Biomedical Essentials of Comprehensive Osteopathic Medicine (BECOM)

Biomedical Essentials of Comprehensive Osteopathic Medicine (BECOM)

There are four phases of the BECOM core element of learning that run longitudinally through the preclinical curriculum. There are three turns (or “passes”) in the preclinical curricular helix, with each turn representing a pass through each of the body’s systems and integration of the  basic sciences and clinical applications. The first turn of the helix occurs in Phases One and Two and focuses first on foundational information and understanding of the normal structure and function that defines states of health and wellness and approaches to health promotion in individuals and populations followed by an introduction to the pathological basis of disease. The second turn begins in Phase Three, where the emphasis is on recognition of disease and the application of clinical understanding that leads to rational patient-centered approaches to prevention, diagnosis, and treatment of disease.  The third and final turn takes place in Phase Four, where students are provided an opportunity for summation and synthesis of the understanding and application of information in multi-system case studies.

Year One

Phase One (BECOM-1)

This phase comprises the first twenty weeks of the curriculum in the first year of osteopathic medical education. BECOM-1 consists of a single course in which students are introduced to fundamental principles, concepts, and mechanisms important to the biological consideration of health and disease. Delivery of the material incorporates traditional lecture combined with case based and team-based learning strategies.  During the first twelve weeks, students learn the fundamental aspects of biochemistry, molecular and cellular biology, genetics, microbiology, and physiology in an integrated, interdisciplinary fashion. The anatomical sciences and cadaveric dissections are taught in a concurrent but separate course.  The second part of the semester begins the first turn of the helix, as students learn integrative biomedicine as it pertains to each system of the body.  This course provides the foundation and systems-based approach upon which the remainder of the curriculum and learning is built throughout the preclinical years of education.

Phase Two (BECOM-2)

This phase extends through the remainder of the OMS-I year and continues the series of basic medical sciences organized predominantly by body regions/system.  A study of traditional medical science disciplines (molecular and cellular biology, genetics, biochemistry, developmental biology and embryology, histology, anatomy, physiology, microbiology and immunology, pathology, and pharmacology) continues and are integrated into the system-based learning format. Delivery of this material continues with weekly didactic lectures combined with expanded team-case-based and team-based learning. This phase emphasizes normal structure-function relationships and the principles, mechanisms, and processes of the human body that are important for the maintenance and promotion of health in individuals as well as populations. In the context of abnormal structure-function relationships, basic principles and mechanisms of disease processes and the rationale for approaches to intervention are introduced as well.

Year Two

Phase Three (BECOM-3)

This phase begins at the start of the second year of medical school and begins a “second pass” through the same body regions/systems that were examined during OMS-I. With this second pass, there is intentional review, with emphasis on recall, application, expansion, and synthesis of understanding and skills. In these OMS-II system-based courses, a greater focus is placed on understanding the epidemiology, risks, pathogenesis and pathophysiology of disease, as well as rational approaches to diagnostic evaluations and interventions aimed at advancing patient health and wellness. An emphasis is placed on developing sound clinical reasoning in generating appropriate differential diagnoses, working diagnoses, and the rationale for patient management plans.

Phase Four (BECOM-4)

The fourth and final phase concludes the second pass through the body systems and begins the third pass through all systems, but utilizing a multi-system, case studies approach. The final two weeks of Phase Four are devoted to a Capstone course which provides summation experiences for the application of professional, ethical, biomedical and clinical knowledge and skill and preparation for the clinical phase of the students’ education. Students will be required to demonstrate the knowledge, skills, competency, and outcomes that were expected to have been acquired throughout the pre-clinical curriculum at a level that demonstrates they are prepared to enter the clinical education phase of their training. Students will also take their first board exam, the COMLEX-USA level one.  Passing of this exam is mandatory for advancement to OMS-III.