DO vs MD: Which is better in July 2020?

Updated: July 14, 2020

If you are trying to figure out the difference between an allopathic (MD) and osteopathic (DO) degree – you've come to the right place! In this blog, you will learn the main differences between osteopathic and allopathic medicine including the educational training, application process, admission requirements, salary, career opportunities and so much more. Finally, this blog will answer any other questions you may have about DO vs MD degrees.

Here's What You'll Learn:

The Main Differences

Application Process

Admission Requirements

Medical School Curriculum

Interviews

Graduate Medical Education and Residency Matching

Licensing

Tuition

Salary

Conclusion

FAQs

The Main Differences

Arguably, the main difference between DO vs MD programs is the philosophy behind their approach to medicine. MD programs, or allopathic medical programs, are rooted in the German model of medical education and emphasize evidence-based evaluation of the patients. This is what we have come to know as “Western medicine”. Osteopathic medicine is a science-based discipline that focuses on the whole person, rather than a collection of body parts that may become injured or diseased. DO programs, or osteopathic medical training, teaches that the whole person is greater than the sum of his or her parts. Osteopathic medicine emphasizes the examination and understanding of the patient and although osteopathic medicine has gone through many changes since its beginnings, it maintains its core values. The distinguishing philosophy of osteopathy and its practice is to provide care that is holistic, mainly preventative, and focused on health rather than disease, delivered within a primary care context.

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Main tenets of osteopathic medicine:

1. The body is a unit. A person is a unity of body, mind, and spirit.

2. The body is capable of self-healing, self-regulation, and health maintenance.

3. Structure and function are reciprocally interrelated.

4. Rational treatment is based upon an understanding of the basic principles of body unity, self-regulation, and the interrelationship of structure and function.

According to these tenets, DO physicians tend to choose primary care specialties, such as family medicine, pediatrics and internal medicine since they allow for a more holistic approach to patient treatment. While MD physicians also go into these exact same specialties, MDs are more represented in focused specialties like dermatology or orthopedics. This does not mean that DOs cannot pursue these specialties, but primary care is a more common route for DO graduates.

Application Process

Most American allopathic medical programs participate in the AMCAS service. It is a centralized application service through which most students apply to medical schools across the United States. Osteopathic medical schools have their own centralized application system, AACOMAS, which simplifies the process of applying to the DO schools.

The AMCAS application cycle starts in May and ends in January of the following year. The AACOMAS application cycle opens in May and closes in April of the following year. Each college has its own application deadlines so make sure to confirm with your school of choice.

Admission Requirements

MD

Overall average GPA of matriculants: 3.73

Average MCAT score of matriculants: 511.5

DO

Overall average GPA of matriculants: 3.56

Average MCAT score of matriculants: 503.83

Both MD and DO applicants must have a Bachelor’s degree, or at least meet the required minimum of undergraduate coursework set by each medical school. Some applicants have also completed master’s or doctoral degrees at the time of application.

Many MD and DO programs have general medical school prerequisites, but the specific course requirements vary from school to school. Generally, both MD and DO programs require experience in the following:

  • One year of biology
  • One year of physics
  • Two years of organic chemistry with lab

AACOM programs’ handbook also specifies that one year of English composition is preferred.

Each medical program may have specific prerequisite requirements. Please check each program’s course requirements before you apply.

Clinical Experience

Just like MD programs, DO programs encourage their applicants to learn more about medical practice by gaining clinical experience. For some colleges, clinical experience is a definite requirement, while for some it is merely a suggestion, although getting accepted without any clinical experience is almost impossible. Working and volunteering in the medical field will expose you to the medical profession and allow you to gain skills in patient interaction. Applicants will have real experience seeing the nuances of medical practice, which can later help in medical school. To gain the necessary work and volunteer experiences, contact your local hospitals and clinics, as well as nursing homes and hospices. These types of working environments will expose you to patient interaction, teach you important skills like communication and empathy, and the knowledge that you are comfortable in a hospital environment. Working and volunteering in the medical field will also build up your medical school application. You will have plenty to speak about in your admissions interview if you get invited. Volunteer and work experiences are opportunities to demonstrate to the admissions committee that you know what the medical profession demands. Participation in clinical experience also indicates your genuine interest and dedication to the medical vocation.

