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Welcome from our Program Director

Welcome to our Osteopathic Neuromusculoskeletal Medicine (ONMM) Residency Program! Our one-year, fellowship-like program concentrates on osteopathic principles and practice (OPP). Our curriculum and training allow a resident from any ACGME-certified program to focus and develop osteopathic-based skills.

Welcome Letter

Program overview

The goal of the Edward Via College of Medicine (VCOM)/LewisGale Hospital Montgomery Graduate Medical Education (GME) Consortium’s ONMM Residency Program is to provide residents with training in the development of osteopathic clinical competencies for practice in both inpatient and outpatient settings as competent, proficient and professional ONMM specialist physicians.

We are a fully accredited, ACGME Osteopathic Neuromusculoskeletal Medicine Third Year (ONMM3) residency program. We were previously a Neuromuscular Medicine-Osteopathic Manipulative Medicine (NMM-OMM) “plus one” program under the American Osteopathic Association.

Our one-year program can be completed after finishing any other ACGME-approved residency program. The NMM-OMM specialist (current terminology for board certification once completing an ONMM residency) or ONMM specialist is a subspecialty in the medical profession.

Additionally, the residency program fosters academic teaching and research growth in future physicians who can competently serve as program directors or researchers. Residents are strongly encouraged to do original research, either as the lead or in combination with current OMM faculty projects.

Our Program Director and staff

Our team is comprised of skilled experts with deep experience and knowledge from which residents and fellows can benefit.

Albert J. Kozar, DO

Program Director

We would love to help you take this journey to realize the potential of your osteopathic roots. Feel free to contact me at any time to discuss ONMM3 training opportunities or other ways to expand your understanding of osteopathic philosophy.

View All Our Faculty

Program details

Residency program highlights

Our curriculum involves a robust program, including:

  • Emphasis on teaching traditional osteopathy and history
  • Emphasis on palpatory skill development and osteopathic principles first, then core skills in all OMT techniques
  • Emphasis on developing teaching and research skills, with strong financial support and logistics
  • Diverse ONMM faculty with active outpatient clinical practices
  • Emphasis on all-around patient care in specialties such as sports medicine, geriatrics and pediatrics (including infants)
  • AOBNMM approved, 40-hour Basic Cranial Course provided annually by Anthony Chila, DO, with a unique emphasis on connective tissue continuity as originally presented by A.T. Still and William G. Sutherland.
  • Supplemental residency-sponsored OMM courses, usually two to three per year. Recent examples include:
    • Steven Blood, DO – Cranial Technique
    • Ed Stiles, DO – AGR Techniques on Body and Cranium
    • Richard Schuster, DO – Teachings of Carl McConnell, DO
    • Hollis King, DO, PhD – OMT for Systemic Disorders and Physiological Functions
  • 120+ hours of hands-on, MSK Ultrasound curriculum (diagnostic and therapeutic injection guidance) to prepare for the Registered in Musculoskeletal (R-MSK) certification
  • Hands-on regenerative medicine exposure
  • Hands-on medical acupuncture exposure
  • Functional rehabilitation of chronic neuromuscular imbalance

Residents are also required to present nationally at the American Academy of Osteopathy Convention in March, as well as on VCOM Research Day. Additionally, they attend the annual VCOM research retreat.

VCOM provides mentoring and financial support at all levels for the resident to help them become effective physician leaders and teachers in osteopathic principles and practice who understand how to formulate and implement research projects in the field of ONMM.

Curriculum and rotation schedule

Our program’s goal is for the resident to have a complete, broad-based musculoskeletal training experience. As such, our program tries to ensure that each resident has had a chance to spend at least one month in all musculoskeletal-related rotations at some point in their post-graduate training. Therefore, we consider each rotation to be a core rotation.

However, for ONMM3 candidates, the program director will meet with each candidate at the beginning of their training and consider their prior musculoskeletal-related rotations before completing their final schedule of core electives to be sure that all requirements are satisfied.

That is, incoming residents that have completed these rotations in the past will have the option to repeat these rotations or spend more time in OMM continuity clinic or with core OMM faculty.

Conference schedule

Our OMM team is committed to providing the complete spectrum of medical education for the resident doctor in training.

Each week, four hours are protected for didactic and clinical education to round out the residents’ training experience.

Our in-house rotations, combined with up-to-date continuing medical education programs, are designed to provide the physician in training maximum exposure to real-world challenges in musculoskeletal medicine.

Resident rotation activities include:

  • Weekly anatomy review
  • Weekly OMM book club
  • Regularly recurring journal club
  • Monthly MSK radiology rounds
  • Optional sports medicine didactic and journal club series
  • Weekly palpation exploration and palpation skill enhancement
  • Historical osteopathic philosophy document review
  • Historical hands-on osteopathic technique review
  • Hands-on osteopathic technique review to cover the basics of approach and technique of all osteopathic treatment techniques
  • Hands-on diagnostic and cadaver lab ultrasound-guided injection practice (120+ hours per year)

Mission statement

The LewisGale Hospital Montgomery ONMM Residency Program's mission is to develop the next generation of physicians and physician leaders.

As a part of HCA Healthcare, we are driven by a single mission: Above all else, we are committed to the care and improvement of human life.

This program is designed to offer residents a rewarding, educational environment where they are provided individualized learning opportunities by faculty and staff who support and sustain one another throughout quality care delivery. Our faculty is committed to ensuring the residents' clinical experience and educational needs are fulfilled while expanding their perspectives to be inclusive of cultures, values and ideals.

Frequently asked questions about our ONMM Residency Program

Here, we answer some of the most common questions about our program.

