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Skeletons in the Closet

In addition to chiropractors, many medical practitioners provide care for the muscles and skeleton. It follows logic that these providers, particularly medical doctors (MDs) and physical therapists, should therefore master the basics of musculoskeletal treatment, which requires a broad knowledge of conditions and symptoms related to the bones, muscles, ligaments, and tendons.

Based on a recent study in The Journal of Bone and Joint Surgery, however, medical students may not be studying the skeletons hanging in their classroom closets.

The authors of this study previously reported that 82% of 85 recent medical school graduates failed to show even basic knowledge of musculoskeletal medicine, based on a written examination scored by orthopedic program directors. This follow-up study was designed to evaluate if the more than 400 program directors of internal medicine departments in the U.S. would similarly rate the importance of the exam questions and required passing score.

Over half of the program directors responded to the exam questionnaire; they suggested an average passing score of 70%. The mean score of the medical-school examinees had been 59.6%, however. Therefore, a full 78% of the examinees would have been unable to demonstrate "basic competency" on the exam, based on review by the internal medicine program directors.

The majority of medical students, who have received all of their scholastic training required to be medical doctors, may lack basic competency in musculoskeletal medicine upon graduation. Chiropractors often treat different conditions than MDs, but are an excellent source of information when it comes to your spine, joints, and other "moving" body parts. Chiropractors have all completed a minimum of four years of education with an emphasis on muscle and skeleton management and care.


Freedman KB, Bernstein J. Educational deficiencies in musculoskeletal medicine. The Journal of Bone and Joint Surgery 2002:84-A(4), pp. 604-608.

For more information about musculoskeletal conditions, go to