Shadowing experience

Shadowing of physicians is a well-known and commonplace practice. Both MD and DO applicants should gain substantial experience to strengthen their applications. If you’re not sure how much shadowing for medical school you need, check out our blog. To gain shadowing experience, you should reach out to either MD or DO physicians, respectively, during your undergraduate education. Do this as early as possible! You can find a physician through college admissions and alumni offices. When you contact them, explain that you are looking to shadow and learn more about the clinical aspect of medicine. If you are a DO applicant, make sure to shadow a DO and not just an MD.

You do not need to go far to search for a physician to shadow. Start by asking your own family doctor if they take on students. If not, see if they can recommend a doctor they know. To broaden your search, start by visiting the American Medical Association (AMA) or the American Osteopathic Association (AOA) websites. Typically, these websites provide lists of physicians you can potentially shadow and their contact information. While you’re on the web, try simply searching for your state’s allopathic and osteopathic associations. These organizations’ websites often post lists of their members interested in having shadowing students.

Once you find the doctor you want to shadow, send an email or call the physician. Do not be discouraged if you do not hear from them right away or if you do not get to talk directly with the physician. Shadowing can be arranged through office administration. Most physicians will be pleased to mentor you, so be sure to express your interest and enthusiasm for the profession when you contact them. This is a good opportunity to learn what a physician does and may help you decide whether you want to pursue medical education! Get some more tips on how to ask to shadow a doctor in our blog. 

Personal Qualities and Experiences

Both MD and DO programs look for applicants who can demonstrate the following qualities and experiences:

  • Academic excellence
  • Strong communication and interpersonal skills
  • Record of community service
  • Record of leadership
  • Clinical experience
  • Shadowing experience
  • Participation in a variety of extracurricular activities
  • Motivation and resilience

If you would like to learn more about the qualities and competencies important in future physicians, make sure to familiarize yourself with AAMC’s core competencies and qualities of a successful DO student.

Personal Statement

As part of your MD or DO school application process you will be required to submit a personal statement either through AMCAS or AACOMAS systems. The length of personal letters for both programs is limited to 5300 characters including spaces. In both letters, you must demonstrate why you want to be a doctor, while supporting your statement with specific life events, work and volunteer experiences, and extracurriculars that solidified your commitment to medicine. The letter should also include your general plans and aspirations in the medical field. A personal statement must articulate and showcase your motivation to be a physician. Although DO and MD personal statements may seem similar, they will differ in content. Considering specifics of the theoretical approach and clinical practice between MD and DO physicians, you will need to carefully consider what personal experiences to include in your statement and how to write about them. Check out some AACOMAS personal statement examples to learn how to write an outstanding DO personal statement. If you need help in preparing your essay, review our blog for AMCAS personal statement tips and our blog with excellent medical school personal statement examples

Letters of Recommendation

Both programs require recommendation letters as part of their application process. The letters are submitted electronically through the AAMC for MD applicants and AACOMAS for DO applicants.

These letters must be written by recommenders who are ready to give you outstanding references. You do not want mediocre recommendation letters. To write strong recommendation letters, the author must know you well and be able to speak to your best qualities, strengths, and accomplishments. To help your referees, provide them with your transcripts, CV, personal statement, exam scores, and any other worthy achievements not included in your CV. You can find out everything you need to know about medical school recommendation letters from our blog.

There is a chance that your recommender may ask you to provide a draft of a recommendation letter. Take this opportunity and present your candidacy in the best possible light! Make sure to read our blog on how to write your own letter of recommendation to get some tips.

