Osteopathic Manipulative Medicine is a hard subject to write test questions about. It is a specialty of medicine that relies totally on feel and experience. Luckily for students taking any level of the COMLEX exam, this gives you the upper hand. Since it is so hard to write a good question, questions tend to be very predictable. By focusing on a few high-yield areas,it is easy to excel in a subject that seems to haunt many DO students. I am going to split this topic into two posts to allow me to elaborate on some topics rather than simply throw out a long list of words.
First off, technique is rarely tested since it varies by institution and attending. It is more important that students focus on the concepts of technique. Knowing that soft tissue is always a direct technique is far more valuable than how to actually perform the maneuver. By test day, students should be able to classify all techniques into direct vs. indirect and know the settings in which to use them. Remember understanding concepts can help you answer any question.
The most important topic regarding OMM for COMLEX is the spinal levels. Every DO student should know spinal levels so well they dream about the subject at night. As stated earlier, it is hard to write a good OMM question, so the majority of questions end up being on this topic. Don’t get scared if you see the same level coming up more than once during an exam. If you have five pulmonary questions in the morning session, you may get asked five times what the spinal levels of the lungs are. If I could summarize this post in four words, I’d use big bold letters saying “memorize your spinal levels!”
While focusing on memorizing the spinal levels chart, the next logical topic to discuss is Chapman’s points. This is another high-yield topic. It is simple to write an appendix question stem and then ask for the Chapman’s point. While everyone reading this says to themselves “tip of rib twelve on the right,” that answer could be wrong. When you encounter Chapman’s points questions, remember to actually read the question; are they asking for the anterior or posterior point? In a 400 question test, fatigue is a real issue, and it is easy to see a paragraph question stem and only read “appendix” and “Chapman”, and then get the question wrong. These are simple questions; just be sure to read them.
Osteopathic principles and practices total 20% of the exam. In my experience, many students wait too long to begin studying for OMM and end up paying for it on test day. The next post will focus on diagnosis of dysfunction, sacral dysfunction, and osteopathy in the cranial field. Until then, memorize your spinal levels!