Journal of Osteopathic Medicine最新文献

{"title":"Prevalence of pelvic examinations on anesthetized patients without informed consent.","authors":"Rachel Cutting, Varsha Reddy, Sneha Polam, Nicole Neiman, David Manna","doi":"10.1515/jom-2024-0058","DOIUrl":"10.1515/jom-2024-0058","url":null,"abstract":"<p><strong>Context: </strong>The pelvic examination is a fundamental tool for the evaluation and diagnosis of women's health conditions and an important skill for all medical students to learn as future physicians for the early detection of treatable conditions such as infection or cancer. Although the American College of Obstetricians and Gynecologists (ACOG) asserts that performing pelvic examinations under anesthesia for educational purposes should only occur if the patient provides explicit and informed consent, there still have been reports of medical students performing pelvic examinations on anesthetized patients across the country, and many states are now starting to pass bills requiring informed patient consents to conduct pelvic examinations under anesthesia.</p><p><strong>Objectives: </strong>The objectives of this study are to evaluate the prevalence of pelvic examinations performed by osteopathic medical students on anesthetized patients without consent while fulfilling their third-year OB-GYN clerkship requirements.</p><p><strong>Methods: </strong>The survey was administered and distributed to all osteopathic medical schools in the country via the Student Osteopathic Medical Association's (SOMA's) chapter emails, outreach emails, and SOMA's social media accounts to collect data. Inclusion criteria included third- or fourth-year osteopathic medical students who completed their OB-GYN clerkship rotations when taking the survey. The exclusion criteria included any osteopathic medical student who had not completed their OB-GYN clerkship rotation. We utilized descriptive analysis to summarize the final data.</p><p><strong>Results: </strong>We received 310 responses. The final number of responses was 291 after meeting the exclusion criteria. Most osteopathic medical students (94.2 %, n=274) considered the practice of performing pelvic examinations on anesthetized patients without their explicit consent unethical. Among the participants, 40.9 % (n=119) admitted to performing pelvic examinations on patients under anesthesia while on OB-GYN rotations, but most of them (57.1 %, n=68) did so without obtaining prior consent from the patients. Notably, the number of pelvic examinations performed by medical students on patients under anesthesia ranged widely from 1 to 25 with a median number of 10. Moreover, 58.9 % (n=70) indicated that they had not been properly educated to obtain specific consent before performing pelvic examinations under anesthesia. Many participants cited efficiency of practice, lack of policy awareness and personal education by medical students, and failure to refuse to perform pelvic examinations on anesthetized patients as trainees when asked by their seniors or preceptors.</p><p><strong>Conclusions: </strong>This study demonstrates that although most osteopathic medical students consider performing pelvic examinations on anesthetized patients unethical, many still admit to practicing pelvic examinations on patients under","PeriodicalId":36050,"journal":{"name":"Journal of Osteopathic Medicine","volume":" ","pages":"153-159"},"PeriodicalIF":1.4,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142373144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of osteopathic manipulative medicine training during graduate medical education and its integration into clinical practice.","authors":"Joanna L Kramer, Kirby Trombetti, Kathleen De Asis, Vivian Mai, Edward Swing","doi":"10.1515/jom-2024-0082","DOIUrl":"10.1515/jom-2024-0082","url":null,"abstract":"<p><strong>Context: </strong>Osteopathic manipulative medicine (OMM) is a unique skill set consisting of physical manipulations that treat the neuromusculoskeletal system. Although OMM can improve patient outcomes such as functionality and pain, as well as increase physician reimbursement, its use is declining. Barriers to its use include a lack of proficiency, support, reimbursement, and time. Knowledge gaps remain as to how OMM training during graduate medical education (GME) affects OMM use.</p><p><strong>Objectives: </strong>This study describes relationships between OMM exposure during GME and the use of OMM in practice.</p><p><strong>Methods: </strong>An online survey of physicians in a variety of medical fields during late 2022 assessed the impact of OMM education during postgraduate training on its use in clinical practice. Survey data were analyzed to compare training characteristics and OMM use via chi-square tests and binary logistic regression.</p><p><strong>Results: </strong>A total of 299 surveys were completed. Respondents who received formal OMM education during residency were more likely (59.8 %) to utilize OMM in medical practice than those who practiced OMM informally (37.8 %, p<0.001) and those who had no OMM exposure during residency (10.3 %, p<0.001). Respondents who trained with more osteopathic attendings (p<0.001) and co-residents (p=0.012) were also more likely to utilize OMM. Those who completed residencies that were accredited by the Accreditation Council for Graduate Medical Education (ACGME) with an Osteopathic recognition track, by the American Osteopathic Association (AOA), and were dually-accredited (ACGME/AOA), were all more likely to utilize OMM (60 %, 56 %, and 53 %, respectively) than those who completed residencies with ACGME accreditation alone (22 %, p<0.01).</p><p><strong>Conclusions: </strong>Although OMM can improve patient outcomes, it is underutilized by Doctors of Osteopathic Medicine (DOs) in practice. Lack of training after medical school has been identified as a contributing factor to its disuse. The results of our study illustrate that there is a positive association between OMM education during postgraduate training and OMM use in clinical practice.</p>","PeriodicalId":36050,"journal":{"name":"Journal of Osteopathic Medicine","volume":" ","pages":"143-151"},"PeriodicalIF":1.4,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142373143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Communication and empathy within the patient-physician relationship among patients with and without chronic pain.","authors":"John C Licciardone, Claire N Middleton, Amin Aboutaj, Tal Allouche, Imran Siddiqui","doi":"10.1515/jom-2024-0112","DOIUrl":"10.1515/jom-2024-0112","url":null,"abstract":"<p><strong>Context: </strong>Chronic pain may affect the relationship between patients and their treating physicians.</p><p><strong>Objectives: </strong>This study was designed to compare four aspects of physician communication and physician empathy reported by patients with chronic pain and in chronic pain-free controls.</p><p><strong>Methods: </strong>A cross-sectional study was conducted within a national pain research registry from July 2020 through January 2024. Patients with chronic low back pain of greater than 3 months duration were matched to chronic pain-free controls utilizing propensity scores derived from a logistic regression model based on 11 variables that included sociodemographic characteristics, cigarette smoking status, history of comorbid medical conditions, and duration of the current patient-physician relationship. Patients reported on the primary outcomes of physician communication utilizing the Communication Behavior Questionnaire (CBQ) and physician empathy utilizing the Consultation and Relational Empathy (CARE) measure. Group means were compared for each aspect of physician communication (patient participation and patient orientation, effective and open communication, emotionally supportive communication, and communication about personal circumstances) and physician empathy, and Cohen's d statistic was utilized to assess the clinical relevance of between-group differences. Secondary exploratory analyses were also performed to compare patients treated by osteopathic physicians vs. allopathic physicians and to determine whether study group X physician type interaction effects were present.</p><p><strong>Results: </strong>The 387 patients in each study group were matched within a caliper width of 0.001 on the propensity score. Overall, patients ranged from 21 to 79 years of age (mean, 50.7 years; standard deviation [SD], 15.1 years), and 617 (79.7 %) of them were female. Patients in the chronic pain group reported poorer scores for all aspects of physician communication and physician empathy than the chronic pain-free controls. All between-group differences were clinically relevant. There were no differences in physician communication or physician empathy according to physician type in the exploratory analyses, and study group X physician type interaction effects were not observed.</p><p><strong>Conclusions: </strong>In this cross-sectional study, patients with chronic pain reported having physicians with poorer communication and less empathy than chronic pain-free controls. Longitudinal research is needed to more clearly determine the temporal relationship between patients' chronic pain and physician communication and physician empathy during medical encounters.</p>","PeriodicalId":36050,"journal":{"name":"Journal of Osteopathic Medicine","volume":" ","pages":"79-86"},"PeriodicalIF":1.4,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142366789","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Modeling the importance of physician training in practice location for Ohio otolaryngologists.","authors":"Samuel Borgemenke, D'Nair Newsom, Patrick Scheatzle, Nicholas Durstock, Elizabeth A Beverly","doi":"10.1515/jom-2024-0035","DOIUrl":"10.1515/jom-2024-0035","url":null,"abstract":"<p><strong>Context: </strong>Underserved communities in southeastern Ohio and Appalachia face significant healthcare accessibility challenges, with the Midwest offering a lower density of healthcare providers compared to coastal regions. Specifically, underserved communities in southeastern Ohio and Appalachia are disadvantaged in otolaryngology care.</p><p><strong>Objectives: </strong>This analysis aims to identify factors that lead otolaryngologists to a respective practice location, and if any of that influence comes from where otolaryngologists completed their medical education.</p><p><strong>Methods: </strong>The proportion of otolaryngologists who performed medical school, residency, and/or fellowship in Ohio was analyzed utilizing a three-sample test for equality. Multivariate logistic regression and Pearson prediction models were produced to analyze the impact of performing medical training (medical school, residency, and fellowship) in Ohio.</p><p><strong>Results: </strong>Going to medical school in Ohio significantly increases the odds of going to an otolaryngology residency in the state (p<0.001). Moreover, between medical school and residency, medical school was a significantly better predictor of otolaryngologists practicing in Appalachia (Δ Bayesian Information Criterion [BIC]>2) and southeast Ohio (ΔBIC>10). Medical school in state was also a better predictor of percent rural and median household income than residency (ΔBIC>10). The multivariate model of medical school and residency was significantly better than either predictor alone for the population (ΔBIC>2). All models predicting percent rural were significantly improved with the addition of a Doctor of Osteopathy (DO) degree (ΔBIC>10).</p><p><strong>Conclusions: </strong>Where physicians complete their medical training (medical school, residency, and fellowship) in state has a significant impact on predicting their future place of practice. This study found that the location of such training has a positive predictive nature as to whether that physician will practice in a rural and underserved area in the future. Notably, the addition of being licensed as a DO also increased the probability of that physician practicing in a rural area.</p>","PeriodicalId":36050,"journal":{"name":"Journal of Osteopathic Medicine","volume":" ","pages":"213-223"},"PeriodicalIF":1.4,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142355708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends of public interest in chronic traumatic encephalopathy (CTE) from 2004 to 2022.","authors":"Blakelee Eggleston, Caitlin Wenske, Carly Sweat, Douglas Nolan, Nicholas B Sajjadi, Anna Mazur, Micah Hartwell","doi":"10.1515/jom-2024-0015","DOIUrl":"10.1515/jom-2024-0015","url":null,"abstract":"<p><strong>Context: </strong>Public interest in sport-related medical conditions is known to be affected by social media and pop cultural coverage. The purpose of this project was to assess the relationship between popular culture concerning chronic traumatic encephalopathy (CTE) and analyze of how often this topic was searched on the internet.</p><p><strong>Objectives: </strong>The objective of this study was to investigate deviations in public interest following player incidents of CTE and the effects that the media has had on public interest in CTE.</p><p><strong>Methods: </strong>To determine our primary objective, we utilized Google Trends to extract the monthly relative search interest (RSI) in CTE between January 2002 and October 2022. To assess the increase in RSI following a major event, an autoregressive integrated moving average (ARIMA) to predict RSI from March 2012 was created through the end of the period, and calculated the differences between the actual and forecasted values.</p><p><strong>Results: </strong>Data indicate that RSI increased over time, specifically following the release of the movie <i>Concussion</i>. The peak in RSI (100) over this timespan was following the release of Aaron Hernandez's autopsy results in 2017, which was 87.8 (95 % CI: 8.7-15.7) higher than forecasted, showing a 720.3 % increase in RSI. While research was published regarding CTE in 2005, the first major spike in search interest occurred after Junior Seau died in 2012. Increasing public interest in CTE continued when media exposure conveyed autopsies of former NFL players, the movie <i>Concussion</i>, and the release of <i>The Killer Inside: The Mind of Aaron Hernandez</i>. Given this increased interest in CTE, we recommend that media broadcasters become more educated on brain injuries, as well as the movement of Brain Injury Awareness Month and Concussion Awareness Day.</p><p><strong>Conclusions: </strong>There has been an increase in public interest in CTE from 2004 through 2022 with surges following media releases of events involving NFL players. Therefore, physicians and media broadcasters must create partnerships to better educate the public about head injuries and the effects of CTE.</p>","PeriodicalId":36050,"journal":{"name":"Journal of Osteopathic Medicine","volume":" ","pages":"173-178"},"PeriodicalIF":1.4,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142355716","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Manual therapy plus sexual advice compared with manual therapy or exercise therapy alone for lumbar radiculopathy: a randomized controlled trial.","authors":"Musa Sani Danazumi, Isa Abubakar Adamu, Musbahu Hamisu Usman, Abdulsalam Mohammed Yakasai","doi":"10.1515/jom-2023-0075","DOIUrl":"10.1515/jom-2023-0075","url":null,"abstract":"<p><strong>Context: </strong>The biopsychosocial approach to managing low back pain (LBP) has the potential to improve the quality of care for patients. However, LBP trials that have utilized the biopsychosocial approach to treatment have largely neglected sexual activity, which is an important social component of individuals with LBP.</p><p><strong>Objectives: </strong>The objectives of the study are to determine the effects of manual therapy plus sexual advice (MT+SA) compared with manual therapy (MT) or exercise therapy (ET) alone in the management of individuals with lumbar disc herniation with radiculopathy (DHR) and to determine the best sexual positions for these individuals.</p><p><strong>Methods: </strong>This was a single-blind randomized controlled trial. Fifty-four participants diagnosed as having chronic DHR (>3 months) were randomly allocated into three groups with 18 participants each in the MT+SA, MT and ET groups. The participants in the MT+SA group received manual therapy (including Dowling's progressive inhibition of neuromuscular structures and Mulligan's spinal mobilization with leg movement) plus sexual advice, those in the MT group received manual therapy only and those in the ET group received exercise therapy only. Each group received treatment for 12 weeks and then followed up for additional 40 weeks. The primary outcomes were pain, activity limitation, sexual disability and kinesiophobia at 12 weeks post-randomization.</p><p><strong>Results: </strong>The MT+SA group improved significantly better than the MT or ET group in all outcomes (except for nerve function), and at all timelines (6, 12, 26, and 52 weeks post-randomization). These improvements were also clinically meaningful for back pain, leg pain, medication intake, and functional mobility at 6 and 12 weeks post-randomization and for sexual disability, activity limitation, pain catastrophizing, and kinesiophobia at 6, 12, 26, and 52 weeks post-randomization (p<0.05). On the other hand, many preferred sexual positions for individuals with DHR emerged, with \"<i>side-lying</i>\" being the most practiced sexual position and \"<i>standing</i>\" being the least practiced sexual position by females. While \"<i>lying supine</i>\" was the most practiced sexual position and \"<i>sitting on a chair</i>\" was the least practiced sexual position by males.</p><p><strong>Conclusions: </strong>This study found that individuals with DHR demonstrated better improvements in all outcomes when treated with MT+SA than when treated with MT or ET alone. These improvements were also clinically meaningful for sexual disability, activity limitation, pain catastrophizing, and kinesiophobia at long-term follow-up. There is also no one-size-fits-all to sexual positioning for individuals with DHR.</p>","PeriodicalId":36050,"journal":{"name":"Journal of Osteopathic Medicine","volume":" ","pages":"25-34"},"PeriodicalIF":1.4,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142297340","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing cranial suture interdigitation in humans and non-human primates: unearthing links to osteopathic cranial concept.","authors":"Janice Blumer, Irisa Arney, Anna Hardin, Morgan Nichols, Luke Arsenault, John Petrucci","doi":"10.1515/jom-2023-0243","DOIUrl":"10.1515/jom-2023-0243","url":null,"abstract":"<p><strong>Context: </strong>Since William Garner Sutherland's inception of osteopathic cranial manipulative medicine (OCMM), osteopathic physicians have practiced with the knowledge that cranial sutures exhibit motion. We hypothesize that the complexity of suture interdigitation in humans may provide clues to elucidate the concept of OCMM.</p><p><strong>Objectives: </strong>We compared the interdigitation of sagittal, coronal (left and right), and lambdoid (left and right) sutures in computed tomography (CT) scans of humans and five nonhuman primate species (<i>Gorilla gorilla</i>, <i>Pongo pygmaeus</i>, <i>Pan troglodytes</i>, <i>Hylobates lar</i>, and <i>Nasalis larvatus</i>).</p><p><strong>Methods: </strong>Human ages are evenly distributed between 10 and 65 years of age, with an equal number of males (n=16) and females (n=16) in the sample. Nonhuman primates are all females, and the sample includes juveniles (n=6) and adults (n=34). Sutures were evaluated on a scale ranging from 0 to 3 (0: fused sutures; 1: no interdigitation; 2: low complexity; and 3: representing the highest degree of interdigitation and complexity).</p><p><strong>Results: </strong>Based on ordinary least squares linear regression, we found no significant relationship between suture interdigitation and age in humans. Chi-square tests were utilized to assess sex differences within humans, species-level differences, and differences between humans and nonhuman primates across all five sutures. Humans exhibited a statistically significant greater degree of suture complexity than all five nonhuman species across all five sutures.</p><p><strong>Conclusions: </strong>These findings indicate that human suture interdigitation is more complex than their closest living relatives (African apes) and other primates (Asian monkeys and apes). We theorize that this would enable subtle movement and serve to transmit forces at the cranial sutures from dietary or ethological behaviors, similar to the pattern observed in other mammals. While humans have a softer diet compared to other living primates, the uniqueness of human craniofacial growth and extended developmental period could contribute to the necessity for complex cranial sutures. More studies are needed to understand variation in human and nonhuman sutural complexity and its relationship to cranial motion.</p>","PeriodicalId":36050,"journal":{"name":"Journal of Osteopathic Medicine","volume":" ","pages":"87-94"},"PeriodicalIF":1.4,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142156223","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Protecting the profession: lessons from the recent physician scandals.","authors":"R Andrew Kelso, Deborah Schmidt, Celia McLay","doi":"10.1515/jom-2024-0127","DOIUrl":"10.1515/jom-2024-0127","url":null,"abstract":"<p><p>Sexual abuse scandals in recent years have eroded some of the trust that is foundational for the physician-patient relationship. A closer analysis of some of these stories of abuse from the standpoint of medical professionalism, primarily utilizing the example of Larry Nassar, DO, yields potential ways in which instances of abuse may be reduced or eliminated. The goal of this paper is to elicit lessons that can be learned from these tragic sequences of events so that physicians, healthcare institutions, physician practices, medical boards, and even patients themselves can introduce measures that help prevent future stories like these.</p>","PeriodicalId":36050,"journal":{"name":"Journal of Osteopathic Medicine","volume":" ","pages":"55-60"},"PeriodicalIF":1.4,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142112970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of self-reported confidence in independent prescribing among osteopathic medical graduating seniors.","authors":"Khalil Eldeeb","doi":"10.1515/jom-2022-0187","DOIUrl":"10.1515/jom-2022-0187","url":null,"abstract":"<p><strong>Context: </strong>Prescribing medications is one of the physicians' most important professional activities throughout their careers. Lack of confidence and competency to prescribe may lead to preventable medical errors. The prevalence of prescription errors among new graduate physicians has been widely studied. Studies have linked this to inadequate foundational pharmacology education and work environment, among other factors. Suggestions were made for different educational interventions to increase the physicians' confidence and competency in prescribing to reduce the risk of medical errors. However, many of these studies were about students or graduates of medical schools other than osteopathic medical schools.</p><p><strong>Objectives: </strong>This study analyzed the self-reported confidence of graduating seniors in the United States osteopathic medical schools in their current ability to prescribe safely and independently and the possible associated factors.