Medical School Curriculum

Osteopathic medical school curricula are similar to those in MD programs. Both programs take four years to complete. However, you must remember that each program varies by college. MD and DO programs provide training to prepare students for a variety of specialties such as family practice, internal medicine, pediatrics, obstetrics/gynecology, psychiatry, radiology, preventative medicine, public health, and surgery. Just like allopathic medical schools, osteopathic medical schools expose their students to early clinical contact. While the first two years focus on the biomedical and clinical sciences, the second two years focus on patient-oriented clinical training. Most MD and DO programs also allow time for elective courses.

Clinical education follows a distributive model in which students get to practice medicine in different health care settings. These include in-hospital experiences, as well as training in community hospitals and out-of-hospital ambulatory settings. Students in many DO programs are required to participate in community-based primary care rotations in rural or underserved areas. To get full information on each program's curriculum, be sure to check their webpages.

The most distinguishing element of osteopathic medical education is the inclusion of osteopathic manipulative medicine (OMM), a hands-on treatment that is used to diagnose and treat people in a primary or adjunctive way. This practice promises to enhance the overall health and holistic functioning of the human body. OMM education usually occurs in the first and second years of theoretical and skills courses and throughout clinical training. In conjunction with OMM, DO programs provide medical training in current and emerging theories and methods of medical treatment and diagnosis.

Both MD and DO programs divide their four-year programs into pre-clerkship training and clerkships. Each school has its own course schedule and preferences, but the majority of MD and DO programs emphasize the basic and clinical sciences in the early years of the four-year programs. The first two years of MD and DO programs focus on medical foundations, anatomy, professional competencies, and learning clinical skills that prepare students for the last two years of clerkships.

The table below represents a general guide to the disciplines and specialties that are covered by the osteopathic medical school curriculum .

1st Year

  • Anatomy
  • Physiology
  • Clinical skills
  • Radiology
  • Osteopathic Principles and Practices
  • Microbiology and Immunology
  • Neuroscience
  • Histology
  • Biochemistry
  • Pathology
  • Doctor/Patient Communication

2nd Year

  • Gerontology
  • Cardiology
  • Gastrointestinal System
  • Hematopoietic System
  • Osteopathic Principles and Practices
  • Pharmacology
  • Endocrinology
  • Psychiatry
  • Respiratory
  • Ethics and Jurisprudence
  • Family Medicine
  • Genitourinary System
  • Pediatrics/Growth and Development

3rd and 4th Years

  • Emergency Medicine
  • Family Medicine
  • Internal Medicine
  • Obstetrics and Gynecology
  • Osteopathic Principles and Practices
  • Pediatrics
  • Psychiatry and Behavioral Sciences
  • Surgery
  • Anesthesiology

  • Anesthesiology
  • Cardiology
  • Dermatology
  • Gastroenterology
  • Laboratory Medicine
  • Nephrology
  • Neurology
  • Oncology and Hematology
  • Orthopedics
  • Otorhinolaryngology
  • Pediatric Subspecialties
  • Public Health
  • Pulmonary Medicine
  • Radiology
  • Rural Medicine
  • Surgical Subspecialties
  • Urology

OMM

Aside from studying all the subjects expected of physicians, DOs must also master osteopathic manipulative medicine, a non-invasive set of skills that is a key component of DO education. Each student completes around 200 hours of OMM training. DOs claim this hands-on treatment alleviates pain, helps diagnosis, restores motion, supports the body's natural structure, and helps it function more efficiently. The osteopathic medical approach believes that structure influences function. A problem in one part of the body can affect the function of that area and other areas of the body. For example, a problem in the ankle can cause painful symptoms in the knee, hip, spine, or cause symptoms in other seemingly unrelated parts of the body. OMM helps relieve the symptoms and helps to improve the functions of the whole body.

Osteopathic medicine also promotes the idea that human bodies have innate abilities to heal themselves. Most OMM techniques aim to reduce invasive medical techniques and eliminate the impediments that prevent bodies to self-heal and function properly.

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Interviews

Both DO and MD medical school programs have rigorous interview processes. To be invited for an interview for either program is a significant achievement. The logistics of an interview will vary by college, but you can start to prepare by practicing common medical school interview questions. Try finding out what kind of interview format is used by your program of choice. These may include traditional interview, group interview, panel interview, hybrid interviews, and multiple mini interview. Check out our blog for lists of MMI questions and panel interview questions to get ready for your interview!

