MD vs. DO, What’s the Difference?

DOs (osteopathic physicians) are the legal and professional equivalents of MDs (allopathic physicians). They practice in all areas of medicine. DOs and MDs compete for residencies and in the job market. DO medical schools generally emphasize primary care.

Is the training of DOs the same as MDs?

The training of DOs is nearly identical to that of MDs. The major difference is DOs complete extra coursework in osteopathic manipulative medicine (OMM). Also, DO medical schools usually require that their students spend more time rotating in primary care specialties such as internal medicine, family medicine, pediatrics, and obstetrics/gynecology during the third and fourth years.

In general, DO medical schools emphasize generalist skills and training and seek to produce comprehensively trained family physicians rather than specialists. DOs take their own boards (called the COMLEX), but have the option of sitting for the MD boards (called the USMLE). Osteopathic medical students will often take the USMLE as well.

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MD residency programs that are particularly competitive often require that all applicants take the USMLE. From a residency program’s perspective, this helps “level the playing field” in the selection process.

How can I get in touch with a DO?

No matter what kind of doctor you want to be, try to talk to as many practicing physicians (MD and DO) as you can. If you want to speak with a DO, try calling one locally and see if you can sit down with them to discuss osteopathic medicine.

Most DOs understand that most people have a limited knowledge of osteopathic medicine and will be willing to talk to you. Ask candid questions about their professional relationships with other physicians in the community and their residency experiences.

Should I be a an osteopathic physician?

Be a smart consumer of your medical education. Don’t rely solely upon any single person’s opinion, including my own. Instead, talk to as many different people as you can. Keep in mind that, ultimately, your professional success is dependent on the residency match process. Your own future career in medicine will depend more upon how much enthusiasm, ambition, and personal drive you have, than where you went to medical school or what degree you obtain.

There are successful physicians in academia, private practice, and industry who have graduated from either private or public schools, from either research oriented or primary care focused schools, or from either DO or MD schools.

With respect to applying to DO schools, ask yourself these questions: Do you like the osteopathic approach to patient care? Are you the kind of person who is comfortable being a minority or different? (DOs comprise only 10% of all physicians in the US.) Will you feel frustrated or inadequate if you have to explain to a patient who has never been to an osteopathic physician what the DO degree is and what osteopathic medicine is all about?

Finally, during your interviews pay attention to what students tell you about their school. Hang around after your interview is over and ask students about their experiences so far. Is the school high stress and competitive or more laid back? Do students like the faculty and feel that the administration appreciates them or do they feel neglected?

Keep in mind that medical school is a long, tedious, and exhausting endeavor. No matter how “good” other people think that a school is, your experience will be an awful one if you wake up every day hating your school.

Is DO school the same as MD school?

Essentially yes. MD and DO medical schools both are 4-year programs. They have the same requirements and course load. The first 2 years of medical school focus on anatomy, physiology, biochemistry, pharmacology, etc. The last 2 years of medical school are in hospital or clinic settings where a student learns their craft through closely supervised patient care.


Do DOs do internship and residency?

Yes. All state medical licensure requires that physicians (MD and DO) have done at least one year of residency (also known as an internship).

Very few physicians only complete one year of residency. Most doctors complete 3-7 year residencies in order to become eligible for board certification in their chosen specialty. Board certification indicates a doctor is an expert in their specialty.

Board certification is completed through a test completed at the end of residency. In order to maintain board certification, doctors (MD and DO) need to repeat their testing every few years or through continuous testing. Osteopathic physicians board certify through the same organization as MDs, but can also can certify through osteopathic specialty boards.

All specialty societies and professional organizations recognize osteopathic board certification.

Do osteopathic doctors make less money?

MDs and DOs make the same amount of money. The type of medical degree (MD or DO) does not influence a physician’s earning potential. Earning potential is entirely based on specialty training.

Doctors that do more procedures (cardiology, gastroenterology, etc.) generally make more money than doctors that bill by patient visit (primary care, general internists).

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Reviewed 2019 by Lee Burnett, DO, FAAFP.

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David Russo, DO, specializes in interventional pain medicine and physiatry. He is in private practice at Columbia Pain Management in Hood River, Oregon. David Russo, DO, specializes in interventional pain medicine and physiatry. He is in private practice at Columbia Pain Management in Hood River, Oreg...