Surgery

Core Knowledge & Elements of Osteopathic Principles in the Discipline of Surgery

Content Outline and Assessment Objectives

The Surgery 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 accord with their curriculum goals and mission. This examination emphasizes core knowledge and elements of osteopathic principles and practice in the discipline of Surgery that are essential for the predoctoral osteopathic medical student. The exam blueprint below contains Surgery topics covered in Dimension 1 – Patient Presentation.

Dimension 1: Patient Presentation

Topic	%
Endocrine/Breast	5–13%
Fluids	5 - 12%
Gastrointestinal	26–35%
Hepato/Biliary	13–20%
Hernias	5-13%
Infections	4–8%
Skin/Subcutaneous Tissues	4 - 8%
Trauma	5–12%

General Learner-Centered Objectives

Based on general learner-centered objectives, as outlined in the Surgery 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 Surgery.
2. Foundational content knowledge and clinical problem-solving ability related to particular physician tasks critical to Surgery.
3. Knowledge and clinical problem-solving as related to the Fundamental Osteopathic Medical Competency Domains, including osteopathic principles and practice and 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 Surgery

For Surgery, 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 defects and hernias in the adult and pediatric patient
2. Endocrine and breast and related issues: thyroid, parathyroid, adrenal, pancreas, pituitary and other glands; surgical issues of the breasts
3. Fluids: shock, fluid and electrolytes, surgical nutrition, coagulation and blood
4. Gastrointestinal and related issues: esophagus, diaphragm, stomach, duodenum, small intestine, large intestine, rectum, and appendix
5. General surgical issues in urology, gynecology, and pediatrics
6. Hepatobiliary and related issues: pancreas, biliary tract, liver and spleen
7. Osteopathic principles and practice in surgical care: somatic dysfunction, viscerosomatic relationships and osteopathic manipulative treatment techniques
8. Surgical oncology and surgical pathology
9. Trauma: musculoskeletal injury and fractures; blunt and penetrating chest injury diagnosis and care
10. Wounds and infections: skin and subcutaneous tissues, immunology and transplantation

Selected Student and Faculty Learning Resources for Surgery

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

• Association for Surgical Education (ASE) – The Manual of Surgical Objectives, 4th Edition
• American Association of Colleges of Osteopathic Medicine (AACOM) – Educational Council on Osteopathic Principles (ECOP)
• American Osteopathic Association (AOA) – Surgery
• American Osteopathic Association (AOA) and the American College of Osteopathic Surgeons (ACOS) – Basic Standards for Residency Training in Surgery and the Surgical Subspecialties

Practice Questions

The Surgery 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 Surgery Practice Questions

Additional Resources

Title	Author	Edition	Year
Essentials of General Surgery and Surgical Specialties	Lawrence	6th	2018
Sabiston Textbook of Surgery	Townsend	21st	2021
Schwartz's Principles of Surgery	Brunicardi	11th	2019
An Osteopathic Approach to Diagnosis and Treatment	DiGiovanna, Amen, & Burns	4th	2020
Foundations of Osteopathic Medicine	Seffinger	4th	2019