Update as of 11/20/2019 – This resolution has been withdrawn.  Thank you to the many people who sent in comments quickly and helped bring about the withdrawal.

We will leave this page up for the time being to help everyone understand the issues that were under consideration.


2019 CCME Resolution 17

There is a new proposal at the AOA to further hinder the teaching of osteopathic skills by denying 1A CME credit for table trainers of OMM or physical exam skills.  The OCA Board of Directors feels this is an illogical, misguided, and harmful proposal.  If you have similar concerns, we urge you to contact the AOA with your input and objections at CCMEResolutions@osteopathic.org

Comments are due by Dec 10 2019.

The full text of the Resolution 17 can be found at online at https://osteopathic.org/about/leadership/proposed-policy-changes-for-open-comment/.  Below we have extracted the important elements.


RESOLVED, that the COCME recommends that no CME credits should be awarded for table training for physical examination or OMM labs

Explanatory Statement:The COCME believes that Category 1-A should not be awarded for table training for physical examination or OMM labs as this is not a method for formal delivery of medical education lectures in osteopathic and allopathic medical colleges for teaching; nor for the formal delivery of medical education to students, interns, residents, fellows and staff.

Category 1-A is designed to enhance clinical competence and improve patient care

Some of our objections to the proposed policy include (feel free to borrow from these for your own comments if you wish):
  • Palpatory skill development is a hallmark that uniquely distinguishes the osteopathic medical profession. Learning these skills requires intensive hand-to-hand mentoring. This learning process takes time, and the guidance of more senior practitioners, who must take time from their busy practices to mentor new and younger doctors.


  • Procedures almost by definition are best taught through practical application rather than by “formal lecture” as referenced in the proposal.  This includes surgical and interventional skills.  Physical diagnosis and osteopathic manual treatment are less invasive but require more finely developed palpatory skills, which can only be learned with close hand-on-hand training.  It makes no sense to award CME for hands-on teaching of some procedures but not for others, unless the AOA is deliberately trying to signal that it doesn’t value the excluded procedures.


  • OMM and physical exam/diagnostic skills very precisely enhance clinical competence and patient care by the physician, which is the definition of 1A credit.


  • Entering an era of voluntary AOA membership, it is foolish to continually belittle the OMM skills that are help define the DO difference and are in such demand from the public.  Instead, the AOA seems determined to create “second class citizens” of physicians who practice manual medicine, which should be one of the AOA’s natural constituencies.


  • Osteopathic manipulation is the most important differentiator between DOs and MDs, and is more and more valued by the public as a part of their health care. This proposal would significantly hinder the profession’s ability to continue to teach, develop, and advance high quality OMM skills in our students and our doctors.


  • MDs are clamoring for training in osteopathic manipulation (OMT) as well as osteopathic principles (OPP).   These physicians need more hands-on guidance in CME classes, especially as MD training programs also gut physical diagnosis skill development in favor of imaging technology.


  • The general public is demanding greater access to OMT, as well as doctors who approach care holistically, following osteopathic principles.  We should be making it easier for physicians to train in these skills, not harder.


  • Physical diagnosis skills are deteriorating in younger physicians.  At the same time that the public has ever greater value for a physician that actually physically examines and connects with them;  this is one of the competitive advantages of DOs over MDs.  Why would we want to reduce the teaching of those skills?


  • At post-graduate CME courses, table trainers are present for the entirety of the course, just as they would be if they were enrolled in the course.   The only difference is that table trainers have a greater participation in hands-on labs, since they have to guide and direct as well as palpate.  How does that not qualify for CME?


  • This policy hinders the ability of Osteopathic Cranial Academy, as well as other providers (e.g., state societies, other component societies) to continue providing the highest quality hands-on training.  The OCA provides to a 1:4 faculty-student ratio at all of its introductory and intermediate classes, and a 1:6 ratio at advanced classes precisely to meet our own internal high standards.    This proposal is not about maintaining standards, in fact it does just the opposite by reducing the ability of CME education to provide high-level hand-on-hand training.
In addition, you can reach out to everyone you know involved with AOA leadership, our specialty organizations, and state societies.  It is especially important to advocate with state societies and specialty organizations as they all send voting members to the AOA House of Delegates and have significant influence on the AOA Board of Trustees.
Please make sure to keep all comments professional and constructive, as that will increase their impact.