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Medical Education  |   June 2017
Osteopathic Medical Students Entering Family Medicine and Attitudes Regarding Osteopathic Manipulative Treatment: Preliminary Findings of Differences by Sex
Author Notes
  • From the Department of Clinical Sciences (Drs Baker and Bauer); the Office of Assessment and Educational Development (Dr Linsenmeyer and Mr Ridpath); and the Office of the Associate Dean (Dr Foster) at the West Virginia School of Osteopathic Medicine. 
  • Financial Disclosure: None reported. 
  • Support: None reported. 
  •  *Address correspondence to Machelle Linsenmeyer, EdD, West Virginia School of Osteopathic Medicine, 400 N Lee St, Lewisburg, WV 24901-1274. E-mail: alinsenmeyer@osteo.wvsom.edu
     
Article Information
Medical Education / Osteopathic Manipulative Treatment
Medical Education   |   June 2017
Osteopathic Medical Students Entering Family Medicine and Attitudes Regarding Osteopathic Manipulative Treatment: Preliminary Findings of Differences by Sex
The Journal of the American Osteopathic Association, June 2017, Vol. 117, 387-392. doi:10.7556/jaoa.2017.077
The Journal of the American Osteopathic Association, June 2017, Vol. 117, 387-392. doi:10.7556/jaoa.2017.077
Abstract

Context: Factors distinguishing osteopathic physicians from their allopathic counterparts include the use of osteopathic manipulative treatment (OMT), application of osteopathic principles and practice (OPP), and a greater likelihood of entering primary care, specifically family medicine (FM). In the United States, the percentage of entering osteopathic medical students who were female rose from 14.3% in fall 1977 to 44.3% in fall 2015.

Objectives: To investigate the perspectives of female osteopathic medical students as they relate to osteopathic distinctiveness.

Methods: Students at the West Virginia School of Osteopathic Medicine who were eligible to participate in graduation exercises in 2014 or 2015 were asked to complete the school's standard Exit Survey. The research team chose 5 items from the survey to include in the current analysis. Sex had been self-identified at admission, and residency in first postgraduate year was categorized as FM or other specialty. Graduates entering a transitional year or traditional internship were removed from analysis.

Results: Analysis was conducted for 308 of the 375 students (82%) expected to graduate in 2014 or 2015. χ2 analysis found no difference by sex in the number of graduates entering FM residencies vs other specialties (P=.727). Statistically significant differences were found in 2 survey items: “Use of OMT will enhance my practice” (P=.005) and “What emphasis do you believe OMT will have in your practice?” (P<.001). Graduating female students responded more favorably to OMT on both items. For the latter item, 91.4% of female and 80.3% of male students indicated OMT would have at least some role in their practices. Sex differences remained after statistically controlling for entry into FM.

Conclusion: Female graduating osteopathic medical students were more likely to report that OMT will have at least some role in their practices. Future studies of the attitudes and practice patterns of osteopathic physicians should analyze for differences by sex.

