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The NMM-OMM Specialist

What is an Osteopathic Manipulative Medicine Specialist?

ONMM stands for Osteopathic Neuromusculoskeletal Medicine. This is the current term used to describe the specialist trained and board certified in specialist-level osteopathic manual therapy since the integration of ACGME & AOAGME graduate medical education began in 2015. This integration will be complete by 2020. Previously, this type of training was designated as Neuromusculoskeletal Medicine & Osteopathic Manipulative Medicine (NMM-OMM) or Specialty Proficiency in Osteopathic Manipulative Medicine (SPOMM).

  • C-NMM/OMM: Certification in Neuromusculoskeletal Medicine and Osteopathic Manipulative Medicine. A certification granted by the American Osteopathic Association through the American Osteopathic Board of NMM & OMM since 1999.
  • C-SPOMM: Certification, Special Proficiency in Osteopathic Manipulative Medicine. A certification granted by the American Osteopathic Association through the American Osteopathic Board of Specialty Proficiency in Osteopathic Manipulative Medicine prior to 1999.

It should be emphasized that all DOs (Doctors of Osteopathic Medicine or Osteopathy) are trained in osteopathic philosophy and osteopathic manipulative therapy (OMT). Some MDs have also sought out this training. All DOs are certified to perform OMT in their practices. ONMM specialists are physicians, who have devoted significant additional study, beyond the foundations of osteopathic philosophy taught during osteopathic medical school.

What are the pathways to becoming an Osteopathic Manipulative Medicine Specialist?

There are currently three pathways to becoming certified as Osteopathic Manipulative Medicine Specialist.

1) Completion of an ONMM Residency

Previously called an NMMOMM Residency, this pathway is a two (2) year program (PGY2 /ONMM1 and PGY3/ONMM2) that starts after a completed internship. This residency involves traditional rotations thru many of the different medical specialties, in addition to a large percentage of time spent in the study of Osteopathic Philosophy and Osteopathic Manipulative Medicine thru both longitudinal hospital and out-patient medical settings.

2) Completion of a “Plus-One” Residency Year

This residency was previously called a post-doctoral fellowship, or NMM-OMM “Plus-ONE” fellowship or residency.  This year (typically PGY4) can be completed after any primary residency, including surgical specialties, but is more commonly completed after a residency in family practice, internal medicine, pediatrics, emergency medicine, or physical medicine & rehabilitation. In this sequence of training, one applies for and completes their primary residency training first. During their last year of this training, they would apply for the “Plus-One” residency year. This “Plus-One” year is considered to be the ONMM2 or second year of an ONMM Residency. Therefore, it is important for prospective resident applicants to be sure they complete the pre-requisites to the ONMM2 year during their primary residency.

VCOM-Virginia is offering the NMM-OMM “Plus-One” Residency option

3) Completion of an Integrated Residency Program

This is a combined residency between a primary care program and an ONMM residency. Currently there are integrated programs in family medicine and ONMM or internal medicine and ONMM.  This combined program is applied for in a single match. These programs will integrate specialty training in ONMM throughout the primary care residency. Including the internship year, these programs are 4 years long. Completion of these programs allows the resident to sit for board certification in both the primary care specialty and ONMM.

A listing of all available AOA programs be found here:

Search under program type “residency” for:
1) Neuromusculoskeletal Med/OMT (NMS)
2) Neuromusculoskeletal Med +1 (NMS1)
3) Integrated FM/NMM (FMNM)
4) Integrated IM/NMM (IMNM)

What kinds of career opportunities are available to the Osteopathic Manipulative Medicine Specialist?

An ONMM specialist can practice in many different ways and settings.  Some ONMM specialists choose to practice in their primary specialty (primary care or surgical) and integrate OMM into their patient management. Some choose to only practice musculoskeletal medicine and OMM. An OMM practice can be hospital based, out-patient based, or a combination. Some ONMM specialists have entered academic medicine to teach further generations of DOs, and/or perform research.  The options are really endless and open to your career goals:

  • Specialty ONMM Private Practice – ONMM only
  • Specialty Private Practice – PMR, Sports Med, OB/GYN. etc with integrated ONMM
  • Specialty Hospital Based Practice – ONMM inpatient consults
  • Academic Positions with various clinical practice levels
  • Primary Care Private Practice – FP, IM, Peds, EM with integrated ONMM

So where do ONMM specialists work? According to 2015 AAO (American Academy of Osteopathy) membership data, the charts below provide some rough information. Keep in mind that this data …

  • Does NOT include retired or inactive categories of members
  • The fact that not all Board Certified ONMM Specialists may be AAO members
  • This specialty data is SELF reported

Chart 1

Chart 2

Chart 3