Mapping of an Osteopathic Medical Physiology Course: Cardiovascular and Respiratory Sections – Preparing for the Osteopathic and Allopathic Merger

Abstract

Physiology has been a foundational course in medical curriculums for several decades. Traditionally, medical physiology relies on biophysical principles and equations; and medical students are expected to use them to solve mathematical problems on USMLE Step 1 exams. As the number of osteopathic schools is increasing, and the two postgraduate medical education systems, AOGME and ACGME, are merging to a single accreditation system, there is a growing interest in student performance on the osteopathic board exam (COMLEX‐USA Level 1). We know the two board exams are written by different groups. However, it remains unknown how well traditional (allopathic) physiology courses prepare students for COMLEX‐USA Level 1 examinations. We at WCUCOM want to give our students every opportunity to succeed. Our overall goal is to map our Medical Physiology I and II courses to available USMLE and COMLEX‐USA review books. We started with mapping the Cardiovascular and Respiratory physiology blocks, because these areas were challenging for our students in the past. We used First Aid for the Basic Sciences: Organ systems (3rd edition) as our USMLE Step 1 resource, and Kaplan COMLEX Level 1 Physiology lecture notes 2018 as our COMLEX resource. The OMS‐1 Medical Physiology I course has 72 lectures. Cardiovascular and respiratory physiology are taught in 23 and 10 physiology, and 10 and 5 pathophysiology lectures, respectively. We mapped the lecture objectives and content of these 48 lectures to both review textbooks. Some of our major observations included: The USMLE book was more focused on equations, while the COMLEX book focused primarily on applications. The COMLEX book, but not the USMLE book, discussed cardiac inward rectifier K+ and T‐type Ca2+ currents in pacemaker cells. The USMLE book only mentioned jugular venous pressure (JVP) waves in the text, while the COMLEX book detailed figures of JVP waves under normal and pathological conditions. In the COMLEX book capillary fluid exchange (Starling forces), as well as systemic and pulmonary edema formation was discussed in the fluid compartments section at the beginning, while it was in the cardiovascular and respiratory sections in the USMLE book. While both books discussed lung mechanics, volumes, and pulmonary function tests, the COMLEX book explained differences between restrictive and obstructive diseases in more detail. The COMLEX book had an entire section on determinants of alveolar gas content including the effects of metabolism, which was not detailed in the USMLE book. We have already made lecture content revisions based on the material covered in the COMLEX review book and will continue to do so with further mapping of other organ systems. We found that although the material is very similar, COMLEX requires a more in‐depth knowledge of certain areas, and focuses especially on clinical application of physiology and pathophysiology. We conclude that it is important to incorporate the material from both USMLE and COMLEX sources to best equip our students for their board examinations.This abstract is from the Experimental Biology 2019 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.