“Treat anyone you can. Seek out opportunities to treat — at least for a few minutes — in all your rotations. Nurses will love you if you can reduce pain in chronic complainers. Attendings will love you if you can help them discharge sooner (e.g.,post-operative ilius, atypical rib pain, labrynthitis).”

“Practice as much as possible.”

“Learn how to treat patients in seated and standing positions, in case you want to do a treatment and not have to make them lie down. Think about Osteopathy as the BEST preventive medicine, and utilize it in all your patient encounters in some way.”

“Practice Practice Practice. They need to be comfortable with their hands and palpatory skills and only way to get comfortable is to get your hands on patients. Don’t be afraid to ask questions.   Try to apply even the smallest or shortest of treatments to your current practice whether it is inpatient or outpatient care.”

“Use it or lose it”

“OMM can help any condition.”

“Pursue OMT throughout your residency”

“Treat anyone you can. Seek out opportunities to treat — at least for a few minutes — in all your rotations. Nurses will love you if you can reduce pain in chronic complainers. Attendings will love you if you can help them discharge sooner (e.g.,post-operative ilius, atypical rib pain, labrynthitis).       Put your hands on people with acute pathologies as much as possible, even if you don’t treat them. Feel at least the diaphragm, and if possible the cranium, of everyone in the ICU. This is going to be your opportunity to see really sick people, so take advantage of it.”

“Practice practice practice on family and friends, esp if your rotations won’t let you.”

“Keep using the skills you have an become an “expert” on what you feel comfortable treating/doing. Keep learning. Stay connected to study groups, CME etc. through your training and beyond.”

“Any time on any rotation strive to do at least one osteopathic procedure/technique on each patient you see, I asked myself-with each patient what is the one most important thing I could do for them-diaphragm release? scar? what would give the greatest impact, in time I could do more each time as i pushed myself to do something with each patient no matter how small, lymphatic pump, CV4, rib raising-that allowed me to develop my skills and become more proficient besides helping the patients.”

“When learning, keep practicing. That develops the skill.”

“Practice what you have learned!”

“Practice and read as often as possible. Don’t be afraid to try OMT on the hospitalized patient. Simple short techniques like targeted rib raising and lymphatic pump can have a huge, positive impact.”

“Treat all your patients. Get as much hands on experience in every office as possible.”

“Practice on everyone you can. Friends, family and anyone who will sit still for you”

“You’ll never regret the extra time you spend doing OMT on patients. Treat every chance you get and amazing things will happen. Plus you will learn the difference between treating your basically healthy adult classmates, and treating old & young patients, both healthy and not.”

“Treat someone every day.”

“Even if you feel overwhelmed by the obligations of your residency, seek out time to learn and to treat people, and it will both help you be a better physician and help you get through residency feeling more sane!”

“Read but never neglect opportunities for hands on experience”

“Trust yourself, develop your hands, and keep exploring!”

“Seek opportunities to use your skill when seeing patients. Most preceptors will not actively ask about use of OMM but I have found that few restrict you from implementing it if you have a strong assessment and plan and are comfortable with you basic skills. Having the opportunity to treat with OMM is the biggest thing needed for learning osteopathy.”

“Practice on your patients. Especially the children. OMT does so much more than just treating pain. Work it into your office visits, it’s a procedure, and you can get paid for it.”

“Work with the billing department so they can get insurance reimbursement;  Medicare pays for OMT.”

“Get your hands on patients – and always try to do it gentler, quicker and more thoroughly”

“Treat someone every day, even if it is only 5 minutes.   Take as many classes as you can, even when told you can’t ;)”

“Treat everyone you can.”

“Be proactive about using OMT on patients; don’t wait for your attending to bring up the subject. Even starting with soft tissue treatment is of benefit; don’t underestimate the value of the simplest forms of OMT.”

“Work on family and friends to build confidence and discuss with people what you do. Go to courses shadow old timers lots of different people.”

“Practice and Palpate. Learn what tissues feel like with different issues like diabetes, renal failure, etc. Osteopathic treatment can be done in many different ways-from a hospital bed, seated, even standing.”

“Put your hands on people with acute pathologies as much as possible, even if you don’t treat them. Feel at least the diaphragm, and if possible the cranium, of everyone in the ICU. This is going to be your opportunity to see really sick people, so take advantage of it.”

