Osteopathic medicine has come a long way in the 120+ years since Andrew Taylor Still opened The American School of Osteopathy in Kirksville, Missouri. I marvel that osteopathic medicine has survived all the challenges and negative pressures that marginalized the many medical disciplines of the time into extinction. Today, American-trained DOs stand as equal partners with their MD colleagues by holding unlimited licenses to practice medicine throughout the world. Osteopathic physicians work in all specialties and subspecialties of medicine and they serve with distinction in the military. DOs now help develop national health policy and often provide the voice of all physicians in the halls of government. They participate in medical research and develop new life-saving medications, along with revolutionary surgical treatments—just as allopathic physicians have done for years. In short, this once-maligned profession has finally taken a permanent place in the House of Medicine, just as our founder had hoped more than a century ago.
One reason our profession has become successful is due to the principle recognized by Dr. Still: the body has the innate ability to heal itself and it is the physician’s role to be a facilitator, not an inhibitor, of that process. Dr. Still was driven to start a new pathway to medical practice because traditional medicine had become enamored with unnatural and often harmful treatment methods. In his mind, osteopathic physicians should support and magnify the laws of nature and not supplant them with ineffective methods. The natural or “alternative” approach with many standard therapies is now popular and even mainstream in today’s world.
The loss of osteopathic hospitals training sites at the end of the last century forced DOs and MDs to work more closely together in hospitals. The responsibility for training residents fell on community hospitals and they began to combine training suited to both professional degrees. As the osteopathic and allopathic professions become more unified in postgraduate education, new concerns will arise about the loss of identity and core principles contained in a distinctive osteopathic program.
Never before has the role of the osteopathic medical school become more vital for the preservation and continuation of our core values than today. After four short years of exposure to osteopathic theory and methods, our students will enter residencies with allopathic physicians where those values may not be present. In many cases, the graduates are the only osteopathic resident in the program and there will be natural peer pressure to follow one standard. That pressure may cause DO residents to sublimate—or even shy away completely—from manipulation, as well as osteopathic principles and practice. Only those students who developed a strong foundation for osteopathic principles in medical school will remain true to the profession’s ideals. Colleges of osteopathic medicine must build that strong foundation and showcase the great value of the DO degree. We take this charge very seriously here at Rocky Vista University by being focused on academic activities and programs that will keep osteopathiccentered education current, relevant, and well understood by all our students.
As the Dean of the College of Osteopathic Medicine, it is it my responsibility to facilitate our students getting the residency of their choice. The key to ensuring this is to give the students the tools to pass the national boards on the first attempt and to log competitive scores on the examinations. RVU has among the highest percentages for first-time pass rates of all osteopathic medical schools. Our innovative, clinically-integrated, and systems-driven curriculum utilizes proven principles of adult learning. Students are given didactic material that is linked to each of the body systems. They participate in a mandatory clinical interactive session with a physician who practices in that particular field by solving case presentations. This activity builds the students’ ability to analyze material and strengthen clinical reasoning, and then synthesizes it into a diagnosis and treatment plan. RVU students will cover the material twice over two years: as freshmen, they cover the body’s systems with an emphasis on normal function and take a five-week bridging course on pathophysiology, which studies how normal function degenerates into diseases of all kinds; as sophomores, they repeat the course, but with a focus on disease mechanisms. The advantage of not covering traditional medical subjects in a silo fashion is that the students’ knowledge as kept current and refreshed throughout the learning process. It has the added benefit of covering the entire curriculum twice before sitting for national board examinations.
Rocky Vista University has a regional mission, as well: to improve access to a physician in all the communitiesof the Mountain West Region we serve. In 1910, Abraham Flexner, who was charged with reforming medical education in America and Canada, said, “The small town needs the best, not the worst doctor, procurable.” His recommendations for improving health care education were visionary and many are still in existence today. In my opinion, Abraham Flexner had more to do with shaping the face of health care education than any other person in the 20th century and he was not even a physician. RVU values service to our community and is dedicated to easing the manpower shortage to underserved individuals living in the region. We actively work with health care planners, residency directors, hospital administrators, legislators, and program accreditors to improve and increase graduate training opportunities in the region.
One of the greatest physicians of the past century, Sir William Osler, summed up the mission of Rocky Visa University College of Osteopathic best:, “We are here to add what we can to life, not to get what we can from it.”
Thomas N. Told, D.O., FACOFP -dist.
Dean for the College of Osteopathic Medicine