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Osteopathic manipulative treatment (OMT) is a defining feature of osteopathic medicine; however, use of OMT by osteopathic physicians is declining. Recent studies reveal that many osteopathic physicians are abandoning use of OMT as early as medical school. Current national efforts are aimed at reversing this trend by standardizing osteopathic medical records and clinical training in OMT. The authors found that a structured clinical curriculum in OMT taught to house staff significantly increased the percentage of patients who received osteopathic structural examinations and the percentage of patients who received OMT as part of their hospital care.

Future graduates of medical schools in the United States will practice in healthcare environments increasingly predominated by managed care. Thus allopathic and osteopathic undergraduate and postgraduate residency training programs should begin to revise their respective curricula and conduct training in managed healthcare environments to prepare graduates for practice in managed care settings. The demand for curricular revision in medicine comes not only from prospective employers and government agencies, but from students and graduates. Educators, clinicians, and government officials have recently defined core competencies that are requisite to the education and preparation of future physicians through the work of the Council on Graduate Medical Education (COGME). This article discusses these core competencies and suggests strategies by which to implement them in undergraduate and graduate medical education.