“Get your hands on as many patients as possible; even if your attending does not allow you to treat, use the opportunity of the physical exam to look for somatic dysfunctions and correlate to their chief complaint”

“Try to get your hands on as many people as possible. Try to apply your Osteopathic skills in both the clinics and the hospitals as you are able or allowed to do. AT Still said to “palpate miles and miles of necks.” And know your ANATOMY!!”

“Put your hands on every patient, feel their body talk to you while you are taking a history. Talk to them about how making the body work better will make their disease processes improve.”

“Be still and know. Listen with your hands. There is so much–it really depends on their skill and comfort level. I think I always tell them to ‘just be’.”

“Practice and Palpate. Learn what tissues feel like with different issues like diabetes, renal failure, etc. Osteopathic treatment can be done in many different ways-from a hospital bed, seated, even standing.”

“At least palpate every patient you can, structural exam, feel everyones back see if you can correlate viscerosomatic reflexes with their complaints or medical hx.”

“For all other rotations that you are on… get your hands on EVERY patient and FEEL what that diagnosis FEELS like. (CHF, vs hypothyroidism, vs COPD). what is the mechanism doing? What are the tissues doing? What is the skeletal structure doing? How does is all effect each patient? What is the disease load on the MSK structure? Every diagnosis has a different feel. Get to know that well.     4) you have the rest of your life to combine and practice medicine and osteopathy. During Residency is the only time you will have to see what true western medicine is. Learn it as much as you can.”

“Put your hands on patients in the hospital even if only for a brief moment. You will learn a lot about how different disease states feel. Treat your patients with manual technique as much as possible regardless of their diagnosis. A. T. Still did not get famous treating musculoskeletal diseases. OMM can help any condition.”

“Get your hands on patients as often as possible, to learn what health and illnesses feel like. Go to conferences and courses. You’ll still graduate.”

“Practice some form of osteopathic diagnosis or treatment everyday! Screening for viscerosomatic reflexes is one fast and useful diagnostic tool that is worth honing. The more you do it, the better you will get at diagnosing. And it can help differentiate acute abdominal pain quickly!”

“Volume. The more people you palpate, the better your skills will be. Don’t be afraid to palpate; if you use common sense and respect for the mechanism you will not hurt the patient. You always have a chance of doing more help than harm. Be curious. Feel what the tissues feel like in someone w compartment syndrome, stroke, MI, post CABG etc.”

“Petition your residency to set aside time periods for specific osteopathic training. Get the residency to sponsor a clinician who would be willing to come and discuss specialty specific cases and situations where osteopathic manipulative medicine could be applied.”

“Choose a program with a faculty member who regularly performs OMT or has a NMM plus one.”

“Find a practicing Osteopath and ask to put their hands on clients as they are being treated.”

“Work hand over hand with as many different style mentors as possible to find your own treatment approach.”

“Train with the masters. Spend as much time, in a balanced manner, with osteopathic mentors. Treat other students, family members, explore, learn, train, enjoy your journey!”

“Spend as much time with as many OMT providers as you can”

“You are likely to meet mentors at courses. Mentors are invaluable and needed to advance your skills and understanding of Osteopathy. Get active in the PAAO and arrange to have visiting clinicians come and teach hand-over-hand on weekends or evenings.”

“Find a physician who is oriented toward true osteopathy and see if that physician will accept them for a rotation. Do the necessary ground work, that is, take any preparatory courses necessary to show interest and meet qualifications for a rotation with a certain physician.   Take time, vacations and weekends if necessary to get to know these physicians and seek their counsel and discuss their experiences.”

“Have your ears open, and pick a practitioner who makes sense to you. Approach the doc and ask to be treated and taught. If you’ve found the right doc, don’t give up. Make sure you find a couple of docs to follow. We know that you are the future of osteopathy, so don’t be afraid of us. Be ready and willing to work hard.”

“Ask to spend time in the office of someone who actually does this work. Someone that you’ve met at a course and think that you could learn from.”

“Seek as much skilled teaching as possible. Use your electives wisely, and use your free time (weekends & vacations) wisely to maximize your access to skilled teaching.     Determine, as quickly as you can, what types of teaching/teachers are most helpful to you. Skilled teaching is useless if you don’t learn from that particular style of teaching… and you should know by now that every teacher has a particular style, methods, verbology, etc.     Not every student learns the same way or at the same pace, so you want to find those teachers who teach in a manner that maximizes your learning – because THERE IS A LOT TO LEARN IN THIS FIELD IF STUDY!”

