DO vs MD for Premeds

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Should we even have a DO degree?

Spoiler

At the end of the day, when you walk into the patient room, and close the door, you are a physician. It does not matter what letters are after your name. All your patient cares about is if you care about them.

Definition

M.D.s practice allopathic medicine, the classical form of medicine, focused on the diagnosis and treatment of human diseases.

D.O.s practice osteopathic medicine which is centered around a more holistic view of medicine in which the focus is on seeing the patient as a “whole person” to reach a diagnosis, rather than treating the symptoms alone.

The belief is that all parts of the body work together and influence each other.  Osteopathic medicine also places emphasis on the prevention of disease.  In medical school, there is specific training on osteopathic manipulative treatment (OMT), a hands-on approach to diagnosis and treatment as well as disease prevention.

There are approximately 800,000 practicing physicians in the United States today; roughly 50,000 of whom are D.O.s, while M.D.s make up the remaining 750,000.  D.O.s therefore make up less than 10% of practicing physicians in the USA today.

Does the difference between M.D. and D.O. degrees matter?  The information below will help you make a more informed decision about what medical school you wish to attend.

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History

M.D.

The practice of medicine dates back to the early 1600’s at which time medical practice was divided into 3 groups: physicians, surgeons, and apothecaries.  When university-trained physicians from England came to the USA, their physicians were expected to perform surgery and prepare medications.  As such, the 3 groups dissolved into a common group of physicians and surgeons.

The first medical societies were developed in the mid-1700’s and began regulating medical practice by 1760.  They created the first medical college known as the medical college of the Medical Society of the County of New York on March 12, 1807.

The American Medical Association was founded in May 1845 and began creating educational standards for the degree of Doctor of Medicine.  The AMA devised a 3-year curriculum including two 6-month lecture sessions, a 3-month dissection laboratory, and a 6-month session of “hospital attendance”.

Dr. William Osler created the first medical residency, and by 1930, M.D.s were required to complete a 1-year internship following completion of medical school. M.D. programs continued to evolve over the years into the current 4-year degree program, currently offered at 137 medical schools in the USA today.  There are also 17 Canadian medical schools which have an M.D. program today.[1]

D.O.

Osteopathic medicine was developed by Dr. Andrew Taylor Still in 1874, founded on the philosophy that all bodily systems are interrelated and depend on each other.  Dr. Still opened the first school of osteopathic medicine in Kirksville, Missouri in 1892.

Because of the philosophy of osteopathic medicine, D.O. programs tend to produce physicians who go on to practice in primary care.  Today, 60% of practicing D.O. physicians work in Family Medicine, Internal Medicine, Pediatrics and Obstetrics and Gynecology.[2][3]

Breakdown of Training: Medical School and Residency

M.D.

  • 137 M.D. programs in the USA; 17 M.D. programs in Canada (check out the LCME for updated list of programs trying to gain accreditation)
  • 4 year college degree required prior to medical school with prerequisite courses (physics, bio, general chem, organic chem, English)
  • 4 year medical school program
  • Applicants use the AMCAS application to apply (includes college transcript, MCAT, personal statement, supplementary application materials for most schools)
  • Many programs also offer M.D./PhD and M.D./MPH degrees and other dual degree programs
  • Graduates enter the National Residency Match Program (NRMP) and go on to residencies in any specialty of medicine
  • Must pass the USMLE to obtain a medical license

D.O

  • 30 D.O. programs in the USA offering 42 locations in 28 states (as of 1 Jan 2015)
  • 4 year college degree required prior to medical school with prerequisite courses (physics, bio, general chem, organic chem, English)
  • 4 year medical school program
  • Applicants use the AACOMAS application to apply (includes college transcript, MCAT®, personal statement regarding reason for wanting to be a D.O., and a letter of recommendation from a practicing D.O.)
  • Osteopathic medical schools seem to primarily be partnered with medical facilities and medical offices in the community, such that students often have to travel more for their clinical rotations. While some M.D. schools are like this as well, it is more common for osteopathic schools.
  • Few programs offer D.O./PhD degrees
  • Graduates go on to residencies in any specialty of medicine; there are more than 500 osteopathic residency programs, but graduates can also enter the NRMP (7.1% of NRMP applicants in 2011 were students/graduates of osteopathic medical schools)[4]
  • D.O.s must pass the COMLEX to obtain a medical license

Reputation: D.O. vs M.D.

