO’s go check out Dr. Mike. He is an NYITCOM alumni and practices OMM and has recently become famous among social media. Here's a link to this video on DO vs MD that I think is pretty accurate: