Osteopathic Curriculum

Memorial Family Medicine Residency gained “initial” osteopathic recognition in July 2022. After a successful site visit with the ACGME, Memorial gained “continued” recognition in January 2025. We are so excited to offer osteopathic residents the opportunity to further their osteopathic knowledge and techniques with this newly developed curriculum. Integrated into the existing 7 curricula, residents will have monthly osteopathic didactics as well as a monthly osteopathic ambulatory clinic. This curriculum is also available to interested allopathic residents.

Click on the link below for a complete review of the longitudinal osteopathic curriculum. The specific additions to your core curriculum (ie OMM workshop, OAC, etc) are included in the link and also listed below the link to easily view and anticipate what to expect with this longitudinal experience.

Memorial Longitudinal Osteopathic Curriculum

Program Goals

The Memorial Family Medicine Residency Program seeks to develop family medicine residents capable of applying and integrating osteopathic principles and practice (OPP) and osteopathic manipulative medicine (OMM) in all aspects of patients care across a broad range of clinical settings. The osteopathic faculty members will embed the four tenets of osteopathic medicine into the educational program to enforce a strong foundation of osteopathy in the daily practice of the resident physicians.

This goal emphasizes the application of OPP in a variety of clinical contexts, ensuring residents can blend OMM with conventional medical practices for improved patient care.

Learner Goals

Upon completion of the longitudinal osteopathic curriculum, the learner will be competent in the ability to discuss, apply, and integrate OPP (and OMM when applicable) into peer and patient interactions while maintaining a patient-centered approach that incorporates the four tenants of osteopathic medicine.

This goal focuses on building practical skills in OMM while also promoting the holistic understanding that is emphasized in OPP that extends osteopathic care beyond just musculoskeletal issues.

Osteopathic Curriculum

The osteopathic curriculum provides structured didactic activities that integrate OPP, learning activities to advance the procedural skills acquisition in OMM for osteopathic residents and faculty, and opportunities to provide osteopathic patient care in a variety of clinical settings. It also provides opportunities for osteopathic residents to teach OPP.

• OMM Workshop
  1. All osteopathic residents are scheduled in Osteopathic Ambulatory Clinic (OAC) on the first Tuesday afternoon of each block. This is documented on their schedule on New Innovations. There are 13 blocks per academic year. The scheduling chief makes every attempt to try to not schedule osteopathic residents on inpatient day call, night call or a day off on these Tuesdays however exceptions do occur (ie. only resident available to be on call, scheduled day off, vacation, sick day, Jeopardy coverage, etc). The first hour of the OAC is blocked for OMM Workshop. This is an opportunity to review common OMM techniques and approaches to the axial skeleton, billing, coding, and documentation via didactic sessions, hands on application, and outside resources (ex. NCOPPE online labs/videos). Osteopathic faculty, osteopathic sports medicine fellows and osteopathic residents lead these workshops based on the 18-month didactic lecture series described below. The workshop takes place in the residency clinic conference room and uses osteopathic tables. All didactic presentations/resources are saved on the resident share drive for easy access.
  2. Osteopathic competencies addressed
     1. Patient Care
     2. Medical Knowledge
     3. Osteopathic Philosophy and Manipulative Medicine (procedural skills)

• Osteopathic Ambulatory Clinic (OAC)
  1. All osteopathic residents are scheduled in Osteopathic Ambulatory Clinic on the first Tuesday afternoon of each block. This clinic is from 2-5p. There are 30 minute appointment slots. Patients are referred to this clinic from fellow residents and faculty as well as fellow osteopathic residents to receive OMM. Residents are expected to take a history, perform an osteopathic structural exam, and develop and execute a treatment plan for each osteopathic encounter.
  2. First year osteopathic residents will see patients with an upper-level osteopathic resident for the first 6 OACs. Osteopathic faculty members will provide direct observation and assist with billing. In December, interns will be evaluated with the bi-annual competency evaluation. If they pass, they can see patients independently with indirect supervision available from the osteopathic faculty members. If they do not pass, osteopathic faculty will provide instruction on areas for improvement and the resident will have the opportunity to redo the evaluation for independent practice each month during OAC.
  3. Second- and third-year residents will see patients independently with indirect supervision from osteopathic faculty members.
  4. An osteopathic faculty member will see up to two patients during each OAC to provide role modeling of osteopathic manipulative treatment in the patient care setting. 1-3 osteopathic residents will accompany the faculty member with each patient to learn from that real-time patient encounter.
  5. All Medicare procedure rules will be followed in terms of faculty supervision.
  6. If a resident’s treatment plan includes cervical HVLA, an osteopathic faculty member will be present in the room during this procedure, regardless of PGY. Residents may request independence with cervical HVLA during their second or third year if they so desire. Osteopathic faculty will determine the resident’s competency and safety with cervical HVLA annually.
  7. Osteopathic residents are assigned an “osteopathic team leader” who will review their OAC charts, billing and coding to ensure appropriate documentation and reimbursement.
  8. Osteopathic residents will log their OMM procedures on New Innovations and document location of OMM (inpatient or outpatient) to create a log to demonstrate to future employers their competency in OMM.
  9. Osteopathic competencies addressed
     1. Patient Care
     2. Medical Knowledge
     3. Practice-based Learning and Improvement
     4. Systems-based Practice
     5. Osteopathic Philosophy and Manipulative Medicine (procedural skills)

