SOMA Spotlight - Des Moines University College of Osteopathic Medicine

This Fall's SOMA Spotlight comes from Des Moines University College of Osteopathic Medicine. We were pleased to interview Erika Jaworski, OMS II, about her experiences at DMU's Amish OMM Clinic. Erika is the Professional Development Director on DMU's SOMA Executive Board.

Erika Jaworski Amish Clinic

What OMM project are you involved in at your school?

DMU’s OMM department really strives to give students the opportunity to work with a variety of patient backgrounds. One avenue through which DMU increases our cultural competency as future physicians is through Amish OMM Clinic. This project is the creation of Dr. Jose Figueroa, a well-respected PM&R physician in the Des Moines community who is also renowned for his skills in OMM. Every month, we get the opportunity to provide OMM and family medical care to an Amish community from Northern Iowa. They travel hours to come to DMU and receive OMM treatment approximately once a month.

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What makes this project so unique?

This is a very unique opportunity because we are working with a group of people that have a very different lifestyle and culture. Learning how to be sensitive to cultural differences is always important for our future success as physicians, as we will be working with patients who come from different backgrounds. Especially in the realm of OMM, there are ways to talk and interact with the patient that allow a patient to have a positive experience. These clinics also progress our OMM skills well beyond just treating classmates as we address the needs of adults, children, and even neonates. Furthermore, the language of the Amish community we work with is a German-Dutch dialect, so working through language barriers with the children (who don’t always speak English) is always a fun challenge.

What aspect of this project do you enjoy the most?

What I enjoy the most about this clinical experience is getting to combine all of our skills as future D.O. physicians. Prior to OMM treatments, we take a thorough history, perform a physical exam, and choose a diagnosis. We get to utilize the skills learned in our clinical medicine course before proceeding to the OMM portion of the visit. This is so important because it allows us to synthesize the information we obtained in the History and Physical with the information we obtain through osteopathic structural screening. Making those correlations between historical complaints and Somatic Dysfunctions is a useful skill to learn now so that we can better serve our future patients. It teaches us to view the patient’s complaints through the Osteopathic lens so that we can utilize every tool we have to help treat the patient.

Can everyone at your school participate in this project?

During the first semester of the year, Amish clinic is limited to 2nd year D.O. students. The only requirement is attendance at didactics that are held before each clinic. These training sessions allow us students to learn new OMM skills from Dr. Figueroa that we will be able to use on our Amish patients that week. Once our first year medical students have completed one semester, they are also welcome to volunteer at Amish Clinic. This allows them to have obtained some palpatory, diagnosis, and treatment skills during the fall before they begin helping treat in the spring.

How does this project help spread osteopathy in your community?

First, this project has been going on for years under Dr. Figueroa’s direction. There is an entire population of Amish People who firmly believe in the power of OMM as a modality of treatment to maintain health and wellness. This is evident as we see people from the community continuing to come to clinics over and over again. It’s really great to be a part of an activity where you can treat a patient who has been attending clinics for over 10 years. That kind of confidence in OMM is inspiring, especially to first year students who may not have had any exposure to manipulation before attending medical school. Second, I think that by allowing students to practice OMM in a primary care setting, you are encouraging the use of OMM once the student is a physician. If a student is able to practice their skills and gain the confidence to do a full body treatment well, I think they are much more likely to utilize it in practice. This is creating a multitude of physicians who will continue to spread osteopathy throughout the state of Iowa through the use of OMM as a tool for patient care.

How has your involvement in this project impacted your future as a physician?

First, I believe the cultural competency aspect is huge. We have had to learn how to appropriately and respectfully interact with a group of people that we are unfamiliar with. This is important because in our future practices, even if we are not knowledgeable about a person’s culture, we have the skills to ask the patient what their values are and make sure we respect those values.

Second, I think that by doing a history, physical, and OMM treatment, I have started to develop my own flow and style of treatment. During Amish clinic, I have the time to critically think about what I receive through a patient’s history and what I perceive about the patient’s system through palpation and osteopathic diagnosis. Synthesizing this information into an effective treatment has progressed my OMM skills far beyond simply remembering techniques for exams. It’s great to develop that sense of comfort with what I’m doing so early in my medical career because it is something I will continue to use in order to help my future patients.