“Find a mentor.  Take a 40 hour course.  Attend a conference”

“Not so much for residents, but for us as mentors/teachers, it is imperative that we know whether or not the student or resident is truly interested in Osteopathy as a profession; or is planning on practicing mostly Allopathic medicine upon graduation or minimum Osteopathy.”

“I learned the most one on one with my mentors. Don’t hesitate to ask if you can visit your teachers/mentors even if just for 1/2 a day. Don’t believe everything you are told, keep an open mind and follow your heart. Most of us have learned that we can build exactly the practice we wish because there is a tremendous demand for our work. Read the writings of Still, Sutherland (TSO & COT), Rachel Brooks’ on the work of Rollin Becker (Life in Motion & Stillness of Life). Study anatomy anatomy anatomy and physiology, then you can figure out any medical problem.”

“I encourage them to seek out a mentor, choose a focus to address for a given time-frame, a week, month, season and focus on one treatment modality or body region to really gain an understanding of how and when itwould be best to follow a certain approach.”

“Work with as many different people as you can–there are a lot of ways to do things and they are pretty much all effective. Find the ways that work best for you and don’t be tied down to one way of thinking.”

“Pursue every opportunity to work with those who practice Osteopathy; take courses and read the literature; and use every clinical encounter you can to perceive the living human mechanism at work. Memberships in the PAAO, OCA, and local state Osteopathic societies are a great way to meet all of these goals. Find ways to treat at least one or two people each week.”

“Osteopathic medicine is a part of almost every available medical specialty. The principles apply to many disease states, not just back pain. Find Physicians to train with that embody all of Osteopathy. You will find deeper understanding and more satisfactory resolution of your patient’s complaints.”

Seek out mentors, attend convocation if possible, arrange an OMM rotation, better yet, make sure that your residency is DO friendly and will allow you to evaluate and treat patients with OMM.

“Study (living) anatomy, and get mentors who do it and can help on an ongoing basis.”

“Seek out your mentors”

” Residency training teaches you how bad medical conditions can become. Somatic Dysfunction is always a component in complex clinical conditions. The challenge in-house is whether OMT can improve the clinical situation medically better than traditional hospital care.

“Look at the big picture. Move beyond treating individual dysfunctions and try to get a sense of how those dysfunctions affect the whole.   Also, ask why those dysfunctions occur–why is the muscle tight? why is there innominate rotation? Dig deeper and get to the etiology so you can treat that.   Otherwise you’re just band-aiding the body’s compensation.  ”

“Master a rapid screening structural exam that you can do on every patient you see on every rotation and correlate your findings with the conventional medical diagnoses. If you have patients where you don’t even have the opportunity to do a screening exam, choose one body part/region and check it on everyone (e.g. the diaphragm, etc.) and change that region over time. Do not worry about treating patients (if you have the chance do it) but make sure to build your palpatory skill and database in a way that is meaningful (integrated into the rotations you are on).   Expand your study of anatomy on each conventional rotation to include osteopathically relevant fascia, innervations, lymphatic and vascular drainage, etc. For example review the osteopathic approach to the pelvis while on OB, the diaphragm and rib cage for Cardiology, etc. They key is to build osteopathic study into your everyday medical study.   Focus on the fundamentals – too often students want to fly before they can crawl and then get overwhelmed. For example, subtle cranial work is not the best thing to focus on during rotations. Don’t get ahead of yourself. Expertise comes from a mastery of the fundamentals. Also, don’t get stuck on one teacher, style or approach. Learn as much as you can from a wide variety of approaches.   Take courses as often as you have time and money for. Remember, as a RESIDENT you often get a discount and you are not paying for office overhead while you are out, which is what makes courses more expensive once you are in practice.”

“I always tell the students to keep reviewing anatomy, and start to tie it in to clinical scenarios they encounter, so they can start to link symptoms with anatomy and physiology directly (as opposed to just memorizing lists). The number of touches is key to learning OMM so they need to keep working with people, even if just for diagnostic practice in situations where they are unable to treat for whatever reason.”

“Learn anatomy and the principles or osteopathy.”

“Even though the amount of material you are trying to gain mastery over is voluminous, nothing takes the place of learning to evaluate the patient directly, without resorting to tests and imaging. This is slowly becoming a lost art in medicine. Spend time with mentors who can teach you “hands on”, as if in an apprenticeship, so that you may develop your skills in evaluating and treating patients osteopathically.”

