What is a DO vs. MD? You may have heard many opinions about which is better, but the two are quite similar, all the way down to their match rates. Do away with everything you may have heard about DOs vs. MDs, and read the facts about these two highly capable physician varieties.
Upon graduating from medical school, students receive credentials to signify their status as a physician. Medical school students can look forward to becoming doctors of medicine (MD) or osteopathic medicine (DO).
There are many similarities between the two, but some significant differences may help you choose the best path for your medical career. So, how is a DO different from an MD? The fundamental difference is the philosophy behind each approach.
Before we determine the differences of a DO versus an MD, let’s take a moment to define each.
Physicians who earn the MD credential attend an allopathic school. An allopathic school is a conventional medical school. It’s what most people associate with becoming a physician.
A doctor of medicine attends a four-year medical school where they earn their MD. After completing their school's program, allopathic students match into a residency, where they will train in their specialty of choice.
Medical students who attend an osteopathic school of medicine become physicians and are awarded a DO credential. Osteopathic medicine may be more unfamiliar than the allopathic path. But DO students will end up working in the same places as those who attended MD programs.
Like allopathic students, DOs complete their medical school program and match into a residency program. They can choose from a variety of specialties and will attend residency alongside MD graduates.
As mentioned above, the fundamental difference in the DO vs. MD battle is philosophy. MDs use symptoms to develop a diagnosis and an appropriate treatment plan via conventional methods. DOs also master the ability to diagnose and treat symptoms. But they undergo additional training in manipulative techniques and take a more holistic approach to medicine.
Allopathy is the foundation of the MD philosophy. This term refers to science-based medicine. The treatments allopathic physicians implement include standard methods, such as prescribing drugs or administering X-rays.
Physicians who follow these practices focus on symptoms displayed by the body. They will rely on medicine and scientifically based treatments to reverse the body's symptoms.
The DO philosophy contemplates all aspects of a patient rather than symptoms alone. Physicians who study this philosophy learn to consider the body's ability to heal and regulate itself. While these physicians are knowledgeable in conventional medicine, they also use hands-on, manipulative techniques to aid the body’s healing process.
DOs and MDs will each learn about conventional medicine. Only DOs will learn the manipulative techniques to aid healing and the holistic conception of osteopathic medicine. This extra component means they will attend two different school types before uniting in residency.
Osteopathic and allopathic schools have separate application systems. Once you have decided which philosophy you want to pursue, you will use the respective application to apply.
Future DOs will apply to medical school using a system provided by the American Association of Colleges of Osteopathic Medicine Application Service (AACOMAS). Students will need to fulfill the required prerequisite courses and extracurricular activities for their application.
Prerequisites vary from school to school. Some schools require a certain number of upper-level biology courses rather than the traditionally required courses alone. Pre-med majors will typically fulfill the prerequisites needed for both DO and MD medical schools.
Letters of recommendation are required to accompany your application. As is the case with prerequisites, the number of letters you need will vary from school to school. Also, some osteopathic schools will specifically require at least one letter from a doctor of osteopathic medicine.
Be sure to connect with osteopathic physicians to fulfill this requirement before you begin your application process. Do not address the need for a DO recommendation at the last minute. Give them the courtesy of time and the ability to prepare a strong letter for you.
You want the letter to be written by someone who will vouch for your connection to the osteopathic medical philosophy. Currently, you can submit up to six letters to AACOMAS. They recommend sending any additional letters directly to prospective programs.
The DO application has four sections made up of several smaller subsections. AACOMAS tracks your progress through each section. The categories are as follows:
Students choosing the allopathic route will apply using the American Medical College Application Service (AMCAS). AMCAS differs from AACOMAS in its display, but it requires much of the same information. Again, prerequisite courses will vary from school to school.
A difference here is that AACOMAS requires you to match prerequisites to schools one by one, in addition to verifying your transcripts before use. The AMCAS system will also verify your transcripts, but you need to satisfy the specific requirements of your school of choice. You can view these elements by visiting the school's website or the Medical School Admission Requirements (MSAR) system provided by the AAMC.
You may find the AMCAS application helpful when it comes to extracurricular experiences. The system gives you the ability to determine your “most meaningful” experiences, meaning clinical or volunteer experiences. Marking an experience as “most meaningful” allows you to write in more detail about multiple experiences and why they are meaningful to you.
An additional application difference to consider is that AMCAS encourages targeted letters. You can upload up to 10 letters, and you must match them to each school. You are not required to submit targeted letters. But if you are determined to attend a particular school, including a targeted letter can strengthen your application.
Both applications come with significant fees. AMCAS charges a processing fee, which includes submission to one school. Additional programs can be added, but each program included on your application will incur a fee after the first school. AACOMAS uses a similar fee structure. The AACOM and AAMC each have fee assistance options in place.
Osteopathic and allopathic medical schools give students an equally thorough education in medicine's basic principles. Because students will learn the same foundations for their medical training, general prerequisite courses to enroll in each school type are similar.