Has your involvement in this project assisted you in your personal professional development?

This clinic really encourages us to synthesize our knowledge and skills, while being a safe environment for us to admit we don’t know everything. Dr. Figueroa and the patients have definitely helped all of us students grow professionally, as the clinic is a time for us to exercise our knowledge and take what we learn in a class room to the next level. I think that because the clinic is a great representation of what we will experience as physicians, I have learned to think critically about my patient’s care to give them the best outcome possible. I believe this experience is something that will always impact how I developed professionally as an Osteopathic physician. 

SOMA Spotlight - Touro College of Osteopathic Medicine, Harlem Campus

This spring's SOMA Spotlight focuses on TouroCOM Harlem's OMM programming and Clark Johnsen, OMS II. Clark is TouroCOM Harlem's SAAO President, an OMM lab TA, and helps to lead a weekly OMM program called Enhancement. Clark is pictured below with Michelle Gaglia, OMS I, Touro Harlem.

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What OMM project are you involved in at your school?

One of the unique aspects of our OMM program is that our school does not yet have an associated clinic.  We don't have a pool of residents, interns, or even students doing rotations as a resource for the 1st year students who are just learning about osteopathic principles, the osteopathic structural exam and treatment modalities.  To answer this need, our school chooses a select group of 2nd year students to serve as TAs.  The TAs attend the first year lab sessions, help facilitate understanding and get the additional benefit of improving their own skills by reviewing the 1st year materials and treatments.  The TA program has been a huge success at Touro, and this year we accepted even more students into the program in the past because there has been increased interest, and the students who applied performed to an extremely high caliber on both practicals and written exams.  This was a promising development and certainly an indication that the program is garnering the kind of interest in OMM that we hope for within an osteopathic medical school.  

What makes this project so unique?  

In our program, we believe that the peer to peer interaction within an osteopathic minded context is one of the most important parts of attending an osteopathic medical school.  We have been inspired by the "Brief Guide to Osteopathic Medicine," By Patrick Wu and Jonathan Siu: a book written for osteopathic medical students by osteopathic medical students.  While learning from practicing OMM physicians is vital to any osteopathic training program, we believe that the student/student interaction is another incredibly relevant activity for garnering interest in the field of osteopathic manipulative medicine and developing young talent in the field.  Our students will be residents in a broad range of specialties in just a few years, and we want them to have a positive impression about their osteopathic training.  We want them to feel that being a DO is a big advantage for them in their careers, be it in everything from family medicine to dermatology.  Having a peer show a treatment may be more memorable and relatable to some students.  We want them to say to themselves, "Hey- she's only one year ahead of me.  If she can learn this, so can I."  

What aspect of this project do you enjoy the most?

Another aspect of our OMM program is an activity called Enhancement.  Enhancement is a 2-3 hour biweekly event that consists of an academic review for the first hour, and then a treatment portion.  During review, the TAs lead a discussion about whatever the 1st or 2nd students have next on the docket: practical or written material.  This portion is completely student run, and allows students to speak up with questions or concerns that may not have been brought up in class or lab due to time constraints or embarrassment.  The review sessions have been a particular success, and on a couple of occasions have been attended by over 100 students from the freshman class of 135.  The treatment portion is overseen by 2 attendings.  Students wishing to be peer treated arrive with a chief complaint, usually something like neck pain, lower back soreness or a headache from too much studying.  One of the TAs/SAAO members takes a brief history and expands the chief complaint, establishes a differential, and then devises a viable treatment plan for the student.  Once this has taken place, one of the attendings is presented the case and then talks through it with both the student doctor and the student patient.  Then the student is treated, given instructions for home exercise or posture/lifestyle modifications.  Because the exercise is both practical and didactic, both students benefit.  That's the goal. 