Factors distinguishing osteopathic physicians (ie, DOs) from their allopathic (ie, MD) counterparts include the application of osteopathic principles and practice (OPP) and use of osteopathic manipulative treatment (OMT).1 In addition, DOs traditionally practice in primary care2 and are more likely to enter family medicine (FM).3 However, Johnson and Kurtz4,5 have suggested a decline in osteopathic orientation, specifically decreased interest in OMT, OPP, and maintaining osteopathic distinctiveness. Cummings6 contends that a smaller percentage of DO graduates now wish to enter primary care. 
Meanwhile, the proportion of women in the osteopathic medical profession has increased. The percentage of entering female osteopathic medical students tripled from 16.5% in fall 1977 to a high of 50.2% in fall 20037 before dipping slightly and plateauing at 44.3% in fall 2015.7 
Does the current high percentage of women in osteopathic medicine have an impact on the specialty choices and osteopathic orientation of future DOs? Nationally, women are more likely to enter primary care8 and specifically FM.9 Although evidence is limited, some studies5,10 have suggested that female DOs are more likely to use some (but not all) forms of OMT, while other reports and studies appear not to have analyzed for differences by sex.8,9,11-18 
During informal discussions with students at the West Virginia School of Osteopathic Medicine (WVSOM), female students appeared to be more receptive than male students to learning osteopathic concepts and were more interested in entering primary care. Furthermore, findings of a separate, unpublished internal survey suggested that female students viewed OMT more favorably than male students. If these findings were confirmed, the higher percentage of female DOs might help address the osteopathic medical profession's concerns about both use of OMT and entry into primary care. 
At WVSOM, we realized that while it was not possible to definitively address these issues with current data, it was possible to link survey data with data from WVSOM's longitudinal database and provide some insight into these issues. 
Hypotheses
Before conducting analyses of possible differences by sex, we developed the following hypotheses: 
  • 1. Graduating female osteopathic medical students are more likely to enter FM residencies than male students.
  • 2. Graduating female osteopathic medical students are more likely than male students to respond favorably on our Exit Survey items regarding OMT and OPP.
  • 3. After statistically controlling for entry into FM, graduating female students will still be more likely than male students to express favorable attitudes toward OMT and OPP.
Methods
Participants in this study were all students eligible to participate in graduation exercises at WVSOM in May 2014 or May 2015 and who therefore were required to complete WVSOM's standard Exit Survey unless excused by the dean. Because the Exit Surveys are a key component of WVSOM's quality improvement program, the WVSOM Institutional Review Board determined that consent was not required. 
Exit Survey
The Exit Survey for WVSOM was created for quality improvement by curriculum committees and administrators and is administered each year by the Office of Assessment and Educational Development. Results are confidential, with students' identities known only to professionals in the Office of Assessment and Educational Development. Most questions on the Exit Survey obtain feedback on components of the WVSOM curriculum (eg, feedback on rotations sites) or relate to mission-relevant attitudes, such as intent to practice in rural areas. 
A few Exit Survey items specifically address osteopathic orientation. Before linking the survey with files regarding sex and residency, the research team for this project reviewed the Exit Survey and chose 5 items to include in the current analysis. After statistical analysis, 1 of these 5 items was discarded when a problem was identified with the wording. Three of the remaining items used a 5-point Likert scale from “strongly agree” to “strongly disagree.” The other item included in this analysis asked, “What emphasis do you believe OMT will have in your practice?” with the response options of “the primary emphasis,” “a major emphasis,” “one of many treatment modalities,” “a minor emphasis,” or “no role.” 
Sex and Specialty Choice
After the research team determined which items from the Exit Survey to include in this analysis, we linked these items from the Exit Survey data to the WVSOM institutional database. The database includes sex as initially self-identified when the student applied for admission and entered a specialty for the first year of graduate medical education. 
Graduates entering traditional osteopathic internships or transitional year programs were removed from further analysis because the specialties of these students were not yet known. The specialties of the remaining graduates were categorized as either FM or all other specialties. 
Statistical Analysis
Because of the hypotheses that women would be more likely to have attitudes more favorable toward osteopathic orientation, statistical tests were directional (1-tailed). Multiple tests of these data were planned, so the .01 level of significance was used rather than .05 to make the study more conservative. Analyses were performed using the SAS 9.2 statistical software program (SAS Institute Inc). Because this was a preliminary study, statistical power was not calculated. χ2 analysis was conducted to determine whether graduating female osteopathic medical students were more likely to enter FM. The Wilcoxon 2-sample Z test was conducted to determine if graduating female osteopathic medical students were more likely to respond favorably on the Exit Survey items regarding osteopathic orientation. The Cochran-Mantel-Haenszel test was used to determine whether women continued to have greater osteopathic orientation after variance attributable to orientation toward FM was removed. 
Results
A total of 182 students (48.5%) self-identified as women and 193 (51.5%) as men. The combined response rate on the Exit Survey for these 2 classes was 357 of 375 (95.2%), indicating that 18 (4.8%) were excused from completing the Exit Survey. Of survey respondents, 176 (49.3%) were women and 181 (50.7%) were men. All who responded to the survey had entered residencies by the following February. 
Complete data (sex, Exit Survey data, and specialty in first-year residency) were available for 357 of the 375 students who had been expected to graduate (95.2%). Of those, 69 (19.3%) entered FM; 239 (67.0%) entered other specialties; and 49 (13.7%) were in traditional internships or transitional year programs. Students entering traditional internships or transitional year programs were removed from further analysis, so analysis was conducted on 308 of the 375 students (82.1%) who had been expected to graduate in 2014 or 2015. Students had the option of not answering every question, and responses to the items reported here ranged from 303 (80.8%) to 304 (81.3%) of all graduating students. 
Regarding our first research hypothesis, we found that female students were no more likely to enter FM residencies than were male students (P=.727) (Table 1). 
Table 1.
Sex Differences of Graduating Students Entering Family Medicine vs Other Specialties (N = 308)a
Sex Family Medicine Other Specialties
Female (n = 155) 36 (23.2) 119 (76.8)
Male (n = 153) 33 (21.6) 120 (78.4)
Total 69 (22.4) 237 (77.6)