“Your patient is your instructor. Pay close attention to what they have to teach you, read about their condition and apply it to the next patient. Try to determine how to incorporate the DO philosophy and OMT at each visit, with every patient. Take accountability for your patient’s health concern.”

“The main thing is to study some philosophy of science so you understand the flaws in what you’re being taught. Osteopathy is an experiential discipline. Try other experiential disciplines and learn why osteopaths speak of osteopathy the way they do.   Any experiential discipline will do – my favorite for residents is coffee. Instead of the crap they serve in hospitals, go find a specialty coffee roaster (not starbucks – nothing franchised) and get an education. Wine works too if you drink (though it causes cancer, whereas coffee reduces mortality). It will all sound like bullshit at first. But stay with it, try to taste those faint notes of honey or maple bark or whatever … and soon you’ll find you speak the same way about coffee. Because in order to discuss an experiential discipline, you have to use words that weren’t intended for that purpose. It becomes poetic because only poetry can express the inexpressible. That’s why osteopathy has to be taught the same way as wine-tasting or coffee-tasting or skiing or martial arts – because it’s an experience, and not everything experiential can be reduced to words.”

“Osteopathic Medicine is a part of almost every available medical specialty. The principles apply to many disease states, not just back pain. Find Physicians to train with that embody all of Osteopathy. You will find deeper understanding and more satisfactory resolution of your patient’s complaints.”

“In every case, ask yourself, ‘what does this patient need osteopathically to promote their health?'”

“Find a residency director who will let you actually explore osteopathy and not try to make you fit into their perceived ‘box’.”

“Read the writings of the great DOs. Even better, work with living DOs practicing Osteopathy in it’s fullness. Get treated as often as possible. Treat others as often as you can.”

“Definitely attend hands-on-hands courses with good teacher to student ratios. Preferably at least 1:4. A basic course in Osteopathy in the Cranial Field will teach you more in a week than you are likely to learn in the years in the OMM classroom and labs at your school or your residency.”

“Go to a cranial course. Use what you learned. Go to another cranial course. Use what you learned. Charge for your time (once you’re in practice) – even though you’re learning as you go, you’re still doing good”

“OMT CME , find free training, and anatomy!”

“Getting an osteopathic treatment is the best way to educate themselves first and foremost. Then, goto courses, apprentice, and treat as much as they can.”

“I learned the most one on one with my mentors. Don’t hesitate to ask if you can visit your teachers/mentors even if just for 1/2 a day. Don’t believe everything you are told, keep an open mind and follow your heart. Most of us have learned that we can build exactly the practice we wish because there is a tremendous demand for our work. Read the writings of Still, Sutherland (TSO & COT), Rachel Brooks’ on the work of Rollin Becker (Life in Motion & Stillness of Life). Study anatomy anatomy anatomy and physiology, then you can figure out any medical problem.”

“Maintain your interest in OMT/osteopathy – find mentors, teachers, attendings who perform OMT regular or utilize OPP consistently.”

“Keep putting your hands on patients. Take several 40 hour basic/Intro courses form different sources. Do not assume one course is enough.”

“Take courses, as many as you can.”

“Take as many additional courses as you can, treat as many people as you can, and remember to review anatomy as you learn new things.”

“Pursue every opportunity to work with those who practice Osteopathy; take courses and read the literature; and use every clinical encounter you can to perceive the living human mechanism at work. Memberships in the PAAO, OCA, and local state Osteopathic societies are a great way to meet all of these goals. Find ways to treat at least one or two people each week.”

“Treat someone every day, even if it is only 5 minutes.   Take as many classes as you can, even when told you can’t ;)”

“If they haven’t done the above, start there. Take as many courses as they can afford. They will never be as inexpensive as NOW.”

“Go to as many courses with a 1:4 teacher to sudent ratio as you possibly can. Definitely take a 40 hour introductory or basic course from OCA or SCTF or OPC. Spend time in an office with an osteopathic physician who practices hand-on”.

“Be patient with yourself.  Residency is a hard time, you may not learn as quickly as you would like, but you have a lifetime ahead of you”

“1) Self care first. Eat. Sleep. And take care of yourself. Don’t feel bad if you are not in place or do not have time to ‘treat’. Most of the time in Residency you are the one that is injured and really not in a good place to treat. Get some sleep and rest before putting hands on someone   2) Get treated. Seriously. You need it.”

