Testing osteopathic medical school graduates for licensure: is COMLEX-USA the most appropriate examination?
(17/284)
Osteopathic and allopathic physicians receive authority to practice medicine through the licensing boards of the states in which they practice. Each state has the responsibility to operate a licensing board for physicians and other medical professionals. These boards choose which examinations are acceptable to establish that a physician is licensable to practice medicine. The National Board of Osteopathic Medical Examiners (NBOME) administers the Comprehensive Osteopathic Medical Licensing Examination (COMLEX-USA). To determine the views of the educational leaders of the osteopathic profession regarding licensure testing, a survey was mailed to leaders in the profession. Of the 799 surveys mailed, 341 (43%) were returned. Respondents were asked 19 questions, using a Likert scale to record responses (strongly disagree, 1; strongly agree, 5). Eighty-eight percent of respondents believed that osteopathic medicine is a distinct profession. Seventy percent of respondents felt that COMLEX-USA is the standard for testing osteopathic trainees, while 70% believed trainees should continue to be tested by a unique process. According to 72% of the respondents, the NBOME, through its testing procedures, continues to be the organization best suited to test the knowledge of osteopathic students and graduates. These results indicate that among the practicing leadership of the osteopathic profession, overwhelming support exists for the profession to retain the ability and the right to examine its own trainees from within. (+info)
Prediction of student performance on the Comprehensive Osteopathic Medical Licensing Examination Level I based on admission data and course performance.
(18/284)
To predict student performance on the Comprehensive Osteopathic Medical Licensing Examination (COMLEX-USA) Level 1 examination based on academic performance during the first 2 years, stepwise regression analysis of COMLEX-USA Level 1 performance with preadmission grade point averages, Medical College Admission Test scores, and academic performance was performed on the class of 2000 to develop three formulae that were then used to predict performance on COMLEX-USA Level 1 for the class of 2001. Models ranged in accuracy of predicting the pass/fail status from 95.2% (all available data) to 96.8% (first-year grades and admissions data). A predictive model for student performance on COMLEX-USA Level 1 can be developed and has a high degree of accuracy. The model with the most variables available to choose from predicts the most failures. (+info)
Segmental definition--Part IV. Updating the differential for somatic and visceral inputs.
(19/284)
The first three parts of this series presented a standardized method of motion testing for motor behaviors specific to segmental dysfunction. When applied to clinical research studies, analysis of these palpatory data differentiated viscero-somatic from somato-somatic reflex manifestations in the thoracic region of subjects with renal dysfunction and/or hypertension. This update for the differential adds new observations regarding palpable findings, specifically at the spinal levels where linkage of costal and vertebral motion asymmetries identified the presence of increased visceral inputs. At each level, the examiner can make a simple comparison for accord in response to two sidebending motion tests in the seated position, one introduced through the shoulders and trunk and one through the head and neck. Lack of accord is a distinctive characteristic of the linked spinal/costal site of visceral input. Also, with regard to linkage sites, behavioral responses to motion tests introduced through the lower extremities suggest new applications for manipulative intervention. The new descriptive clinical data about segmental motion behaviors described in this report provide a basis for new questions in neuromusculoskeletal research. (+info)
Cold-induced urticaria.
(20/284)
Cold-induced urticaria is a form of physical urticaria that develops on cold exposure in susceptible individuals. The majority of cases have an unknown etiology (primary or idiopathic). In rare forms, it is associated with various disease entities (secondary). The workup of a patient includes a history and physical examination, cold challenge, and a battery of laboratory tests. The management of such patients includes precaution and avoidance measures as well as treatment with antihistamines. Life-threatening symptoms necessitate carrying a self-administered injectable epinephrine. (+info)
Allergy test results of a rural and small-city population compared with those of an urban population.
