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MD vs. DO: What is the Difference?

DOs (osteopathic physicians) are the legal and professional equivalents of MDs (allopathic physicians). They practice in all areas of medicine. So what’s the difference? In this FAQ, we’ve compiled many of the common questions that prospective students and patients have about osteopathic physicians and how they are similar yet still unique.

Reviewed and updated 2021 by Lee Burnett, DO, FAAFP.

Is DO school the same as MD school?

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 students learn their craft through closely supervised patient care.

What is the major difference between MD and DO training?

In medical school, osteopathic medical students take an additional 200 hours of musculoskeletal training. Osteopathic medical schools tend to be more primary care focused. Therefore, they often require their students to spend more time rotating in primary care specialties such as internal medicine, family medicine, pediatrics, and obstetrics/gynecology during the third and fourth years.

Otherwise, the schools are equivalent in terms of scientific rigor and educational requirements.

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If I pursue a DO degree instead of an MD degree, will I be limiting my career options?

As of 2021, approximately 25% of all graduating medical students are DOs. Residency placement for DO schools is essentially equivalent to MD schools, and both use the same match. However, not everyone matches: for 2019 there were 38,373 match applicants for 35,185 positions. Highly competitive residency programs often select students from the ‘big name’ medical schools for prestige factor. As there are no ‘big name’ DO schools, this becomes a disadvantage for DO students.

(Note that Caribbean MD schools residency placement is far lower than US MD or DO schools. It is hard to fully quantify as some Caribbean schools do not publish their residency placement statistics.) See this article in Forbes for more information.

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 as they generally face insurmountable challenges in the job market. Most doctors complete 3-7 year residencies 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 the residency. To maintain board certification, doctors (MD and DO) need to repeat their testing every few years or through continuous testing. Osteopathic physicians are board-certified through the same organization as MDs but can also certify through osteopathic specialty boards.

All specialty societies and professional organizations recognize osteopathic board certification.

Do MDs and DOs have different residency programs?

In the past, there were separate programs, but the Accreditation Council For Graduate Medical Education (ACGME) and the American Osteopathic Association (AOA) have consolidated their match process.

Do DOs take the USMLE?

DOs take the COMLEX, but they can also take the USMLE. Some particularly competitive residency programs require that all applicants take the USMLE. This helps “level the playing field” in the selection process from a residency program’s perspective.

In which specialties do most DOs practice?

DOs can be found in every medical and surgical specialty. Statistically, more DOs are found in Emergency Medicine, Family Medicine, Pain Medicine, Physical Medicine and Rehabilitation, and Preventive Medicine.

What’s more important, the medical degree or the residency training?

Residency training. No experienced physician will argue this point. Where a doctor completes residency is more important than which medical school they attended. Residency is where a physician learns their specialty, builds their skill, and masters the art of medicine. As a patient, pay more attention to where your physician attended residency than the degree on their jacket.

I have been accepted to a DO school and a Caribbean MD school, which is the better choice?

Before making any decision, take a careful look at acceptance rates for residency. US MDs and DOs have a significant statistical advantage over foreign medical school graduates. This article in the New York Times provides a cautionary tale regarding residency training for foreign graduates.

Do osteopathic doctors make less money?

No. 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 who do more procedures (cardiology, gastroenterology, etc.) generally make more money than doctors who bill by patient visits (primary care, general internists).

Do all medical insurance companies accept DOs?

Yes. There is no difference in insurance acceptance.

My physician only uses “Dr.” How can I tell if they are an MD or DO?

Some osteopathic physicians incorporate osteopathic evaluation techniques into their examinations. However, without knowing a physician’s degree, there is usually no obvious practice or style difference in a typical patient visit.

Do some areas of the US have more DOs?

Historically, DOs were more common in areas where more osteopathic medical schools were present, such as in the Northeast. However, with the expansion of osteopathic medical schools over the past thirty years, this geographic pattern is becoming more homogeneous.

Can I serve in the military as a DO?

Yes. Osteopathic physicians serve in every specialty within the Armed Forces. DOs have attained the rank of general officer. A DO has served as Surgeon General of the US Army.

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 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 attend an osteopathic medical school?

Be smart about your medical education. Talk to as many different people as you can before making a decision. Keep in mind, your professional success is dependent on where you attend residency.
Your own future career in medicine will depend more upon your enthusiasm, ambition, and personal drive than where you went to medical school or what degree you obtain.

Is it easier to get into DO school than MD school?

Prior to the expansion of osteopathic medical schools and the increased number of osteopathic physicians in the US workforce, it was believed that earning a DO degree was the easier pathway to becoming a physician. However, as more students have become aware of osteopathic medicine, and the number of applicants has increased, the MCAT and GPA gap has narrowed. Today, the average MCAT score for MD schools is roughly 510 and the average MCAT score for DO schools is 504. The average GPA for MD schools is 3.71 and the average GPA for DO schools is 3.54.

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Reviewed 2021 by Lee Burnett, DO, FAAFP.