“It’s not just what you do, it’s who you are and how you care.”

“The education you want is the education you search out. Continue the pursuit of osteopathy wherever you can find it, often in the patient that is right in front of you”

“Study some philosophy of science so you understand the flaws in what you’re being taught. Osteopathy is an experiential discipline. Try other experiential disciplines and learn why osteopaths speak of osteopathy the way they do.   Any experiential discipline will do – my favorite for residents is coffee. Instead of the crap they serve in hospitals, go find a specialty coffee roaster (not starbucks – nothing franchised) and get an education. Wine works too if you drink (though it causes cancer, whereas coffee reduces mortality). It will all sound like bullshit at first. But stay with it, try to taste those faint notes of honey or maple bark or whatever … and soon you’ll find you speak the same way about coffee. Because in order to discuss an experiential discipline, you have to use words that weren’t intended for that purpose. It becomes poetic because only poetry can express the inexpressible. That’s why osteopathy has to be taught the same way as wine-tasting or coffee-tasting or skiing or martial arts – because it’s an experience, and not everything experiential can be reduced to words.”They must make the effort on their own, and not use the excuse that there is no one to teach them. They must seek it out and practice themselves.”

“Perform structural exams on all your medical exams when you first evaluate a patient to hone on your osteopathic examination skills.”

“Keep osteopathic principles in mind. You never know how OMM can help unless you try it.”

“Seek opportunities to use your skill when seeing patients. Most preceptors will not actively ask about use of OMM but I have found that few restrict you from implementing it if you have a strong assessment and plan and are comfortable with you basic skills. Having the opportunity to treat with OMM is the biggest thing needed for learning osteopathy.”

“Your patient is your instructor. Pay close attention to what they have to teach you, read about their condition and apply it to the next patient. Try to determine how to incorporate the DO philosophy and OMT at each visit, with every patient. Take accountability for your patient’s health concern.”

“It is similar with residents as students, only by then I, [as practitioner] have a much higher expectation of knowledge, skill, and awareness. My patients are used to having them and we are often treating patients together, which adds another dimension to my learning and theirs as well.   I have an extensive library of early texts, and ask them to read not only recent literature, but to delve into the historic writings to gain perspective about how to think like an Osteopathic Physician.”

“Study from the best. Read Still, Sutherland, Clark McConnel

“Read Sutherland, Fulford, Becker and McGintis texts. Spend time with mentors. Treat a lot of people. Don’t be afraid. Keep your intent filled with love and respect for the amazing workings of the human body and you will learn so much from your hands it will amaze you.”

“Study the writing of Still, Sutherland, Rollin Becker.   Spend time with osteopaths in their offices.   Take as many courses as you can.”

“Even if you feel overwhelmed by the obligations of your residency, seek out time to learn and to treat people, and it will both help you be a better physician and help you get through residency feeling more sane!”

“Focus on one area of interest at a time like asthma and gradually build expertise. Pick a case and solve the underlying clinical problem, Learn the relevant anatomy of that case and master a treatment strategy that addresses the neurovascular regulation of perfusion and drainage,”

“Be persistent & patient with acquiring & honing your skills.”

“Shadow as many osteopaths as possible. Attend courses like the ASSSG spring course and workshops offered at the schools. Read classic osteopathic literature. Think osteopathy all the time.”

“Osteopathy is a philosophy and not a technique. Learn allopathy and drug therapies; their limitations, side effects, and damaging effects. Learn how it is all symptom relief. OMT is taught in the same manner as symptom relief. This in not Osteopathy!   One must discard all of this harmful thinking and practice of Allopathic medicine in order to be an Osteopathic healer which AT Still teaches us to be.”

“Do not accept a residency that won’t definitely allow you to continue to train and prance OMM. Put your foot down on this one issue.     If you treat 1-2 patients per week then your skills will detiorate slowly over 3-4 years. If you treat 3-5 pts you will tread water and perhaps improve to a small degree. You must make your own way in the world of OMM, in sharp distinction to the rest of medicine. No one will hand this to you.     Find a mentor, read and train OCF to have a chance at private practice in OMM if that is your goal.”

“If you are in an allopathic residency, don’t believe a word they say”

“What you do, matters.”