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.
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.
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?"
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.