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From the Virginia College of Osteopathic Medicine and Virginia Polytechnic Institute and State University, both in Blacksburg, Va (Stockard), and Oklahoma State University College of Osteopathic Medicine in Tulsa (Allen). Dr Stockard served as president of the American Osteopathic Academy of Sports Medicine from 2002 to 2003. Dr Allen served as the American Osteopathic Association's editor in chief from 1987 to 1998.

Address correspondence to Alan R. Stockard, DO, Virginia College of Osteopathic Medicine, 2265 Kraft Dr, Blacksburg, VA 24060-6360. E-mail: astockard{at}vcom.vt.edu

Background: Consistent with osteopathic principles and practice, the nation's colleges of osteopathic medicine (COMs) have emphasized the significance of the musculoskeletal system to the practice of medicine. The authors hypothesized that graduating COM students would, therefore, demonstrate superior knowledge and competence in musculoskeletal medicine when compared with graduates of allopathic medical schools.

Methods: The authors asked graduating COM students to complete a standardized and previously validated 25-question basic competency examination on musculoskeletal medicine in short-answer format. Originally developed and validated in the late 1990s, the examination was distributed to allopathic medical residents at the beginning of their residencies. The authors compare their results with those reported by Freedman and Bernstein for allopathic residents.

Results: When the minimum passing level as determined by orthopedic program directors was applied to the results of these examinations, 70.4% of graduating COM students (n=54) and 82% of allopathic graduates (n=85) failed to demonstrate basic competency in musculoskeletal medicine. Similarly, the majority of both groups failed to attain the minimum passing level established by the directors of internal medicine programs (graduating COM students, 67%; allopathic graduates, 78%).

Conclusion: In an examination of competence levels for musculoskeletal medicine, students about to graduate from a COM fared only marginally better than did their allopathic counterparts. To ensure that all graduating COM students have attained a level of basic competence in musculoskeletal medicine, the authors recommend further study as a prelude to evaluation of the didactic and clinical curriculum at all 22 COMs and their branch campuses.