Be prepared to articulate your interest in the program by asking program-specific questions. Research and understand unique aspects of the program and relate them to you background and qualifications. Be sure to show your interviewer what you can bring to the programs’ medical school community.

Graduate Medical Education and Residency Matching

In the past, DO and MD students had separate graduate medical education accreditation systems. This kind of split also helped to propagate the rivalry between DO and MD degrees. Today, a unified GME accreditation system is available to all medical school graduates under the Accreditation Council for Graduate Medical Education (ACGME). Graduate programs previously accredited by the AOA (American Osteopathic Association) are now accredited by ACGME, which levels the playing field between DO and MD graduates. This unified GME accreditation system makes the application and participation process for DO graduates much easier than before. It gives osteopathic graduates opportunity to be in many of the same programs as MDs. In this system, osteopathic medical graduates have the opportunity to pursue ACGME programs with osteopathic emphasis or programs with “Osteopathic Recognition” designation. Any ACGME program can apply for osteopathic recognition. These programs, which may be not osteopathic in their core, will be recognized as incorporating osteopathic principles and practices. Osteopathic Recognition is conferred upon a program, rather than its graduates. The program is required to formally designate which residents will receive a formal osteopathic education. It may choose to designate all or a portion of the residents as osteopaths, based in the graduates’ interests and the ability to meet established matriculation requirements. So, the Osteopathic Recognition requirements will be only applied to designated residents. If MD residents choose to enter the ACGME-accredited osteopathic program, they may be required to satisfy additional prerequisite requirements. Prerequisite criteria may differ by program.

Most DO and MD graduates focus on one field of practice in their graduate education. Due to osteopathic medicine’s whole-person approach, the majority of DOs choose to practice medicine in the primary care specialties like family medicine, general internal medicine, and pediatrics. However, DO graduates practice a variety of medical specialists including geriatrics, sports medicine, and trauma surgery.

Allopathic and osteopathic graduates have the following options:

1. Residency (Categorical): a “categorical” residency position offers full residency training required for board certification in that specialty.

2. Preliminary: Once MD or DO graduates choose a specialty, they may be required to do a year of preliminary work. The preliminary program is a first-year program that may be separate or related to the specialty training you will pursue.

3. Transitional year: This graduate option offers a multitude of clinical disciplines. It is designed to facilitate the choice of and preparation for a specific specialty.

4. Military GME: These programs are not much different from civilian GME. All specialties are represented. Joining the military will not limit your choice of specialties . Military graduate education programs may limit your choice of location. In Canada, if you apply as an active-duty military member to a GME be ready to have a limited choice of location.

5. Fellowship: MD and DO graduates may choose to pursue training that will further their knowledge in a particular specialty.

Residency Match

Both MD and DO graduates use the Electronic Residency Application Service (ERAS) to apply to their chosen residency programs. If you want to learn more about navigating ERAS’s application system, check out our blog. Elected applicants are invited to interviews, where their candidacy will be assessed by the Program Director, faculty, and other residents. The interview is also the applicants’ chance to examine the programs to which they applied. Based on the interviews, students submit a list of their choices, ranked from their first choice to last. Programs also rank the applicants. Based on these two lists, the residency match is made.

Residency matching is highly competitive for both MD and DO graduates. Osteopathic graduates have relatively high matching rates in GME programs; however they are much lower than MDs’ matching rates. According to the NRMP Main Residency Match, DO students experience lower success rates of matching compared to MD graduates for the majority of specialties. For example, even though DOs are competitive in primary care residencies where they have strong acceptance rates, they still have much lower acceptance rates than MDs. According to the latest statistics, in the state of New York, DO seniors matched 136 residency spots in internal medicine, while MD seniors matched 576 spots. The same trend can be observed in another primary care specialty, pediatrics. While 176 MDs matched in New York, only 44 DOs matched a residency in pediatrics.

