While
it is true that all osteopathic physicians learn the basics of manipulative
medicine in medical school, less than half are proficient at it or actually
practice it after graduation. D.O.s that want to continue their
education in osteopathic manipulation have several options. One option
is fellowship training, which is one year long and may be done during medical
school or after residency training. Fellowship training translates into
approximately 2,500 hours of instruction and patient care in manipulative medicine in addition
to the four years of medical school and whatever residency training the
physician decides to do. 
There
is opportunity to attend many continuing medical education courses and learn a
wide variety of treatment techniques from several different instructors.
Of course, the opportunities will vary depending on the particular program
attended, but D.O.s who are fellowship trained are some of the best
practitioners of osteopathic manipulation in the country. The only
programs that offer more training in manipulative medicine are two-year
residencies.