Letters to the Editor  |   May 2007
Author Affiliations
  • Alan R. Stockard, DO
    Fit-N-Wise Sports Medicine – Wise Regional Health System, Decatur, Texas
    Director of Sports Medicine
Article Information
Medical Education / Neuromusculoskeletal Disorders / Sports Medicine / Graduate Medical Education
Letters to the Editor   |   May 2007
The Journal of the American Osteopathic Association, May 2007, Vol. 107, 198-199. doi:
The Journal of the American Osteopathic Association, May 2007, Vol. 107, 198-199. doi:
Dr Ruane clearly points out the deficiencies in current osteopathic musculoskeletal curricula, both at the predoctoral and postdoctoral levels, brought to light by our study in the June 2006 issue of JAOA—The Journal of the American Osteopathic Association (2006;106:350-355). Those of us practicing the specialty of primary care sports medicine see these deficiencies daily when we precept students and residents in every primary care specialty. 
Osteopathic medicine is keenly situated to fill this void by giving our residents in the primary care specialties (ie, family practice, emergency medicine, internal medicine, occupational and environmental medicine, osteopathic manipulative medicine, pediatrics) the basic musculoskeletal clinical skills needed to diagnose the most common musculoskeletal dysfunctions and treat and rehabilitate patients with these complaints. 
The problem as I see it, after 14 years of involvement in osteopathic medical education, involves the following two points: 
  • Every specialty thinks the others are supplying this knowledge (or mistakenly thinks a 2- to 4-week rotation on orthopedics supplies this knowledge).
  • Our residency programs have become too allopathically oriented, focusing on medical issues other than the musculoskeletal system, which is relegated to the level of triviality, as so eloquently pointed out by Dr Ruane.
I recommend that a task force be formed to address this important issue, including representatives from the colleges of osteopathic medicine, program directors from each of the primary care specialties, and representatives from the American Osteopathic Academy of Sports Medicine (AOASM). I mention AOASM because this group understands how to bring all these elements together; we currently bring them together in our American Osteopathic Association–approved sports medicine fellowship programs. Although achieving that level of musculoskeletal expertise would be impossible to impart in the general knowledge base of the primary care specialties, at least a framework could be developed to augment the basic musculoskeletal knowledge in our existing residency programs. 
I, for one, would volunteer for such a task force in a heartbeat—but medical educators need to identify this issue as one that could unify and strengthen our profession, which was founded on the principle of “extra education in the musculoskeletal system.” In medicine, knowledge without application is useless. We can know all the genetic markers of a disease, for example, but unless that knowledge is converted into diagnostic or treatment protocols, what good is it?