• Integrated OMM Appointments
  1. First year osteopathic residents who are able to see patients with indirect supervision (see 2 above) and second and third year osteopathic residents are encouraged to perform OMM during their regularly scheduled continuity clinics as the opportunities arise. The goal here is to simulate the integration of OMM into the typical daily practice of most osteopathic family physicians. Osteopathic faculty are available for indirect supervision. Those residents wishing to perform cervical HVLA will still require direct supervision by an osteopathic faculty member unless the resident has achieved independence with cervical HVLA (see f above).
  2. Osteopathic Competencies addressed
     1. Patient Care
     2. Practice-based Learning and Improvement
     3. Systems-based Practice
     4. Osteopathic Philosophy and Manipulative Medicine (procedural skills)

• OMM Inpatient Rounds
  1. Twice during the academic year, the OMM workshop time will be spent treating patients with OMM on the resident inpatient medicine, pediatric, or obstetric service. These two times will coincide with when an osteopathic faculty member is on the resident inpatient medicine service. The osteopathic faculty member will choose 2-4 patients and present their cases to the osteopathic residents during OMM workshop. The residents will then divide into groups and evaluate those patients in the hospital. They will get a signed informed consent, take a brief history, do a complete osteopathic structural exam and perform OMM under direct supervision from an osteopathic faculty member. The resident will then write a SOAP note which incorporates the osteopathic structural exam and the plan for treatment of the somatic dysfunctions identified. Residents will be expected to communicate with the patient the concepts of OMM, the specific treatments, and the anticipated outcomes in relation to the working diagnosis.
  2. Osteopathic Competencies addressed:
     1. Patient Care
     2. Medical Knowledge
     3. Practice-based Learning and Improvement
     4. Interpersonal and Communication Skills
     5. Osteopathic Philosophy and Manipulative Medicine (procedural skills)

• Osteopathic Clinic Elective
  1. There are osteopathic physicians in the community who have practices predominantly dedicated to OPP and OMM. They have agreed to take residents for a 2- or 4-week rotation to further their skills and application of OPP and OMM in the ambulatory setting. Osteopathic residents are encouraged to take this rotation during their second or third year. Allopathic residents following the designated osteopathic resident curriculum are required to take at least a 2-week osteopathic clinic elective during their second or third year.
  2. The Osteopathic Clinic Elective goals and objectives can be found in the Longitudinal Osteopathic Curriculum appendix.
  3. Osteopathic Competencies addressed:
     1. Medical Knowledge
     2. Practice-based Learning and Improvement
     3. Interpersonal and Communication Skills
     4. Professionalism
     5. Osteopathic Philosophy and Manipulative Medicine (procedural skills)

• Osteopathic Didactic Lecture Series
  1. An osteopathic lecture will take place during the first hour of the monthly Osteopathic Ambulatory Clinic. Second- and third-year osteopathic residents are required to give one lecture per academic year. As available, the osteopathic sports medicine fellow will also give one lecture per academic year. The osteopathic faculty will provide the remaining lectures.
     1. Residents and fellows will sign up for lectures at the beginning and halfway point of each academic year
  2. The osteopathic lectures should follow the 18-month curriculum as described in the appendix. Osteopathic faculty, residents and fellows will utilize resources found on the National Center for Osteopathic Principles and Practice Education “OPP Curriculum” website. All residents, fellows, and faculty have access to this resource. Residents and fellows will provide an overview of their didactic session to the osteopathic faculty 1 week before the lecture to ensure that it is covering the intended overarching learning objectives for that topic listed in the curriculum. There is no set format for lecture to encourage presenter creativity in delivering the content and implementing hands-on education. The lectures should be clinically focused and discuss one or more of the following elements, inclusive of the underlying relevant osteopathic principles and tenets:
     1. Osteopathic techniques for regional anatomy
     2. Osteopathic techniques for anatomical systems
     3. Osteopathic techniques for specific disease categories
  3. The Director of Osteopathic Education will provide feedback on resident osteopathic lectures via semi-annual evaluation of performance and progression (see appendix).
  4. The osteopathic lecture series during OAC also includes 4 journal club didactic sessions per academic year. More information about osteopathic journal club is found in the section “Osteopathic Scholarly Activity.”
  5. The biannual skill proficiency evaluation will be done during the first and seventh osteopathic didactic lecture each academic year.
  6. Memorial Family Medicine Residency Program has daily didactics every week day for all residents. This is called “Noon Conference.” Quarterly, the osteopathic faculty will give an osteopathic Noon Conference for all residents (allopathic and osteopathic) that focuses on common musculoskeletal and office-based complaints and osteopathic techniques to help treat those complaints.
  7. All residents are required to give a specified number of case conferences during their three years of training. Osteopathic residents are encouraged to incorporate OPP into their case conferences. Osteopathic faculty members then document this in a New Innovations evaluation “Oral Case Presentations OMT” (see appendix).
  8. Osteopathic Competencies addressed:
     1. Medical Knowledge
     2. Practice-based Learning and Improvement
     3. Interpersonal and Communication Skills
     4. Professionalism
     5. Osteopathic Philosophy and Manipulative Medicine (procedural skills)