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COMAT Clinical – Emergency Medicine


Core Knowledge & Elements of Osteopathic Principles in the Discipline of Emergency Medicine

Content Outline and Assessment Objectives

The exam blueprint below contains the Emergency Medicine topics covered in two dimensions: Dimension 1 – Patient Presentation and Dimension 2 – Physician Tasks.

Dimension 1- Patient Presentation

Topic Percentage
Abdominal Pain 6-11%
Chest Pain 6-11%
Environmental/Travel Disorders 2-5%
Gastrointestinal Bleeding 3-6%
Genitourinary 4-7%
HEENT (Head, Eyes, Ears, Nose, and Throat) Disorders 4-7%
Mental Status Change/Weakness 6-11%
Musculoskeletal Disorders 6-11%
OB/GYN 4–7%
Poisoning/Overdose/Withdrawal 4-7%
Psychiatric/Behavioral 2–5%
Rashes/Disease of the Skin 2–5%
Resuscitation/Shock 5–8%
Shortness of Breath 6–11%
Special Populations 4–7%
Traumatic Injuries 4–7%

Dimension 2 – Physician Tasks

Topic %
History & Physical Examination 20-28%
Differential Diagnosis & Diagnostic Technologies 15-25%
Management 15-25%
Scientific Understanding of Health & Disease Mechanisms 5-15%
Health Care Delivery Issues 4-8%
Understanding of Procedural Skills (Indications/Performance Description/Contraindications) 10-20%
Health Promotion & Disease Prevention 2-4%

Selected Specific Learner-Centered Objectives for Emergency Medicine

For Emergency Medicine, 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. Abdominal Pain: Aortic aneurysm, appendicitis, bowel obstruction, cholecystitis/cholelithiasis and diverticulitis
  2. Mental Status Change/Weakness: Cerebrovascular disease, hypoglycemia, infection, seizure, synce and metabolic disorders
  3. Chest Pain: Acute coronary syndromes, aortic dissection, pneumothorax and pulmonary embolism
  4. Environmental/Travel Disorders: Chemical and thermal burns, envenomations and hypothermia/hyperthermia
  5. HEENT Disorders: Infection, headache including migraine and subarachnoid hemorrhage, glaucoma, epistaxis and trauma
  6. Gastrointestinal Bleeding: Upper including peptic ulcer disease and variceal, and lower including diverticulosis, hemorrhoids and malignancy
  7. Poisoning/Overdose: Anion gap acidosis, decontamination, and overdoses of acetaminophen, carbon monoxide, opioids, salicylates, tricyclic antidepressants and toxic alcohols
  8. Psychiatric/Behavioral: Psychosis, depression, substance abuse and suicidal ideation or attempt
  9. Resuscitation/Shock: Basic airway management, cardiopulmonary resuscitation, dysrhythmia identification and treatment and first minute of a code, treatment of shock states including anaphylaxis, cardiogenic, hypovolemic and septic
  10. Shortness of Breath: Airway obstruction, asthma/COPD, heart failure, pulmonary embolism, and infections including pneumonia, bronchitis, and epiglottitis
  11. Traumatic Injuries: Abdomen including bowel, hepatic, and splenic injuries, chest including hemothorax, pneumothorax, and tension pneumothorax, extremities including dislocations, fractures and splinting, head injuries including epi-/subdural hematomas, neck including cervical fractures and spinal cord damage, and pediatric non-accidental trauma/domestic violence
  12. OB/GYN: Abortion including complete, incomplete, inevitable and threatened, ectopic pregnancy, placenta previa and placental abruption. Infections including pelvic inflammatory disease and sexual transmitted infections
  13. Wound Care: Irrigation, local anesthesia, primary closure and tetanus prophylaxis

Selected Student and Faculty Learning Resources for Emergency Medicine

In addition to the aforementioned objectives, examples of supplementary resources used by the NBOME to inform the development of the Emergency Medicine exam are listed below:

Additional Resources

Tintinalli’s Emergency Medicine: A Comprehensive Study Guide

By: Tintinalli et al. 9th Edition, 2019

Rosen’s Emergency Medicine: Concepts and Clinical Practice

By: Walls, Hockberger, & Gausche-Hill 10th Edition, 2022

Roberts and Hedges’ Clinical Procedures in Emergency Medicine and Acute Care

By: Roberts et al. 7th Edition, 2018

Tintinalli’s Emergency Medicine Manual

By: Cydulka et al. 9th Edition, 2019

An Osteopathic Approach to Diagnosis and Treatment

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

Foundations of Osteopathic Medicine

By Seffinger 4th Edition, 2019