The first competency, Osteopathic Philosophy and Practices (OP P), is the lynchpin competency that holds the other seven competencies together, with integration. Students and Curriculum can be referred to by Osteopathic Medical Student (OMS) followed by an Arabic numeral that corresponds to placement in training therefore, students or curriculum may be referred to as OMS 1, OMS 2, OMS 3, or OMS 4 respectively. The pre-clerkship curriculum includes a total of four semesters, two semesters in the OMS 1 year and two in the OMS 2 year. Students are immersed in introductory basic science concepts and develop skills in physical examination, doctor-patient interactions, and osteopathic principles and practice.