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COMAT Clinical – Osteopathic Principles & Practice


Core Knowledge & Elements of Osteopathic Principles

Content Outline and Assessment Objectives

The exam blueprint below contains Osteopathic Principles and Practice topics related to concept & philosophy, diagnosis, and treatment methods.

Dimension 1- Patient Presentation

Topic Percentage
Osteopathic Concept & Philosophy 11-35%
Osteopathic Philosophy & Musculoskeletal Structure/Function
Vascular, Lymphatic, & Neurologic Structure/Function
Osteopathic Diagnosis 22-52%
Chapman’s Reflexes, Cranium, Abdomen, Ribs
Cervical, Thoracic, & Lumbar Spine; Pelvis and Sacrum; Lower Extremities & Upper Extremities
Osteopathic Treatment Methods 24-56%
Articulatory, Facilitated Positional Release, Still Technique, Balance Ligamentous Technique, Functional Technique, Indirect, Exercise Therapy, Soft Tissue, & Myofascial Release
Muscle Energy, HVLA (High-Velocity – Low-Amplitude) Manipulation, Counterstrain, Cranial
Somatovisceral (Autonomic-Oriented Techniques), Visceral, Lymphatic

Selected Specific Learner-Centered Objectives for Osteopathic Principles and Practice

For Osteopathic Principles and Practice, the examinee will be required to demonstrate the ability to diagnose and manage selected patient presentations and clinical situations involving, but not limited to:

  1. Osteopathic concept and philosophy: osteopathic tenets, musculoskeletal structure and function, somatic nerve structure, and lymphatic drainage
  2. Osteopathic diagnosis: observation, palpation, and range-of-motion testing of the lower/upper extremities, cervical/thoracic/lumbar spine, pelvis/sacrum, head, abdomen, and ribs
  3. Osteopathic treatment methods: counterstrain, muscle energy, myofascial release, high velocity low amplitude (HVLA), soft tissue, lymphatic technique, cranial osteopathic manipulative medicine, articulatory techniques, balanced ligamentous tension, ligamentous articular strain, facilitated positional release, Still technique, visceral technique, Chapman reflexes, and trigger points

Throughout these three categories, examinees will be required to demonstrate the ability to:

  1. Discuss the basic principles of the osteopathic philosophy and describe the impact on the health care delivery of osteopathic physicians.
  2. Discuss the scientific knowledge supporting the utilization of osteopathic principles and practices and osteopathic manipulative treatment (OMT), including the basic science of the mechanisms of OMT and somatic dysfunction, and the current evidence base for the clinical application of OMT.
  3. Define the types of physical examination findings consistent with somatic dysfunction.
  4. Define and describe the types of somatic dysfunction found within the ten body regions, including the head, cervical, thoracic, rib, lumbar, pelvic, sacral, abdominal, upper extremity and lower extremity body regions.
  5. Describe the symptoms and physical findings consistent with viscerosomatic, somatovisceral and somatosomatic reflexes.
  6. Define and describe indirect and direct types of OMT, including articulatory, balanced ligamentous tension, counterstrain, cranial osteopathic manipulative medicine, muscle energy, high velocity low amplitude (HVLA), visceral, lymphatic, exercise therapy, soft tissue and myofascial release techniques.
  7. Describe the basic principles of treatment of functional technique, facilitated positional release, ligamentous articular strain and Still techniques.
  8. Discuss the indications and contraindications of different types of OMT.
  9. Discuss the relative value, advantages and disadvantages of different types of OMT.
  10. Correctly diagnose somatic dysfunction within the ten body regions, prioritize a differential diagnosis and develop an appropriate care plan.
  11. Effectively communicate with patients and their families regarding risks, benefits and alternatives associated with the use of OMT.
  12. Maintain the safety and dignity of the patient while administering OMT.
  13. Identify viscerosomatic relationships and the role of the musculoskeletal system in health and disease by performing a structural examination and documenting findings reflective of this relationship.
  14. Show sensitivity to ethnic diversity as it may impact on the presentation of somatic and/or visceral dysfunctions.

Selected Student and Faculty Learning Resources for Osteopathic Principles and Practice

In addition to the aforementioned objectives, examples of supplementary resources used by the NBOME to inform the development of the Osteopathic Principles and Practice exam are listed below:

Sample Questions

The sample questions for Osteopathic Principles and Practice are primarily designed to assist the candidate in navigating through the examination, and it is provided to facilitate the actual testing experience. It is not designed to give the candidate a score or provide information about how a candidate might perform on the examination.

COMAT-SE

COMAT-SE is designed to provide exposure to COMAT style questions and resources for additional learning, prior to taking the COMAT Osteopathic Principles and Practice (OPP) exam.

Additional Resources

An Osteopathic Approach to Diagnosis and Treatment

Author: DiGiovanna, Amen, & Burns, 4th Edition, 2020

Atlas of Osteopathic Techniques

Author: Nicholas, 3rd Edition, 2015

Foundations of Osteopathic Medicine

Author: Seffinger, 4th Edition, 2019

Glossary of Osteopathic Terminology

ECOP/AACOM, 2017

Greenman’s Principles of Manual Medicine

Author: DeStefano, 5th Edition, 2016

Osteopathic Core Competencies for Medical Students

AACOM, 2012

Somatic Dysfunction in Osteopathic Family Medicine

Author: Nelson, 2nd Edition, 2014