In general, your qualifications such as exam scores, research experience, grades, letters of recommendation, your residency personal statement and the impression you make in the residency interview will have much more impact on your chance to match to a desired program than your degree. However, it is important to be aware of the current conditions for matching. As it stands, DO graduates tend to have lower match statistics and be represented in less medical specialties. If you need help to get ready for your residency interview, visit our blog to go through residency interview questions you absolutely need to know. 

Licensing

Just like their MD peers, DO graduates go through a rigorous licensing process to ensure a high caliber of their theoretical and practical knowledge. To become a licensed allopathic or osteopathic physician, you must:

  • Graduate from an accredited US college of medicine.
  • Successfully complete licensing examinations accepted by the state’s licensing board. MDs take the USMLE. DO students may be required to complete both the USMLE and COMLEX-USA exams to apply to some residency programs.
  • Successfully complete more than one year of graduate medical education.
  • Stay on top of medical developments related to your specialty through Continuing Medical Education (CME) programs. Participation in CMEs will provide ongoing education and retraining. As the medical field grows and develops new technologies and practices, you as a medical professional will need to improve your competencies. Each state has its own CME requirements.

Licensing Exams

United States Medical Licensure Examination (USLME)

The USMLE is the standard examination required for all US and international MD students to practice medicine in the United States. DO students and residents are also eligible to take this exam. The USMLE consists of the Step 1, Step 2 Clinical Knowledge and Clinical Skills, and Step 3. Check your residency program’s deadlines to see when you should schedule your USMLE exams.

Comprehensive Osteopathic Medical Licensure Exam (COMLEX-USA)

COMLEX-USA is the standardized test of osteopathic medical skills. The goal of this exam is to test the competency of students’ knowledge of osteopathic medical practice. This exam tests DOs’ theoretical knowledge and essential clinical skills. COMLEX-USA consists of standardized test questions and a pass/fail observed clinical examination performed by the student.

There are three COMLEX-USA components:

1. Level 1 is taken by the end of the second year of medical school before clerkship training.

2. Level 2 Cognitive Evaluation (CE) and Performance Evaluation (PE). Level 2 CE is taken during clerkship years before graduating from the osteopathic medical school. Level 2 PE tests physical examination skills and is also taken before graduation.

3. Level 3 is taken during graduate medical education.

Therefore, completing Levels 1 and 2 is required for graduation from the osteopathic school.

Important note: some MD residency programs may accept COMLEX-USA exam scores, but most will require DO students to also take the USMLE exam in addition to COMLEX-USA.

Tuition

DO vs MD tuition costs are comparable. The difference in cost mostly depends on your residency status (in-state or out-of-state) and whether the school is private or public. Visit our blog if you want to learn more about American and Canadian medical school tuition costs.

Private MD programs average tuition cost: in-state and out-of-state students pay north of $60,00 in tuition costs.

Public MD programs average tuition cost: in-state: $37,556 and $60,000 for out-of-state.

Private DO programs average tuition cost: in-state: $53,462 and $53,821 for out-of-state.

Public DO programs average tuition cost: in-state: $30,833 and $56,671 for out-of-state.

Salary

On average, there is a slight difference in salary between MD and DO physicians. Keep in mind that a doctor’s salary is heavily influenced by his or her specialty, i.e. radiology, plastic surgery, cardiology, and so on. With this said, MD practitioners do earn a slightly higher salary on average, simply because more MDs are qualified for higher-paid specialties compared with DOs.

Even though the majority of MDs end up in primary care specialties, MD graduates can earn higher salaries because they are more likely to go into highly competitive, lucrative specialties. DO graduates are not likely to do this. DOs tend to work in rural areas. They are less represented in specialties located in metropolitan areas, where the cost of living and average wages are much higher than in rural areas. DO vs MD initials do not influence the physician’s salary directly, but your choice in specialty and place of work do – as I discussed, your choice in specialty may be limited if you’re a DO.

Conclusion: DO vs MD degree - Which is Better?