Osteopathic medical schools have historically been considered to be less competitive than allopathic medical schools.  In 2010, the average MCAT score of students matriculating into osteopathic medical schools was 26.48[5], vs 31.1[6] for students matriculating into allopathic medical schools.  It may be that osteopathic medical schools continue to attract less competitive applicants based on admissions from previous years, thereby perpetuating the reputation.

D.O. programs are thought to focus more on the “whole candidate” rather than grades and MCAT scores, often making their programs more attractive to older students who have had other careers prior to their medical school training.

In 2012, the acceptance rate is actually less for osteopathic medical school then for allopathic medical school. Yes – it was statistically easier to get into M.D. school!

When applying to residency programs, M.D. applicants are often considered to be more competitive than D.O. applicants.  If you are a 4th-year student in a D.O. program and you want to complete an allopathic residency, your chances of matching are approximately 70% compared to about 95% for 4th-year students in M.D. programs[7].

As was previously stated, it is now typically harder to get into an osteopathic school, than an allopathic school. So why does the reputation continue to be perpetuated? It mostly has to do with stats. As stated previously, DO schools have done a much better job at looking at the whole applicant. Don’t let peoples perceived competitiveness of your program limit where you want to apply!

Salaries: D.O. vs M.D.

All things being equal, salaries between a D.O. and an M.D. are comparable.  This assumes same position, years of service and other experience.  The biggest determining factor in how much a physician makes is his/her field of specialty.  Compared to M.D.s, D.O.s  often go into primary care which is not as well compensated as many specialties.  M.D.s are also more commonly in practice in busy urban areas where costs of living, and thus salaries, may be higher.

QUICK BULLETS:

  • Both M.D. and D.O. schools are 4 year degrees with similar basic curricula
  • 137 M.D. schools vs 26 D.O. schools in the USA
  • D.O. matriculants tend to have lower MCAT® score on average compared to M.D. matriculants (26.12 vs 30.9)
  • D.O. graduates and seniors who apply to the NRMP match about 70% of the time.  M.D. seniors match at a rate of about 95%
  • Similar salaries across similar specialties

Where Can You Work?

Historically, there has been a difference between where M.D.’s and D.O.’s could practice. The M.D. degree has been recognized everywhere, but the D.O. degree, having been born in the U.S. has been limited. With some hard work though, the A.O.A. seems to be making good headway with that! Check out this map:

http://www.osteopathic.org/inside-aoa/development/international-osteopathic-medicine/Pages/international-practice-rights-map.aspx

http://www.osteopathic.org/inside-aoa/development/international-osteopathic-medicine/Pages/international-practice-rights-map.aspx

My Story

When I initially thought about what kind of medical school I wanted to attend, I was leaning towards going to an osteopathic medical school.  I was studying exercise physiology at the time.  I was also working and completing an externship for school at a gym as a personal trainer.  When reviewing the difference between M.D. and D.O. schools, I liked some of the philosophies and teachings of Osteopathic medicine.  Ultimately I chose to only apply to allopathic med schools because at that time I was certain I wanted to be an orthopedic surgeon.  As you can see above with match rates, an osteopathic applicant to an allopathic residency has a much harder time matching.  Yes there are osteopathic residencies, but the numbers are very slim compared to allopathic.  So while I do still lean towards some osteopathic thinking today, I chose to have the numbers on my side and apply to allopathic medical schools.  In the end did it matter?  Yes and No.  Yes, because I met my wife in medical school.  No, because I’m working as a flight surgeon in the Air Force and loving my job!

References

1. http://www.nlm.nih.gov/medlineplus/ency/article/001936.htm  – Retrieved 2012 Mar 01
2. http://www.aacom.org/about/osteomed/Pages/History.aspx – Retrieved 2012 Mar 01
3. http://www.osteopathic.org/osteopathic-health/about-dos/what-is-a-do/Pages/default.aspx – Retrieved 2012 Mar 01
4. http://www.nrmp.org/data/chartingoutcomes2011.pdf – Retrieved 2012 Mar 01
5. http://www.aacom.org/data/applicantsmatriculants/Documents/2010Matriculantsummary.pdf – Retrieved 2012 Mar 03
6. https://www.aamc.org/download/161690/data/table17.pdf – Retrieved 2012 Mar 01
7.http://www.nrmp.org/data/resultsanddata2011.pdf – Retrieved 2012 Mar 03