(21/284)
The frequency of sensitization to environmental antigens changes in different regions. As such, the pattern of sensitivity to common allergens was studied at multiple sites across central Pennsylvania, an area composed of small cities and rural communities, to determine uniqueness of allergies in populations from this area in contrast to allergies as determined by skin testing in large urban centers. The study reported was undertaken to determine allergen variation from an urban population compared with a rural population of a Northeastern state so that environmental avoidance and immunotherapy can be more precisely prescribed. Patient charts were retrospectively reviewed to determine sensitivity to house dust mites (Dermatophagoides pteronyssinus, Dermatophagoides farinae), cockroach, Penicillium, Aspergillus spp, dog, cat, timothy grass, ragweed, oak, and Alternaria tenuis at five sites in Pennsylvania. All of these sites were classified as "small city" or "rural" for the study. One hundred patient records were examined at each site for the results of allergy testing by the prick puncture, radioallergosorbent test (RAST), or intradermal methods. These small-city and rural data were pooled and compared with that of the National Cooperative Inner-City Asthma Study (NCI-CAS), which included 1286 patients from urban environments. The prevalence of allergy to both species of dust mites, dog, timothy grass, and ragweed was significantly greater in the pooled rural group than in the NCICAS inner-city patients (P < .05). In contrast, sensitivity to cockroach antigens and Alternaria was significantly greater in the NCICAS urban population than in the pooled rural group (P < .05). No statistically significant difference was found between the NCICAS and the pooled rural patients in reference to Penicillium, cat, and oak (P > .05). (+info)
Sinusitis in children: the importance of diagnosis and treatment.
(22/284)
The complications from untreated sinusitis in a 10-month-old male infant, though at the more severe end of the spectrum, brings to light the importance of diagnosis and treatment even in the very young patient. Acute sinusitis should be diagnosed using established guidelines. Appropriate pharmacologic and osteopathic manipulative treatment should be initiated on diagnosis. Initial antibiotic therapy is a 14-day course of amoxicillin. If the sinusitis fails to resolve, a trial of a second-line antibiotic should be considered. The use of adjunctive medications such as antihistamines, decongestants, and nasal steroids remains controversial. If the patient fails maximal medical therapy, a computed tomography scan and referral to an otolaryngologist for possible surgical intervention should be considered. (+info)
Correlation of scores for the Comprehensive Osteopathic Medical Licensing Examination with osteopathic medical school grades.
(23/284)
The authors evaluated construct validity of scores for the Comprehensive Osteopathic Medical Licensing Examination (COMLEX-USA), the examination used to evaluate osteopathic physicians for licensure. They computed correlations between students' grades in the first 2 years of osteopathic medical school and their scores on the COMPLEX-USA Level 1 (N = 187) and Level 2 (N = 86), as well as correlations between third- and fourth-year clerkship grades and the COMLEX-USA Level 2. Correlations of Level 1 scores with grades for years one, two, and the first 2 years combined were .74, .80, and .81, respectively; for Level 2, correlations were .59, .70, and .71. Correlation between clerkship grades and scores for the COMLEX-USA Level 2 was .26. The strong correlation between COMLEX-USA results and grades for the didactic curriculum in the first 2 years of medical school provides evidence for the construct validity of scores for the COMLEX-USA Levels 1 and 2. (+info)
Characteristics, satisfaction, and perceptions of patients receiving ambulatory healthcare from osteopathic physicians: a comparative national survey.
(24/284)
A national telephone survey was conducted in 1998 using random-digit dialing and the first Osteopathic Survey of Healthcare in America (OSTEOSURV-I) instrument to determine patients' satisfaction with their healthcare, as well as their perceptions of osteopathic medicine. Of the 1106 respondents, 243 (22.0%) had received medical care from an osteopathic physician, and another 307 (27.8%) claimed to be aware of osteopathic physicians. Patients of osteopathic physicians reported the highest levels of satisfaction in 8 of the 11 elements studied when compared with patients of allopathic physicians, chiropractors, and nonphysician clinicians other than chiropractors. Respondents perceived osteopathic manipulative treatment (OMT) to be beneficial for musculoskeletal disorders (P < .001). In addition, respondents perceived that healthcare services provided by osteopathic physicians were similar to those provided by allopathic physicians (P < .001), but not to those provided by chiropractors (P = .01). A total of 97.9% of current patients of osteopathic physicians agreed with the statement that osteopathic physicians practiced in their local community, compared with 80.6% of former patients of osteopathic physicians and 67.8% of patients who had never visited osteopathic physicians (P < .001). In general, the most favorable perceptions of osteopathic medicine were reported by current patients of osteopathic physicians, followed by former patients of such physicians. The least favorable perceptions came from patients who had never been patients of osteopathic physicians. The perception that OMT should be covered by health insurance was significantly associated with the use of osteopathic physicians (odds ratio, 3.2; 95% confidence interval, 1.5 to 6.7, among patients who had ever been to an osteopathic physician). The results of our survey suggest that greater access to osteopathic services, including OMT, is desirable and that promotional efforts aimed at encouraging the use of osteopathic medical services among the general population are warranted. (+info)