As you ponder medical school, you may be wondering, “What is the difference between an MD and a DO?” In the U.S., there are two types of degrees that lead to the practice of medicine as a physician: an MD, a doctor of medicine, or a DO, a doctor of osteopathic medicine.
The two degrees reflect different types of medical school training. MD-granting institutions are often called allopathic medical schools, while DOs attend osteopathic medical schools.
The similarities
About one-quarter of U.S. medical students train at osteopathic medical schools. That number has grown significantly in recent years, with the American Association of Colleges of Osteopathic Medicine reporting that first-year enrollment at osteopathic medical schools rose by 68% between 2011–2012 and 2021–2022. That growth is, at least in part, due to the opening of additional DO-granting medical schools.
In terms of the applications requirements for MD and DO programs, the criteria are virtually the same, with both osteopathic and allopathic programs weighing grade-point average and Medical College Admission Test (MCAT) scores heavily. The curricular structure of both programs is largely the same, with students typically spending much of their first 12–24 months in the classroom and the majority of their training beyond that in a clinical setting.
Single accreditation, residency training
In the past, graduates from osteopathic and allopathic medical schools had generally matched with residency programs through separate processes.
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In an effort to simplify the graduate medical education (GME) accreditation system in the United States, the organizations that accredit GME—the Accreditation Council for Graduate Medical Education and the American Osteopathic Association (AOA)—have changed how they do things.
The 2020 Main Residency Match marked the completion of the transition to a single accreditation system and the consolidation to a single Match for U.S. DO and MD seniors.
Most residency programs will accept the Comprehensive Osteopathic Medical Licensing Examination (COMLEX-USA) taken by DO students, as well as the United States Medical Licensure Exam (USMLE) that is taken by MD students and may also be taken by DO students.
Mind, body, spirit
Historically, DO programs have described their methods as more holistic than those taught at allopathic programs. One unique aspect of osteopathic education is osteopathic manipulative treatment (OMT), defined by the AOA as a “a set of techniques used by doctors of osteopathic medicine to diagnose, treat and prevent illness and injury. Using OMT, a DO moves a patient’s muscles and joints using techniques including stretching, gentle pressure and resistance. “Those skills typically mean an added curricular focus in training on the musculoskeletal system.
“If a student is somebody who really enjoys that patient-centered approach and really is of the mindset that medicine is a mind-body-spirit relationship, a DO program will serve them well,” said John D. Schriner, PhD, associate dean for admissions and student affairs at Ohio University Heritage College of Osteopathic Medicine, which has received grant support from the AMA for innovation in education.
In an interview recorded as part of the “What I Wish I Knew in Medical School” series, AMA Trustee Ilse R. Levin, DO, MPH & TM, said she applied to MD and DO programs and was accepted into both types.
“I was very drawn to the philosophy of how to practice medicine from the osteopathic side,” said Dr. Levin, an epidemiologist. For me, it was really following that philosophy which called to me.”
She added that aspiring physicians tend to “self-select, not just for allopathic or osteopathic, but for the individual medical school as well. There are things about those places that call to us. And I think that's something that we should own and be proud of.”
Most DOs choose primary care
The 2022 Match, the third fully combined Match for DOs and MDs, yielded positive results for graduates from both types of schools. About 7,300 U.S. DO seniors submitted rank-order lists of programs, and 91.3% of them matched. That percentage is a bit lower than the 93.9% Match percentage posted by seniors at U.S. MD-granting medical schools.
According to 2020–2021 AOA figures, nearly 57% of DOs practice in primary care specialties: 30% are family physicians, 19% are internists and 7.5% are pediatricians.
By comparison, 28% of active U.S. physicians with MDs practice in primary care specialties: 11% are family physicians or in general practice, 10.4% are internists and 6.8% are pediatricians. This data comes from the Association of American Medical Colleges.
Which is right for you?
One admissions officer provides this tip: Don’t worry about the degree.
“People ask often: Should I apply to an allopathic or osteopathic school?” said Benjamin R. Chan, MD, associate dean for admissions at the University of Utah School of Medicine. “What I tell everyone is you should apply to both. Then if you get into both schools, just the same as if you got into two osteopathic schools or two allopathic schools, you need to do your research as a pre-med to figure out which is the best fit.”
