By Sean Martin
Now that you have your spinal levels memorized (if you haven’t done that yet, see my last post), we can talk about the rest of the high-yield topics in OMM from COMLEX Level 1. To review, it is always more important for level one to understand how to diagnose a dysfunction than to treat it. Make sure you are aware of dysfunction names and how they are written out. For example: thoracic segment ten, side bent right, rotated left and neutral will appear on an exam as T10 N SRRL.
Now let’s move on to the good stuff.
Level 1 also tests your ability to make a diagnosis based on the description of a palpatory diagnosis. For example: on palpation, the transverse process on the right was found to be deep and would become more symmetrical in extension; what is the dysfunction? This type of question tests your knowledge of what somatic dysfunction feels like in addition to your knowledge of facilitated segments and Frayett’s Laws.
Knowing the mechanics of the spine and naming are both high yield for Level 1. Remember, we always name somatic dysfunction for its ease. In the above example, if the segment becomes more symmetrical in extension than the segment, it is said to be in extension. It sounds easy now, but be sure to review these types of questions, because once test day fatigue sets in, it becomes easy to make simple mistakes.
Sacral dysfunction is another heavily tested area on the exam. These types of questions are simple to write, so they show up all over the exam. You will have to understand both the mechanics of the sacrum as well as the relationship of the sacrum to L5. If asked a management question, remember that you always treat the L5 dysfunction before treating the sacrum.
The best way to learn sacral mechanics and diagnosis of dysfunction is to have a routine. Like looking at a chest xray the same way every time, you need to approach the sacrum with the same plan of attack every question. For me, I like to define whether I am dealing with a sacral or pubic dysfunction first based on the standing and seating flexion tests, next define my axis, and only then do I approach the dysfunction. Whether the question seems straightforward or not, follow your plan to ensure you nail these questions. Like most OMM questions, practice makes perfect and can add up to easy points on test day.
The topic that makes most students nervous is osteopathy in the cranial field (OCF). This field of osteopathy is very complicated and has a steep learning curve. The question writers do not expect you to be a master, but rather they want to know that you have a basic understanding of the major concepts.
Here, one of most high yield topics involves which bones cause specific dysfunctions such as tinnitus. This is one of the few areas of the exam where the test writers would like to know that you have some idea of hand placement. Many students who have already taken the exam report that they saw questions on where to place their finger in the different holds to make a cranial diagnosis.
Again, specific treatments are of lower yield, so do not spend a lot of time bogging yourself down with specifics.
Hopefully, these last two posts have helped guide some of your study for the upcoming exam. It may seem like a lot, but remember to make a study plan and stick to it. OMM is a part of the exam that can feel like a breath of fresh air if you put in the time. The worst thing you can do is put OMM off until the last minute and show up on test day unprepared for twenty percent of the exam.
Got any ideas for studying that you’d like to share with other students? Comment below!
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