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I think what I love most about these sessions is the opportunity to see light bulb moments in the students.  It's wonderful to watch their facial expressions as they move from confusion to clarity.  Their eyes light up, "I get it!"  That is incredibly exciting for me.

Can everyone at your school participate in this project?

Our enhancement sessions are open to all of our students as well as students in our Pharmacy and Masters programs, with whom we share campus space.  

How does this project help spread osteopathy in your community?

I think that getting students excited about osteopathic manipulative medicine is a huge step in furthering the understanding and impact of the field.  I think that if students have a positive experience with osteopathic manipulative medicine in the first 2 years of medical school, I think it stays with them.  They feel a sense of pride in being a DO.  They see it as an asset.  If they look at the extra training they received as DOs through this lens, they will be more likely to educate other physicians they meet in their careers about what it means to be a DO.  They can do more than just say, "We treat the whole patient," which to some allopathic physicians may seem like a trite and idealistic statement, not to mention something that many MDs may find insulting.  I would like to see our students entering the work force feeling excited about their identity as DOs.  And when a colleague says, "What did you learn in osteopathic medical school," he or she can say, "How about I show you?"

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Touro Harlem faculty and a few of the 2nd year OMM TAs

How has your involvement in this project impacted your future as a physician? 

For me, teaching others has been the most effective and powerful learning tool in medical school.  I think the concepts that you teach to another person are the ones that you really understand deeply, and the ones that stay with you.  I am not certain of which specialty I want to choose in the coming years, but I am confident that our program and the opportunity to participate and teach others these valuable concepts will mean that these concepts will stick with me as I move forward in my learning.  I think having osteopathic principles embedded into my medical mind will help me to think differently about each and every patient that I see.  I think I will do better by them as a result of what I have learned at TouroCOM.  

Has your involvement in this project assisted you in personal professional development?

The opportunity to work with attendings and discuss diagnoses and treatment plans is something that many 2nd year medical students do not get the chance to do.  Our talented attendings have helped develop our minds and our hands to be more attuned to critical thinking about the people who walk into our enhancement sessions for treatment.  I think some students just walk in wanting their necks cracked.  We hope that with our program the students leave with a real learning experience that we hope takes them out into the world as better osteopathic physicians.  

SOMA Spotlight - MWU Chicago College of Osteopathic Medicine

This SOMA Spotlight focuses on Chicago College of Osteopathic Medicine's OSTCE and Todd Kruse, OMS II. Todd is the President of CCOM's Student American Academy of Osteopathy Chapter and a SOMA member. 

1. What OMM project are you involved in at your school?

I am the student coordinator for the Osteopathic Soft Tissue Clinical Experience (OSTCE) or “Soft Tissue Clinic” at Midwestern University CCOM. This free student run clinic, which is open every Wednesday to MWU students, faculty and staff, started up just over a year ago.

2. What makes this project so unique?

The Soft Tissue Clinic is a free clinic that is located on campus in the OMM department office, rather than being at a clinic somewhere in the city of Chicago (about a 45 minute drive) like most of our other clinics, that students can work at. This makes it easy for the patients – who all study or work at Midwestern – to take an hour out of their work day to receive an OMM treatment that they probably wouldn’t get otherwise. It’s also convenient for the student doctors, because we don’t have to travel far and can just stop in after class.

3. What aspect of this project do you enjoy the most?

I really enjoy working with the Midwestern students, faculty and staff. Everyone we treat is so grateful. Most of our cases are patients who have chronic conditions like osteoarthritis or carpal tunnel, overuse injuries, or sub-clinical aches and pains – issues that cause enough discomfort for the patients to seek free OMT treatment with us, but not enough for them to seek professional treatment. Normally patients wouldn’t be able to see their physician for OMM treatment of these conditions on a regular basis, but since our clinic is free and usually not too overbooked, our patients can come in every 2-3 weeks and they are making us a part of their healing process or chronic pain management plan.

4. Can everyone at your school participate in this project?

Not quite. Space is limited so we only allow students who are members of SAAO or SOMA to participate. We also limit the number of MS1s that can volunteer to ensure that they get enough experience in the clinic to really get something out of it. Since we started last year, we’ve had 18 MS1s and about 25 MS2s participate in the clinic each year plus a handful of MS4s, but we are hoping to expand eventually.