a Data are presented as No. (%). Differences were not statistically significant.

Table 1.
Sex Differences of Graduating Students Entering Family Medicine vs Other Specialties (N = 308)a
Sex Family Medicine Other Specialties
Female (n = 155) 36 (23.2) 119 (76.8)
Male (n = 153) 33 (21.6) 120 (78.4)
Total 69 (22.4) 237 (77.6)

a Data are presented as No. (%). Differences were not statistically significant.

×
Regarding our second hypothesis, female osteopathic medical students were more likely to respond favorably on the Exit Survey items regarding osteopathic orientation (Table 2). A significant difference was found for the item, “Use of OMT will enhance my practice” (P=.005), with 69.7% of female students and 52.6% of male students indicating “agree” or “strongly agree” for this item. A significant difference was also found for the item, “What emphasis do you believe OMT will have in your practice?” (P<.001). Very few students indicated that OMT would be “the primary emphasis” or “a major emphasis,” but 91.4% of female students and 80.3% of male students indicated that OMT would have a “minor emphasis” or more in their practices. 
Table 2.
Sex Differences in Graduating Students’ Responses to Exit Survey Items Related to Osteopathic Distinctiveness or OMT (N = 308)a
Item No. (%) P Valueb
Female (n = 155) Male (n = 153)
It is important for the osteopathic profession to maintain its distinctiveness from the allopathic profession.
 Strongly agree 8 (5.3) 12 (7.8) >.999
 Agree 36 (23.8) 40 (26.1)
 Neutral 53 (35.1) 52 (34.0)
 Disagree 41 (27.2) 26 (17.0)
 Strongly disagree 13 (8.6) 23 (15.0)
For all practical purposes, the medical philosophies of DOs and MDs are the same. [scale reversed]
 Strongly agree 18 (11.8) 13 (8.5) .313
 Agree 66 (43.4) 71 (46.4)
 Neutral 19 (12.5) 38 (24.8)
 Disagree 43 (28.3) 26 (17.0)
 Strongly disagree 6 (3.9) 5 (3.3)
Use of OMT will enhance my practice.
 Strongly agree 23 (15.1) 24 (15.8) .005
 Agree 83 (54.6) 56 (36.8)
 Neutral 31 (20.4) 41 (27.0)
 Disagree 13 (8.6) 20 (13.2)
 Strongly disagree 2 (1.3) 11 (7.2)
What emphasis do you believe OMT will have in your practice?
 The primary emphasis 1 (0.7) 2 (1.3)  < .001
 A major emphasis 9 (6.0) 6 (3.9)
 One of many treatment modalities 84 (55.6) 47 (30.9)
 A minor emphasis 44 (29.1) 67 (44.1)
 No role 13 (8.6) 30 (19.7)

a Some participants did not complete every item.

b All significance tests were 1-tailed tests, measuring whether female students were more likely to have the desired attitudes.

Abbreviations: DOs, osteopathic physicians; MDs, allopathic physicians; OMT, osteopathic manipulative treatment.