There are no specifically required rotations prior to your entry to our program. However, ONMM3 residents benefit from the ability to count MSK rotations performed during their primary residencies towards the required rotations during the ONMM3 year. The more MSK rotations completed during primary residencies, allow significantly more flexibility to customize rotations to personal interests.

Specifically seeking out providers that perform OMT on these rotations, rotating with NMM-OMM certified physicians, and attending AAO convocation along with other local, regional or national OMM workshops will improve your skills, knowledgebase and success at being chosen and completing the ONMM3 program.

ACGME dictates all required rotations and your previous experience contributes to this. So, required selective rotations are chosen after reviewing the incoming resident's rotations completed during their PGY2 and PGY3 years. VCOM’s emphasis is to encourage all ONMM3 residents to do at least one rotation in all musculoskeletal disciplines during the course of their training.

By the end of the ONMM3 year, at a minimum, you must have completed:

  1. Selective A (two needed) — Orthopedic surgery, neurosurgery, podiatry, sports medicine, occupational medicine
  2. Selective B (two needed) — Physical medicine and rehabilitation (PMR), neurology
  3. Selective C (one needed) — Pain management, radiology, MSK radiology
  4. Hospital OMM consult service (two needed) — completed longitudinally

  • Outpatient Neuromusculoskeletal Medicine (NMM)
  • Primary care sports medicine
  • Orthopedic surgery
  • Neurosurgery
  • Podiatry, PMR
  • Neurology
  • Pain management
  • MSK radiology
  • Oncology/hospice
  • Regenerative medicine
  • Medical acupuncture (with certified physician)
  • Rehabilitation
  • Academics

Pediatrics, family medicine, internal medicine and outpatient obstetric gynecology are also available upon request, but do not count towards the required MSK rotations.

We do not currently have a rheumatology rotation.

The schedule for next year would include the following:

  • Five to six half-days per week are on the monthly rotation (required under ACGME; and 1 required and additional elective NMM rotations
  • Four half-days on OMM resident continuity clinic (one evening at VSOM, one at local VA)
  • One evening every 2nd or 3rd week — longitudinal sports medicine/procedural rotation with Dr. Kozar
  • One half-day of OMM didactic
  • 120+ hours in MSK US training (with 60 percent front-loaded in the first few months)

ONMM is an MSK specialty. VSOM is a primary care-based, osteopathic musculoskeletal specialty clinic. We do not provide primary care, family medicine, internal medicine or pediatric services. However, we expect the resident to approach musculoskeletal pain from all MSK and medical discipline perspectives.

You should know all orthopedic exams, know how to work up and screen rheumatologic issues, know family medicine and internal medicine workups for hormonal issues, understand the growth and development of infants, know the issues associated with obstetrics and develop integrated treatment plans for complex chronic pain patients.

We do not treat patients for OMT care only. Patients should be worked up for their pain complaints from a primary care-based, ONMM specialty perspective. It is most similar to PMR or primary care sports medicine, but with an obvious osteopathic and OPP focus.

We want you to be physicians who deliver holistic care.

We spend a lot of time on research training and development. VCOM fosters and invests a large amount of money in research development within its multi-school system. VCOM has a yearly research day and a yearly research retreat at each campus where ONMM residents participate in. VCOM provides hundreds of thousands of dollars yearly in starter grants for beginning researchers.

There are several half days given for research during the first half of the year, ONMM residents will complete their CITI training either prior to matriculation or upon arrival. The program front loads research training, development and planning so that posters can be presented by the 7th or 8th month of the program for VCOM Research Day and present at the American Academy of Osteopathy (AAO) convocation in March each year.

In our program we require the following:

  • Completion of Collaborative Institutional Training Initiative (CITI) training modules, to make the resident eligible for institutional review board (IRB) retrospective and prospective study submission
  • Completion of at least one retrospective or prospective clinical study
    • Many of the OMM and SM faculty have ongoing projects that the residents can participate in. Many residents have also chosen to do their own projects. There is the potential to continue and expand prior ONMM resident projects.
  • Submission of at least one (OPP)/OMM-related poster to VCOM Research Day and a national convention (usually AAO).
  • Submission of a formal written paper (article review, case study, or paper on your research) for possible publication in a journal
    • Residents work with Dr. Kozar to complete this in the second half of the year.

All ONMM residents take home calls for one-week periods, usually every five to eight weeks total for the year (shared by ONMM residents and sports medicine fellows). You might get five to six actual calls all year. You'll need to be available by phone. There is always an OMM or SM attending physician available for backup.

All ONMM residents, during their first half-year, will be on OMM hospital consult service daily, Monday thru Friday. There are no weekends and no major holidays. We average zero to four inpatients per day. These are shared by the residents. Once numbers are good, we may rotate which week you do hospital. We see patients most times over the lunch hour or after afternoon clinics.

Base rotations are all very local:

  • VCOM Sports and Osteopathic Medicine (VSOM) — OMM resident clinics, OMM rotations, longitudinal SM rotation, PMR and SM
  • LewisGale Hospital Montgomery is in Blacksburg, Virginia and only two miles from the VSOM Clinic

The majority of the rotation sites are within the local area with a 10-20 minute drive. The furthest location is normally Roanoke, Virginia, or Bluefield, West Virginia, (40 minutes) for pain management (usually necessary), and elective rotations in neurosurgery and podiatry.

Credentialing is completed through the VSOM Clinic. Residents are credentialed as residents in training for insurers. For your OMM resident clinic, you are the primary doctor in the electronic (EHR), that is, patients become part of your panel, but billing is thru the attending preceptor.

The school covers malpractice insurance for the residents during the residency and tail coverage afterward up to the required maximum levels by law for Virginia physicians. Providing tail coverage is required under ACGME. Carriers can vary coverage from year to year depending on the cost to the school.