Emergency Medicine

Core Knowledge & Elements of Osteopathic Principles in the Discipline of Emergency Medicine

Content Outline and Assessment Objectives

The Emergency Medicine examination is designed for end-of-course or end-of-clinical rotation/clerkship assessment for students enrolled at a college of osteopathic medicine (COM). Individual COMs may also administer the examination at other times in accordance with their curriculum goals and mission. This examination emphasizes core knowledge and elements of osteopathic principles and practice in the discipline of Emergency Medicine that are essential for the predoctoral osteopathic medical student.

The exam blueprint below contains the Emergency Medicine topics covered in two dimensions: Dimension 1 – Patient Presentation and Dimension 2 – Physician Tasks.

Dimension 1: Patient Presentation

Topic	%
Abdominal Pain	6–11%
Chest Pain	6–11%
Environmental/Travel Disorders	2–5%
Gastrointestinal Bleeding	3–6%
Genitourinary	4–7%
HEENT (Head, Eyes, Ears, Nose, and Throat) Disorders	4–7%
Mental Status Change/Weakness	6–11%
Musculoskeletal Disorders	6–11%
OB/GYN	4–7%
Poisoning/Overdose/Withdrawal	4–7%
Psychiatric/Behavioral	2–5%
Rashes/Disease of the Skin	2–5%
Resuscitation/Shock	5–8%
Shortness of Breath	6–11%
Special Populations	4–7%
Traumatic Injuries	4–7%

Dimension 2: Physician Tasks

Topic	%
History & Physical Examination	20–28%
Differential Diagnosis & Diagnostic Technologies	15–25%
Management	15–25%
Scientific Understanding of Health & Disease Mechanisms	5–15%
Health Care Delivery Issues	4–8%
Understanding of Procedural Skills (Indications/Performance Description/Contraindications)	10–20%
Health Promotion & Disease Prevention	2–4%

General Learner-Centered Objectives

Based on the general learner-centered objectives outlined in the Emergency Medicine Examination Blueprint, the examinee will be required to demonstrate the ability to apply:

1. Foundational content knowledge to situations and patient presentations encountered in clinical settings and important to Emergency Medicine.
2. Foundational content knowledge and clinical problem-solving ability related to physician tasks critical to Emergency Medicine.
3. Knowledge and clinical problem-solving as related to the Fundamental Osteopathic Medical Competency Domains, including osteopathic principles and practice and osteopathic manipulative treatment (OMT), osteopathic medical knowledge, interpersonal and communication skills, practice-based learning and improvement, systems-based practice, professionalism and patient care.
4. Osteopathic principles and practice in commonly encountered patient care scenarios.

Selected Specific Learner-Centered Objectives for Emergency Medicine

For Emergency Medicine, the examinee will be required to demonstrate the ability to diagnose and manage selected patient presentations and clinical situations involving, but not limited to:

1. Abdominal Pain: Aortic aneurysm, appendicitis, bowel obstruction, cholecystitis/cholelithiasis and diverticulitis
2. Mental Status Change/Weakness: Cerebrovascular disease, hypoglycemia, infection, seizure, syncope and metabolic disorders
3. Chest Pain: Acute coronary syndromes, aortic dissection, pneumothorax and pulmonary embolism
4. Environmental/Travel Disorders: Chemical and thermal burns, envenomations and hypothermia/hyperthermia
5. HEENT Disorders: Infection, headache including migraine and subarachnoid hemorrhage, glaucoma, epistaxis and trauma
6. Gastrointestinal Bleeding: Upper including peptic ulcer disease and variceal, and lower including diverticulosis, hemorrhoids and malignancy
7. Poisoning/Overdose: Anion gap acidosis, decontamination, and overdoses of acetaminophen, carbon monoxide, opioids, salicylates, tricyclic antidepressants and toxic alcohols
8. Psychiatric/Behavioral: Psychosis, depression, substance abuse and suicidal ideation or attempt
9. Resuscitation/Shock: Basic airway management, cardiopulmonary resuscitation, dysrhythmia identification and treatment and first minute of a code, treatment of shock states including anaphylaxis, cardiogenic, hypovolemic and septic
10. Shortness of Breath: Airway obstruction, asthma/COPD, heart failure, pulmonary embolism, and infections including pneumonia, bronchitis, and epiglottitis
11. Traumatic Injuries: Abdomen including bowel, hepatic, and splenic injuries, chest including hemothorax, pneumothorax, and tension pneumothorax, extremities including dislocations, fractures and splinting, head injuries including epi-/subdural hematomas, neck including cervical fractures and spinal cord damage, and pediatric non-accidental trauma/domestic violence
12. OB/GYN: Abortion including complete, incomplete, inevitable and threatened, ectopic pregnancy, placenta previa and placental abruption. Infections including pelvic inflammatory disease and sexual transmitted infections
13. Wound Care: Irrigation, local anesthesia, primary closure and tetanus prophylaxis

Selected Student and Faculty Learning Resources for Emergency Medicine

In addition to the aforementioned objectives, examples of supplementary resources used by the NBOME to inform the development of the Emergency Medicine exam are listed below:

• Society for Academic Emergency Medicine (SAEM) – Emergency Medicine Clerkship Curriculum: An Update and Revision
• American Osteopathic Association (AOA) – Emergency Medicine
• American Osteopathic Association (AOA) and American College of Osteopathic Emergency Physicians – Basic Standards for Residency Training in Emergency Medicine

Practice Questions

The Emergency Medicine Practice Questions are primarily designed to assist the candidate in navigating through the examination, and it is provided to facilitate the actual testing experience. It is not designed to give the candidate a score or provide information about how a candidate might actually perform on the examination.

Launch Emergency Medicine Practice Questions

Additional Resources

 

Title	Author	Edition	Year
Tintinalli's Emergency Medicine: A Comprehensive Study Guide	Tintinalli et al.	9th	2019
Rosen's Emergency Medicine: Concepts and Clinical Practice	Walls, Hockberger, & Gausche-Hill	10th	2022
Roberts and Hedges’ Clinical Procedures in Emergency Medicine and Acute Care	Roberts et al.	7th	2018
Tintinalli's Emergency Medicine Manual	Cydulka et al.	9th	2019
An Osteopathic Approach to Diagnosis and Treatment	DiGiovanna, Amen, & Burns	4th	2020
Foundations of Osteopathic Medicine	Seffinger	4th	2019