OSTEOPATHIC MEDICAL STUDENTS PERSPECTIVES ON THE IMPORTANCE OF PRIMARY CARE RESEARCH

Historically, osteopathic medicine has focused primarily on clinical medicine. Research was a secondary concern, although scientific inquiry was originally part of the vision of founder Andrew Taylor (A.T.) Still, MD, DO.¹ With increased recognition of the connection between research and improving health outcomes, both medical education and health care professions overall have emphasized the need for scholarly activity. Engaging osteopathic medical students in research has become even more crucial to be competitive for highly desired residencies due to the creation of a single accreditation pathway for graduate medical education through the Accreditation Council for Graduate Medical Education (ACGME).² Primary care research, which often focuses on improving health outcomes through clinical and preventative care practices, is a natural fit for osteopathic physicians emphasizing a holistic, whole-body approach to healthcare. The Ohio University Heritage College of Osteopathic Medicine (OU-HCOM) has worked to elevate primary care research within the college by providing research opportunities and training; connecting students, faculty, residents and community; and enhancing the infrastructure to support research.³

Since its inception in 1892¹, osteopathic medicine has utilized the philosophy of interconnectedness between the mind, body, and spirit to treat conditions disrupting the body’s functional capabilities. In addition to traditional medical practices, osteopathic physicians are trained in the utilization of osteopathic manipulative treatment (OMT), a non-invasive, holistic modality of manually treating acute and chronic dysfunctions that are common in primary care medicine. This philosophy helps mold physicians that are better equipped to address the concerns and improve health outcomes in the primary care setting, which is often the focus of osteopathic research.

As the first point of health care contact for most patients, primary care physicians encounter a broad range of conditions, making them an ideal front line observer for research that informs preventative interventions and clinical care practice. However, primary care research is undervalued by many students, faculty, and funding organizations due to a lack of clarity about what it encompasses. As part of a broader effort to guide, inform, and frame its primary care research culture as well as encourage more scholarly activity, an interdisciplinary health care team from OU-HCOM drafted a definition of primary care research grounded in foundational literature from Mold and Green.^3,4 This definition serves as the basis for our primary care research faculty and students’ endeavors.

Students develop and implement research projects by collaborating with faculty members, participating in research programs (eg, Research and Scholarly Advancement Fellowships), and building on prior working relationships. Many research ideas also develop through informal conversations. Actively participating in and contributing to annual scientific meetings helps mold our culture for research and innovation. To that end, annually, the number of OU-HCOM medical students presenting research at NAPCRG and sharing the tenants of osteopathy with fellow health care professionals has increased, growing from no students in 2014 to 20 students in 2018. A medical student stated, “Attending NAPCRG was a phenomenal experience and I would highly recommend to anyone involved in primary care research. I enjoyed networking with fellow students … as we have limited access to medical students outside of our school.”

Whether it was their first conference experience, or they had previously presented their work, OU-HCOM students of all skill levels presented topics from food insecurity in Peru to utilizing OMT with roller-derby skaters. The research projects from OU-HCOM mirrored the diversity of research at NAPCRG. A medical student stated, “What surprised me most about the conference was all of the different types of primary care research that are currently going on and the amount of opportunities that there are to network with others who share common interests.”

The welcoming atmosphere allowed for open discussion and constructive feedback from professionals across the globe. One student expressed, “It was truly an environment of mentorship and not one of criticism.”

This collegiality fostered the growth of osteopathic physician and medical student participation, reinforcing the importance of osteopathic medicine within primary care research.

Attending the conference did much more than check a box or put a research line on students’ curricula vitae, it built confidence and valuable skills that will make students more competitive when applying for residency. The skills that osteopathic medical students gained at the conference included problem-solving, fostering collaboration, and managing feedback. During the poster sessions, personal development was promoted by refining presentation skills, receiving valuable feedback on next steps, and preparing for future research. Regarding the unique global atmosphere at NAPCRG, one student said, “My favorite part was during my poster presentation, I was able to converse with many experts in the field and established strong networks with researchers in the United States, Australia, and Canada.”

Students reflected on what they would recommend to future NAPCRG student attendees. Their preconference suggestions included: preparing business cards, reviewing the breadth of research topics, and planning their conference schedule to engage their personal interests. “…I would have researched posters that were in the same field as my own research so that I could efficiently network and navigate the poster sessions,” one student reflected.

During the conference, students recommended taking advantage of networking opportunities in the uniquely supportive environment of NAPCRG. Attending the trainee preconference also gave students the opportunity for one-on-one mentorship with distinguished researchers. “At one after-hours event, I found myself in conversation with a program director from across the country,” one student said.

Overall, students were enthusiastic about their NAPCRG experiences. They wanted to share the importance of student participation in helping to grow the body of scholarly knowledge, especially regarding primary care research. As one student stated, “Every contribution to primary care research, whether big or small, is something to be proud of and worth sharing.”

They also echoed the importance of pursuing opportunities for professional growth: “…don’t allow yourself to believe that you are doing all that you can to set yourself up for success if you aren’t attending conferences such as NAPCRG.”

Attending conferences such as NAPCRG where medical students can grow as both researchers and health care providers is the first step to creating a more inclusive, primary care–focused research community. As modern health care continues to evolve, research will remain vital to the improvement of primary care and preventative medicine. Osteopathic physicians are optimally positioned to develop new research projects that not only address relevant health care concerns but also establish better methods of providing holistic medicine in the primary care setting. With more funding and grant opportunities, osteopathic institutions such as OU-HCOM will be able to actively engage in research opportunities as well as develop and assess new ways to approach primary care medicine.

To build healthier communities, it is imperative to invest in preventative medicine influenced by osteopathic philosophy. This begins with bolstering our primary care research, something that cannot happen without the ability to nurture collaboration and mentorship between physicians and researchers across the globe. As modern health care continues to evolve, conferences such as NAPCRG work to foster the next generation of osteopathic and allopathic physicians to confront new challenges, engage patients, and advance medicine through innovative solutions.

• © 2019 Annals of Family Medicine, Inc.