Allopathic students do not receive the training in manipulative techniques that osteopathic students receive. Although always based on conventional medicine, the allopathic curriculum content will vary slightly from school to school. Both allopathic and osteopathic students can look forward to a robust, challenging curriculum.
According to the AACOM, osteopathic students are to spend approximately 200 hours or more learning osteopathic manipulative medicine. Skills acquired during this training will allow students to treat and diagnose symptoms using their hands and conventional means. Allopathic students study how to diagnose and treat symptoms using medicine rather than their hands.
According to the AACOM, the average first-year tuition and fees of an osteopathic program are $55,455 for out-of-state applicants and $51,811 for in-state candidates. For allopathic programs, the AAMC reports that a first-year student’s tuition and students fees are as follows on average:
Both programs will also incur costs beyond their tuition despite the difference between the DO vs. MD school learning experiences. For example, the University of New England notes that, aside from the $62,580 of “Total Direct Costs” for its DO program, you should expect to pay additional “Indirect Costs.” For your first year of study, the school estimates you’ll spend around:
Unsurprisingly, the practice, lifestyle, and residency experiences of DOs and MDs have similarities and differences, so let’s explore each of them.
The practice and lifestyle of DO and MD physicians are similar. DOs may rely on their additional training when conventional medicine techniques do not completely resolve symptoms. MDs will use their allopathic studies and experiences in their practices.
Allopathic and osteopathic physicians enter the workforce with the same clinical medical knowledge but different approaches. Osteopathic students train with great emphasis placed on analyzing the whole patient rather than the symptoms alone. They may take more time learning about their patients’ lifestyle and health-impacting habits.
Allopathic physicians also receive training that teaches them to consider multiple elements of their patients’ health. But their focus will be on symptoms and narrowing down diagnoses based on symptoms present during a patient's visit.
Both DOs and MDs can practice medicine to the fullest extent as licensed physicians. Formerly, DOs and MDs applied to residency through two different systems. These systems were the American Osteopathic Association (AOA) and the Accreditation Council for Graduate Medical Education (ACGME).
The ACGME accepted MD and DO students but did not streamline the process for DO applicants. The AOA was specifically for osteopathic residencies. Using two different systems created challenges.
First, osteopathic students had to submit two separate applications because they applied to the AOA and ACGME separately. Second, osteopathic students were previously presented differently from allopathic students in the ACGME applicant pool. Fortunately, the residency application has merged, and students are reviewed more uniformly.
Another issue osteopathic students faced was the having different board exams. The COMLEX exam is part of the osteopathic graduation process. The USMLE is part of the allopathic graduation process. Previously, the ACGME did not officially recognize the COMLEX board exam as an equal alternative to the USMLE board exam.
In recent years, the ACGME has acknowledged the COMLEX board exam as equivalent to the USMLE. This acknowledgment is good news for osteopathic students who previously had to take both exams if they wanted to enter an ACGME residency program. Many residency programs are now accepting of the COMLEX exam.
Keep in mind that some programs still require the USMLE, despite the merger and equality declaration. This preference for the USMLE in some programs does not reflect on licensure. Like the USMLE, the COMLEX boards are valid in all U.S. states.
It may be necessary to take both board exams to be as competitive as possible for specific programs. You will have an advisor who can help you decide whether taking both boards is appropriate to be competitive in your specialty of choice. Medical students in both school types will apply to residency through the ACGME.
Students will be able to partake in the National Residency Match Program’s match process, known as “The Match.” Exciting yet frightening, Match Day is a rite of passage for many graduating medical students. Now, all medical students can partake in the fear and splendor of Match Day equally.
DOs and MDs can choose from the same specialties. You will find them working in roles as primary care physicians, dermatologists, and surgeons. They are equally qualified to administer medications, order follow-up tests, make diagnoses, and treat ailments.
DOs and MDs have equal responsibilities and decision-making power. Each physician type obtains full licensure. Whether you choose to become a DO or MD, you will have the entire experience of the physician lifestyle.
Both MDs and DOs have fantastic career outlooks and salaries, but several key differences exist between the two paths.
According to the Bureau of Labor and Statistics, physicians' projected career outlook is the same as any other occupation. The demand for physicians is expected to grow three percent over the next several years.
Physicians' employment opportunities may be more generous in certain areas, such as rural communities that are medically underserved. As the population grows older and experiences the health effects of advanced age, the need for physicians is expected to increase.
The main factor in career prospects for medical school graduates is matching into a residency program. The residency merger's benefit for DO applicants was proven in its introductory year, with the highest DO match rate reported since 1992. The post-merge match rate for MD applicants remained within the average range.
According to the NRMP, the match rate for PGY-1, postgraduate year or first year of residency, positions was 90.7 percent for DO seniors and 93.7 percent for MD seniors. Those who do not fully match can undergo a process called SOAP. The SOAP process places unmatched students into unfilled programs.