</p><p><strong>Methods: </strong>This study analyzed secondary data on the graduating seniors' surveys published by the American Association of Colleges of Osteopathic Medicine (AACOM) from the 2012/2013 to 2020/2021 academic years. Data were analyzed utilizing SPSS version 26.0 and MedCalc version 22.009, and statistical inferences were considered significant whenever p≤0.05.</p><p><strong>Results: </strong>The aggregated data show that 38,712 Doctor of Osteopathic Medicine (DO) seniors responded to the AACOM survey, representing 72.1 % of expected graduates during the study period. Most of the DO graduating seniors (70.8 %) reported feeling confident in their current abilities to independently write safe and indicated orders and to prescribe therapies or interventions in various settings. The percentage of respondents who perceived the time devoted to clinical pharmacology instruction as appropriate increased systematically over these reported years. A positive correlation was found between the percentage of students who reported the time dedicated to clinical pharmacology as excessive and the percentage of students who reported being confident in prescribing. A statistically significant positive correlation was found between the percentage of students who agreed that the first two years of medical school were well organized and the percentage of students who reported being confident in prescribing. A statistically significant correlation was found between the percentage of students who agreed with statements about frequent interactions with the attendee, testing at the end of each rotation, and being prepared for Comprehensive Osteopathic Medical Licensing Examination Level 2-Cognitive Evaluation (COMLEX Level 2-CE) during the required clerkships and the percentage of students who reported being confident in independent prescribing.</p><p><strong>Conclusions: </strong>During this study period, most osteopathic medical graduating seniors (70.8 %) felt confident about their cu","PeriodicalId":36050,"journal":{"name":"Journal of Osteopathic Medicine","volume":" ","pages":"61-70"},"PeriodicalIF":1.4,"publicationDate":"2024-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142082049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Foot and ankle fellowship-trained osteopathic orthopaedic surgeons: a review, analysis, and understanding of current trends.","authors":"James P Henry, Matthew J Partan, Katharine M Chen, Randy M Cohn, Adam D Bitterman","doi":"10.1515/jom-2024-0092","DOIUrl":"10.1515/jom-2024-0092","url":null,"abstract":"<p><strong>Context: </strong>Over the past several decades, orthopedic surgery has seen a substantial increase in the number of surgeons completing fellowship training. Doctors of Osteopathic Medicine (DOs) continue to advance their orthopedic education through subspecialty fellowship training. DOs have represented between approximately 6 % and 15 % of American Orthopaedic Foot and Ankle Society (AOFAS) fellows. Although historical representation has been considered strong, the fellowship match years 2020 and 2021 have seen a decline in osteopathic orthopedic surgeons participating in foot and ankle fellowships. This deviates from the recent trends of increasing participation across orthopedic subspecialities.</p><p><strong>Objectives: </strong>To investigate and review the trends of orthopedic foot and ankle fellowship training.</p><p><strong>Methods: </strong>Data was reviewed from the AOFAS regarding number of fellows matched and degree obtained. Data from the Federation of State Medical Boards (FSMB), American Orthopaedic Foot and Ankle Society (AOFAS) and Association of American Medical Colleges (AAMC) were reviewed for physician trends and match statistics.</p><p><strong>Results: </strong>Fellowship match years 2020 and 2021 have seen a decline in osteopathic orthopedic surgeons participating in foot and ankle fellowships, with only roughly 3% of AOFAS fellows being osteopathic trained.</p><p><strong>Conclusions: </strong>Orthopedic surgery has the highest rate of subspecialty training of all surgical specialties. Although there is hope for an increasing osteopathic presence in orthopedic surgery, recent literature has pointed to potential for continued bias in opportunities for osteopathic students. We hope that increased participation of osteopathic graduates in orthopedic surgery training programs will result in the continued expansion of osteopathic orthopedic surgeons completing fellowship training, including in foot and ankle surgery.</p>","PeriodicalId":36050,"journal":{"name":"Journal of Osteopathic Medicine","volume":" ","pages":"19-24"},"PeriodicalIF":1.4,"publicationDate":"2024-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141976839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}