5. How does this project help spread osteopathy in your community?

Midwestern University is a health science graduate school, and many of our patients from the other programs don’t know very much about Osteopathic Medicine before the come in. At each patient visit, we have the opportunity to explain to our inter-professional colleagues what we do as D.O.s, and better yet, we get to show them by giving them an OMM treatment!

6. How has your involvement in this project impacted your future as a physician?

I think it really solidified my interest in using OMT as part of my practice when I move on to residency and my career as a primary care physician. All of our patients are so appreciative of us student doctors taking the time to put our hands on their aches and pains and doing something to make them feel better in that moment. It doesn’t have to be anything major, even just a few minutes of soft tissue treatment goes a long way. 

7. Has your involvement in this project assisted you in personal professional development?

Absolutely. I jumped on this program about a month before we had our first clinic day, and with that I was able to learn (mostly by trial and error) a lot about the logistics of starting up a clinic from scratch.  There is a lot that goes into it. A group of MS2s did most of the paperwork to get it approved before I started, but I was able to help with scheduling, recruiting, and training student doctors; advertising to patients; and putting together all of the necessary paperwork for documentation, workflow, etc.  Now that the clinic is up and running, there is a lot less work, but I still get experience working on a team with our student board and the faculty, organizing and communicating with the student volunteers, and problem solving when issue come up. We are constantly trying to make improvements to our clinic.

SOMA OMM Spotlight

Michigan State University College of Osteopathic Medicine's Sports OMT Elective

Interviewee: Chris Mattson (left), OMS II, a former collegiate baseball player from Hope College in Holland, MI. 

What OMM project are you involved in at your school?
-- I am one of the Clinical Coordinators for the Sports OMT elective, formerly known as the Injury Prevention in Distance Runners Study (IPDRS). 10 years ago this was a research project that set out to determine if lower extremity OMT could decrease the prevalence of stress fractures in collegiate cross country athletes (it did!). After years of data collection and publication, the project turned into an elective for medical students.

What makes this project so unique?
-- This elective offers first and second year medical students the opportunity to diagnose and treat Division I athletes from the Men's and Women's Cross Country Teams at Michigan State University. Given the amount of milage that these athletes put in as part of their training (over 40 miles per week), their somatic dysfunctions and compensations provide a unique and valuable experience for osteopathic medical students.

What aspect of this project do you enjoy the most?
-- My favorite part of the Sports OMT elective would have to be the opportunity to work with such driven and health-conscious individuals. These athletes want to perform at their peak every day, and they see the elective as a tool to help them decrease pain and reduce risk of injury. For me, it is very rewarding to hear their testimonials of how Sports OMT has helped them in their sport; it makes every week exciting.

Can everyone at your school participate in this project?
-- This elective is open to 25 OMS I students each year (we have 300 students per class), and is a two-year commitment. As such, if you are not a part of the elective in your first year, you are unable to participate in your second.

How does this project help spread osteopathy in your community?
-- This elective is a way for athletes to become familiar with some of the unique tools that osteopathic medicine has to offer. The positive experiences and treatments that they've had may broaden the reasons that these athletes choose to visit an osteopathic physician in the future.

How has your involvement in this project impacted your future as a physician?
-- This experience has really piqued my interest in osteopathic manipulative medicine as it relates to athletics and preventative care. The elective has increased my confidence in diagnosing and treating somatic dysfunction. I believe that confidence will carry over into my practice and the skill set I have acquired will enable me to treat my patients efficiently in the future.

Has your involvement in this project assisted you in personal professional development?
-- This elective has enhanced my organization and communication skills, and it has helped me become more comfortable teaching students and working with athletes/patients. These will be valuable skill sets moving forward, both in medical education and in everyday life as a physician leader. 

Osteopathic Principles & Practice Director


Michael "Mikey" Padilla, OMS III

Midwestern University Chicago College of Osteopathic Medicine