The choice is entirely up to you. Your preference will largely depend on your philosophical approach to theoretical training and clinical practice. In today’s world, completing an MD degree is a more prestigious accomplishment. Out of two equal candidates with fitting credentials, MD graduates still have the upper hand over DOs in a job interview. DO degrees are often met with suspicion. Most people are less familiar with the DO curriculum and admission requirements. In reality, most people cannot tell the difference between MD and DO physicians’ treatment. As DO degrees gain popularity and their graduates grow in number, the stigma will likely dissolve.

It is important to remember that prestige is fleeting. Even if the current medical professional environment bestows more respect to MD degrees, that does not mean that your choice must be based on that seeming prestige. You must choose the path that is best suited to your worldview and your career aspirations. Do what makes you happy and be confident that you are doing the right thing. Ask yourself some important questions:

  • Do you agree with DO’s philosophical tenets? Do you believe that body, mind, and soul are a unit?
  • Do you think focusing on treating the physical body is not a sufficient approach to healthcare?
  • Do you believe OMM is an appropriate method of patient treatment? Can you see yourself working with your hands to physically manipulate the body?
  • Do you want to live and practice in an urban center or a rural area?

It is difficult to know what specialty you will want to practice when you are applying to medical school. Most students’ interests change as they learn, which is normal. But beware, that your choice between DO and MD should also depend on the specialty you wish to pursue. As previously discussed, your choices in specialties may be more limited if your graduate with a DO. Keep in mind that highly competitive specialties and residency programs will require DO applicants to complete USMLE in addition to COMLEX-USA.

FAQs

1. Are DO programs less competitive than MD programs? Is it easier to get in?

DO programs are less competitive. Firstly, the GPA and MCAT scores for DO admissions are much lower. While the acceptance rates for both DO and MD are around 40-41%, the number candidates for the MD programs is much higher and therefore there is more competition. Remember, DOs have lower matching rates for residency spots, even through the DO match rates have been increasing steadily over the last few years.

2. Can DO physicians write prescriptions?

Yes, they are licensed physicians who can write prescriptions and order tests, just like MDs can.

3. Can I change my mind and transfer from one program to another?

No, you cannot. You will need to reapply to your chosen program and school.

4. Does being a DO limit my choice in residency matching?

Osteopathic medical degree will limit your choice and chances of matching. Currently DO students have lower residency match rates than their MD counterparts. More MDs tend to go into non-primary care that DOs. For example, less DOs become surgeons, even though surgeons do perform a lot of primary care. Due to some requirements for the surgical specialty, MD are more equipped to enter this field.

5. If I’m a Canadian, can I get into a DO program?

Currently, there are no training programs for Doctor of Osteopathic Medicine in Canada. Canadian applicants are welcome to apply to DO programs in the United States. Canadian prerequisites are acceptable and do not need any verification. Your Canadian undergraduate university must simply send your transcript to AACOMAS.

6. As a Canadian, can I come back to Canada to practice medicine as a DO?

Generally, yes, you can practice medicine as a DO graduate in Canada. After you complete your DO degree and residency, you must apply through the Provincial or Territorial College of Medicine for medical practice. Each province has different regulations and requirements to obtain a medical license in that province. Be sure to check registration information to learn more. Some provinces will require a Medical Council of Canada examination (MCCQE), while others accept USMLE and COMLEX exams.

7. I am interested in research and academia, will a DO affect my ability to pursue this? Will having a DO hold me back?

No, it will not hold you back. In fact, research is one of AOA strategic priorities. The unified ACGME accreditation system calls for DO resident participation in scholarly activity on par with MD graduates. The need for evidence to support and promote osteopathic medicine has only grown. AOA is even providing its professionals with research initiatives.

8. Where can I learn more about DO programs?

Start by visiting DO programs’ websites. The Choose DO Explorer is a useful tool to find information about osteopathic medical schools. You can filter colleges by state, whether they are private or public, for profit or non-profit, and more criteria. If you get a chance, try visiting the program that interests you. Talk to current students and faculty, they may be able to answer most of your questions.

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BeMo Academic Consulting