Is there a DO vs. MD salary difference?
The salary for DO and MD physicians will not differ due to their credentials. Physician salaries will only vary based on specialty. For example, pediatrics tends to earn less than other specialties, with a reported average annual income of $232,000. Orthopedics is often paid a higher salary, with an average of $511,000 annually.
Keep in mind that higher-salary specialties will be more challenging to enter and often require an extended residency in addition to possible fellowships. For example, general pediatrics residencies are typically three years. Orthopedics residencies are, on average, five years.
Regardless of DO vs. MD pay, finances should not be the driving force when working in care-focused roles. It is natural to be curious about the financial soundness of your decision to spend years amassing debt rather than working. But you must carry out your medical responsibilities with patient care at the center of all you do.
Picking your healthcare route is one of the most important decisions you'll ever make in your life. Your medical school route will shape you as a physician in various ways. It is critical that you make your decision based on which path resonates with you most.
Neither path is necessarily better than the other; institutions have effectively equalized allopathic and osteopathic schools. Your decision comes down to a few considerations.
If you view health as vastly interconnected with lifestyle and would like to get to the root of a problem, DO school may be right for you. Understanding the cause of symptoms is one of the goals of osteopathic medical training.
If you believe you would like to use symptoms to chisel down to a diagnosis, then an MD school may be right for you. Allopathic medical training will teach you to offset exhibited symptoms using medicines and conventional therapies. You may ultimately discuss lifestyle changes, but you may not be trained to innately emphasize that aspect when speaking with patients.
While most residency programs accept the COMLEX, a few may still require you to take the USMLE to be competitive. So, you may have to sit two board exams. If you choose the DO route, you will be obligated to take the COMLEX to graduate from your program.
Allopathic students do have a marginally higher match rate. This difference may continue to decrease each year. Still, the 3 percent match difference is something to be aware of, especially if you hope to enter a highly specialized residency program. These residencies will generally be challenging to enter.
We’ve outlined several questions and answers to help you further understand what a DO is versus an MD.
1. Is it easier to become a DO than an MD?
The average MCAT score for students accepted into an osteopathic medicine program is 503.83, based on the most recent matriculant profile reported by AACOM. The average MCAT is 511.5 for an allopathic medicine matriculant, according to the AAMC.
If you are viewing the level of ease solely from an MCAT standpoint, attending a DO school may appear more manageable. Keep in mind that many factors, like GPA requirements, go into acceptance at both medical school styles.
2. Will COMLEX become a pass/fail like USMLE?
Current projections of Step 1 of the COMLEX determine it will go to a pass/fail structure, just as USMLE Step 1. This new structure means it may be beneficial to have a Step 2 COMLEX score to show competitiveness in the future.
The same logic applies to those taking USMLE Step 1 who want to appear competitive among their peers, as it is now a pass-or-fail score.
3. Is COMLEX harder than USMLE?
The material is similar for COMLEX and USMLE, except COMLEX incorporates topics related to OMM training. The COMLEX has more questions and different timing for breaks.
4. Can I learn osteopathic manipulative techniques (OMT) if I choose an MD school?
Yes. MDs interested in learning OMT may join an ACGME residency program awarded osteopathic recognition. Some osteopathic schools may also provide continuing medical education courses that offer training in OMT.
5. Can DOs become surgeons?
Yes, DOs can become surgeons of all types, including plastic surgeons and orthopedic surgeons. Remember — these positions will take hard work, extraordinary effort, and dedication to match into, no matter which credentials you obtain.
6. Will people know if I am a DO instead of an MD?
Typically, your patients will not notice whether you are a DO or an MD.
To most patients, you will be a physician. A difference is not likely to be perceived unless you make them aware or they see your DO credential printed somewhere. You will be addressed by those you work with as "Doctor." A difference in care provided by DOs and MDs will be challenging to detect unless you are using OMM.
7. Do DOs take the USMLE?
DOs don’t have to take the USMLE. But you may need to sit it to be competitive for certain residency programs.
8. Is there a difference in the prestige of a DO vs. MD?
In terms of prestige, a DO vs. MD is effectively equal; both occupations are highly respected, supported by in-depth training, and have a fantastic career outlook. But one thing to note is that some countries do not recognize the DO qualification as equivalent to the MD.
Neither an MD nor a DO is better than the other; both professional tracks treat patients, save lives, and have brilliant career prospects. Of course, there are many differences between a DO vs. MD, but there are also many similarities.
Your decision to attend medical school vs. osteopathic school depends on your preferred approach to healthcare. Although each occupation takes a different approach to help people, both occupations study conventional medicine.
While certain residency programs favor MDs over DOs, both occupations are in demand and are expected to grow. Additionally, both occupations can practice in all 50 U.S. states and perform in every specialty.
There are many reasons to choose osteopathic medicine and allopathic medicine. In the end, though, the choice is yours.