Table 2.
Sex Differences in Graduating Students’ Responses to Exit Survey Items Related to Osteopathic Distinctiveness or OMT (N = 308)a
Item No. (%) P Valueb
Female (n = 155) Male (n = 153)
It is important for the osteopathic profession to maintain its distinctiveness from the allopathic profession.
 Strongly agree 8 (5.3) 12 (7.8) >.999
 Agree 36 (23.8) 40 (26.1)
 Neutral 53 (35.1) 52 (34.0)
 Disagree 41 (27.2) 26 (17.0)
 Strongly disagree 13 (8.6) 23 (15.0)
For all practical purposes, the medical philosophies of DOs and MDs are the same. [scale reversed]
 Strongly agree 18 (11.8) 13 (8.5) .313
 Agree 66 (43.4) 71 (46.4)
 Neutral 19 (12.5) 38 (24.8)
 Disagree 43 (28.3) 26 (17.0)
 Strongly disagree 6 (3.9) 5 (3.3)
Use of OMT will enhance my practice.
 Strongly agree 23 (15.1) 24 (15.8) .005
 Agree 83 (54.6) 56 (36.8)
 Neutral 31 (20.4) 41 (27.0)
 Disagree 13 (8.6) 20 (13.2)
 Strongly disagree 2 (1.3) 11 (7.2)
What emphasis do you believe OMT will have in your practice?
 The primary emphasis 1 (0.7) 2 (1.3)  < .001
 A major emphasis 9 (6.0) 6 (3.9)
 One of many treatment modalities 84 (55.6) 47 (30.9)
 A minor emphasis 44 (29.1) 67 (44.1)
 No role 13 (8.6) 30 (19.7)

a Some participants did not complete every item.

b All significance tests were 1-tailed tests, measuring whether female students were more likely to have the desired attitudes.

Abbreviations: DOs, osteopathic physicians; MDs, allopathic physicians; OMT, osteopathic manipulative treatment.

×
With our third hypothesis, after statistically controlling for entry into FM, female students were still more likely than male students to express favorable attitudes toward OMT and OPP (Table 3). Significant differences were found on the same 2 items as Table 2, with female students responding more favorably on both items. 
Table 3.
Sex Differences in Graduating Students’ Responses to Exit Survey Items Related to Osteopathic Distinctiveness or OMT After Controlling for Variation Attributable to Entering Family Medicine vs Other Specialties (N = 308)a
Item χ21 P Value
It is important for the osteopathic profession to maintain its distinctiveness from the allopathic profession 0.1824 .669
For all practical purposes, the medical philosophies of DOs and MDs are the same. [negative item] 0.4737 .491
Use of OMT will enhance my practice. 7.9950 .005
What emphasis do you believe OMT will have in your practice? 17.2213  <.001

a Some participants did not complete every item.

Abbreviations: DOs, osteopathic physicians; MDs, allopathic physicians; OMT, osteopathic manipulative treatment.

Table 3.
Sex Differences in Graduating Students’ Responses to Exit Survey Items Related to Osteopathic Distinctiveness or OMT After Controlling for Variation Attributable to Entering Family Medicine vs Other Specialties (N = 308)a
Item χ21 P Value
It is important for the osteopathic profession to maintain its distinctiveness from the allopathic profession 0.1824 .669
For all practical purposes, the medical philosophies of DOs and MDs are the same. [negative item] 0.4737 .491
Use of OMT will enhance my practice. 7.9950 .005
What emphasis do you believe OMT will have in your practice? 17.2213  <.001

a Some participants did not complete every item.

Abbreviations: DOs, osteopathic physicians; MDs, allopathic physicians; OMT, osteopathic manipulative treatment.

×
Discussion
Although more than half of both female and male students agreed or strongly agreed that OMT would enhance their practices, female students were significantly more likely to indicate that they believed OMT would enhance their practices. 
On the item “What emphasis do you believe OMT will have in your practice?”, more than 80% of male students and more than 90% of female students indicated that OMT would have at least some emphasis. These statistically significant findings suggest that sex should be considered in looking at items that may influence the outcomes of medical school graduates and their practices. It is possible that the increasing proportion of women in the osteopathic medical profession may help promote the uniqueness of the profession. Furthermore, we were pleased that the vast majority of graduating students indicated an expectation that OMT would have at least some role in their future practices. We believe that WVSOM's institutional emphasis on OPP and OMT may be a factor in explaining this finding.15 
A national survey of DO graduates in 2015 found that 40% of female graduates but only 27% of male graduates planned to practice primary care.8 Similarly, but specific to FM, residency data in 2014-2015 regarding US and Canadian DO and MD graduates show 3559 women and only 2825 men in FM residencies accredited by the Accreditation Council of Graduate Medical Education.9 We expected to find similar sex differences, and because DOs in family medicine are more likely to say they use OMT than those in traditional specialties,5 we also expected that we would need to control for a difference in specialty choice to understand sex differences in osteopathic orientation. However, this study found no difference by sex in selecting FM. Our finding that male students were as likely as female students at WVSOM to enter FM might relate to the emphasis WVSOM places on primary care in the admissions process and curriculum. This theory deserves more study. 
In this study we did not find sex differences in perception of the importance of the osteopathic medical profession maintaining its distinctiveness, or in perception that DOs and MDs had different medical philosophies. Directional hypotheses were used to test whether women had a more positive perception of osteopathic distinctiveness than men, so the initial analysis would not have revealed whether men were more positive. We conducted a post hoc analysis to determine if men responded significantly more favorably, and they did not (1-tailed; P=.286). However, in the future, we will use nondirectional tests, and we recommend that others do so as well. 
No difference by sex was found on the item, “For all practical purposes, the medical philosophies of DOs and MDs are the same,” with the majority of all students agreeing or strongly agreeing with this item. Graduates’ perception of few differences may in part reflect their experiences with the MDs who sometimes teach WVSOM students. These MDs were selected in part because they demonstrated the compassionate, holistic care appropriate for any physician, and WVSOM had provided them with faculty development about OPP and OMT. However, it is important that graduates embrace the unique attributes of the osteopathic medical profession and apply these in their medical practices, so WVSOM is redoubling efforts with both students and preceptors to highlight this distinctiveness. 
This study has several limitations. It was conducted at only 1 osteopathic medical school, and results were available for only 2 years. Graduates of WVSOM may not be representative of the profession because of the school's mission in rural medicine and strong tradition of emphasizing OPP and OMT. Graduates were asked their expectations for practice, but we did not measure their actual OMT use in practice. Further research with graduates from multiple schools is needed to better understand the actual practice patterns of male and female DOs. However, we believe this study highlights the need for future studies to include sex as a variable when studying attitudes and practice patterns of osteopathic physicians. 
Conclusion
More female than male graduates reported that OMT will enhance their practices and that they will use OMT, with 91.4% of female and 80.3% of male students who indicated OMT would have at least some role in their practice. Similarly, 69.7% of female and 52.6% of male students indicated that they agree or strongly agree that use of OMT will enhance their practices. It is possible that the increasing number of female DOs may have an impact on use of OMT within the osteopathic medical profession. Future studies of the practice patterns of DOs should analyze for differences by sex in use of OMT. 
Acknowledgment
We acknowledge Matthew Comeau, DO, PhD, a recent graduate of WVSOM now in residency training at Fairfield Medical Center in Lancaster, Ohio, for his research as a student on a study of the attitudes of male and female students toward OMT and primary care. 
References
Seffinger MA, King HH, Ward RC, Jones JMIII, Rogers JR, Patterson MM. Osteopathic philosophy. In: Chila , executive ed. Foundations of Osteopathic Medicine. 3rd ed. Baltimore, MD: Lippincott Williams & Wilkins; 2011:3-22.
OMP report: medical specialties. American Osteopathic Association website. http://www.osteopathic.org/inside-aoa/about/aoa-annual-statistics/Pages/medical-specialties.aspx. Accessed April 14, 2017.
Kozakowski SM, Crosley PW, Bentley A. Entry of US medical school graduates into family medicine residencies: 2013-2014. Fam Med. 2014;46(9):696-700. [PubMed]
Johnson SM, Kurtz ME. Diminished use of osteopathic manipulative treatment and its impact on the uniqueness of the osteopathic profession. Acad Med. 2001;76(8):821-828. [CrossRef] [PubMed]
Johnson SM, Kurtz ME. Osteopathic manipulative treatment techniques preferred by contemporary osteopathic physicians. J Am Osteopath Assoc. 2003;103(5):219-224. [PubMed]
Cummings M. Osteopathic students’ graduate medical education aspirations versus realities: the relationship of osteopathic medicine and primary care. Acad Med. 2016;91(1):36-41. doi: 10.1097/ACM.0000000000000892 [CrossRef] [PubMed]
Trends in Osteopathic Medical School Applicants, Enrollment, and Graduates, 2016. Chevy Chase, MD: American Association of Colleges of Osteopathic Medicine. http://www.aacom.org/docs/default-source/data-and-trends/2016-trends-COM-AEG.pdf. Accessed April 26, 2016.
Table 47. In: AACOM 2014-15 Academic Year Survey of Graduating Seniors Summary. Chevy Chase, MD: American Association of Colleges of Osteopathic Medicine; 2015. http://www.aacom.org/docs/default-source/data-and-trends/2014-15-GSSSR.pdf?sfvrsn=16. Accessed May 4, 2016.
Table B3: number of active residents, by type of medical school, GME specialty, and gender. Association of American Medical Colleges website. https://www.aamc.org/data/448482/b3table.html. Accessed April 26, 2016.
Fryer G, Morse CM, Johnson JC. Spinal and sacroiliac assessment and treatment techniques used by osteopathic physicians in the United States. Osteopath Med Prim Care. 2009;3:4. doi: 10.1186/1750-4732-3-4 [CrossRef] [PubMed]
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Table 1.
Sex Differences of Graduating Students Entering Family Medicine vs Other Specialties (N = 308)a
Sex Family Medicine Other Specialties
Female (n = 155) 36 (23.2) 119 (76.8)
Male (n = 153) 33 (21.6) 120 (78.4)
Total 69 (22.4) 237 (77.6)

a Data are presented as No. (%). Differences were not statistically significant.

Table 1.
Sex Differences of Graduating Students Entering Family Medicine vs Other Specialties (N = 308)a
Sex Family Medicine Other Specialties
Female (n = 155) 36 (23.2) 119 (76.8)
Male (n = 153) 33 (21.6) 120 (78.4)
Total 69 (22.4) 237 (77.6)

a Data are presented as No. (%). Differences were not statistically significant.

×
Table 2.
Sex Differences in Graduating Students’ Responses to Exit Survey Items Related to Osteopathic Distinctiveness or OMT (N = 308)a
Item No. (%) P Valueb
Female (n = 155) Male (n = 153)
It is important for the osteopathic profession to maintain its distinctiveness from the allopathic profession.
 Strongly agree 8 (5.3) 12 (7.8) >.999
 Agree 36 (23.8) 40 (26.1)
 Neutral 53 (35.1) 52 (34.0)
 Disagree 41 (27.2) 26 (17.0)
 Strongly disagree 13 (8.6) 23 (15.0)
For all practical purposes, the medical philosophies of DOs and MDs are the same. [scale reversed]
 Strongly agree 18 (11.8) 13 (8.5) .313
 Agree 66 (43.4) 71 (46.4)
 Neutral 19 (12.5) 38 (24.8)
 Disagree 43 (28.3) 26 (17.0)
 Strongly disagree 6 (3.9) 5 (3.3)
Use of OMT will enhance my practice.
 Strongly agree 23 (15.1) 24 (15.8) .005
 Agree 83 (54.6) 56 (36.8)
 Neutral 31 (20.4) 41 (27.0)
 Disagree 13 (8.6) 20 (13.2)
 Strongly disagree 2 (1.3) 11 (7.2)
What emphasis do you believe OMT will have in your practice?
 The primary emphasis 1 (0.7) 2 (1.3)  < .001
 A major emphasis 9 (6.0) 6 (3.9)
 One of many treatment modalities 84 (55.6) 47 (30.9)
 A minor emphasis 44 (29.1) 67 (44.1)
 No role 13 (8.6) 30 (19.7)

a Some participants did not complete every item.

b All significance tests were 1-tailed tests, measuring whether female students were more likely to have the desired attitudes.

Abbreviations: DOs, osteopathic physicians; MDs, allopathic physicians; OMT, osteopathic manipulative treatment.

Table 2.
Sex Differences in Graduating Students’ Responses to Exit Survey Items Related to Osteopathic Distinctiveness or OMT (N = 308)a
Item No. (%) P Valueb
Female (n = 155) Male (n = 153)
It is important for the osteopathic profession to maintain its distinctiveness from the allopathic profession.
 Strongly agree 8 (5.3) 12 (7.8) >.999
 Agree 36 (23.8) 40 (26.1)
 Neutral 53 (35.1) 52 (34.0)
 Disagree 41 (27.2) 26 (17.0)
 Strongly disagree 13 (8.6) 23 (15.0)
For all practical purposes, the medical philosophies of DOs and MDs are the same. [scale reversed]
 Strongly agree 18 (11.8) 13 (8.5) .313
 Agree 66 (43.4) 71 (46.4)
 Neutral 19 (12.5) 38 (24.8)
 Disagree 43 (28.3) 26 (17.0)
 Strongly disagree 6 (3.9) 5 (3.3)
Use of OMT will enhance my practice.
 Strongly agree 23 (15.1) 24 (15.8) .005
 Agree 83 (54.6) 56 (36.8)
 Neutral 31 (20.4) 41 (27.0)
 Disagree 13 (8.6) 20 (13.2)
 Strongly disagree 2 (1.3) 11 (7.2)
What emphasis do you believe OMT will have in your practice?
 The primary emphasis 1 (0.7) 2 (1.3)  < .001
 A major emphasis 9 (6.0) 6 (3.9)
 One of many treatment modalities 84 (55.6) 47 (30.9)
 A minor emphasis 44 (29.1) 67 (44.1)
 No role 13 (8.6) 30 (19.7)

a Some participants did not complete every item.

b All significance tests were 1-tailed tests, measuring whether female students were more likely to have the desired attitudes.

Abbreviations: DOs, osteopathic physicians; MDs, allopathic physicians; OMT, osteopathic manipulative treatment.

×
Table 3.
Sex Differences in Graduating Students’ Responses to Exit Survey Items Related to Osteopathic Distinctiveness or OMT After Controlling for Variation Attributable to Entering Family Medicine vs Other Specialties (N = 308)a
Item χ21 P Value
It is important for the osteopathic profession to maintain its distinctiveness from the allopathic profession 0.1824 .669
For all practical purposes, the medical philosophies of DOs and MDs are the same. [negative item] 0.4737 .491
Use of OMT will enhance my practice. 7.9950 .005
What emphasis do you believe OMT will have in your practice? 17.2213  <.001

a Some participants did not complete every item.

Abbreviations: DOs, osteopathic physicians; MDs, allopathic physicians; OMT, osteopathic manipulative treatment.

Table 3.
Sex Differences in Graduating Students’ Responses to Exit Survey Items Related to Osteopathic Distinctiveness or OMT After Controlling for Variation Attributable to Entering Family Medicine vs Other Specialties (N = 308)a
Item χ21 P Value
It is important for the osteopathic profession to maintain its distinctiveness from the allopathic profession 0.1824 .669
For all practical purposes, the medical philosophies of DOs and MDs are the same. [negative item] 0.4737 .491
Use of OMT will enhance my practice. 7.9950 .005
What emphasis do you believe OMT will have in your practice? 17.2213  <.001

a Some participants did not complete every item.

Abbreviations: DOs, osteopathic physicians; MDs, allopathic physicians; OMT, osteopathic manipulative treatment.

×