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  • datsa

    Several other factors to mention and/or consider:
    1. Average GPA for osteopathic (DO) medical schools is lower than that for allopathic medical schools in the United States.
    2. DO schools tend to look more favorably on older applicants, and repeat applicants. Some allopathic medical schools will not accept applicants over certain ages (yes, I asked) while most DO schools had no such age limitations.
    3. Some very competitive residencies, including some dual residencies, will only take top MD applicants, and not DO applicants, and they often state that.
    4. Some fellowships are not open to DO.
    5. DO is a uniquely U.S.-based medical degree, and some foreign countries do not recognize it as being the equivalent to MD, although this perception is slowly changing and new DO opportunities are opening up.
    6. Much of the general U.S. public are unaware of DOs, and may not understand who they are and what they can do. The distribution of DOs is uneven throughout the U.S.; states with DO medical schools tend to have higher numbers of DOs in practice.
    7. Most DO medical schools are private, but at least two, the University of Oklahoma and Michigan State University, are public.
    7. Most, if not all, foreign medical schools also grant MDs. Many foreign medical graduates (FMGs) who apply for U.S.-based residencies have considerably lower chances at matching than DOs for the same spots.

    • http://www.medicalschoolhq.net/author/Ryan Ryan Gray, MD

      Those are all good points. Thank you for contributing.

      • datsa

        I came to this site from OldPreMeds.

        • http://www.medicalschoolhq.net/author/Ryan Ryan Gray, MD

          I noticed you over there as well! I just came across that forum yesterday and think it’s great!

    • Correction

      Correction on # 7.
      UNTHSC University of North Texas Health Science Center, a public osteopathic medical school.
      Makes it three.

      • http://www.medicalschoolhq.net/ Ryan Gray, MD

        Thanks for the update!

    • Kioh

      ^^slight correction:
      University of Oklahoma has an MD program, while Oklahoma State University is the one with the DO program.

  • Jean

    I’m a DO student who recently finished a pediatrics rotation in Oklahoma, and just wanted to straighten out that it is Oklahoma State University, and not University of Oklahoma, that has an osteopathic medical school. University of Oklahoma is allopathic.

    • http://www.medicalschoolhq.net/author/Ryan Ryan Gray, MD

      Good catch Jean – I didn’t see that in datsa original comment.

  • Matt

    “I chose to have the numbers on my side and apply to allopathic medical schools. In the end, did it matter?”

    It would seem it did matter, because you did not receive the training in the osteopathic philosophy nor in training in OMT that a osteopathic physician would.

    • http://www.medicalschoolhq.net/author/Ryan Ryan Gray, MD

      True, I do not have that specific training. I do work side by side with a DO who does the OMT! At some point I will try to read some or attend a conference about OMT to see if there are things I can/should try to incorporate.

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  • norma fay

    Personally, I chose to look into foreign
    medical

    schools rather than go with a DO. I am now at UMHS St. Kitts. I think there program really prepares us for the future and will help me get the career I want. I don’t think a DO would do as well for me.

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  • Haley Jo

    Did you do hpsp or ushus? I’m enlisted AF and thinking about going that route. What’s your opinion on those programs?

  • Adrienne0711

    Very helpful article. I am getting a basic plaque test and looking at the staff noticing more D.O. than M D.s at NKC Hospital. I’ve never seen a D.O. and my false assumption was that they had inferior education and training. Hopefully I won’t need either but with my genetics my best guess is that I probably will. Thanks for the information! I’m feeling completely confident with either type of Doctor.

    • http://www.medicalschoolhq.net/ Ryan Gray, MD

      I’m glad it helped! Good luck w/ your tests!

  • gthomson

    While this is an old thread, I thought I’d ask anyway…
    I’m 51, and didn’t have any regular doc for 25 years.
    I had never heard of DO before, so it wasn’t a piece of the criteria in finding a primary care doc for me.
    But I found my doc, an MD, and there are three DO’s at the same medical group.
    And I think my doc is more of a DO than an MD based on the way he goes about things so far – focused on the whole person, not just fixing the symptoms.
    What I’m curious about…
    I’ve heard MD’s only get a single class in nutrition while in school.
    Is that true?
    And does the DO curriculum include more education on nutrition as a way to prevent problems?

    • http://www.medicalschoolhq.net/ Ryan Gray, MD

      I don’t think I had any nutrition classes during med school. It unfortunately is a huge tragedy that it’s not emphasized in most curricula. I don’t think it’s an MD/DO thing, just that there is too much other stuff to teach, and not enough time.

      One of the biggest “myths” out there is that DOs treat holistically and MDs do not. All good physicians, whether they are MDs or DOs will look at the whole patient, and treat accordingly!

  • Lynn Gordon

    Hi! Question: I have always been told that D.O.’s are academically and intellectually inferior to M.D.’s. That the “degree” requires less school time and “if you can’t be a doctor, be a D.O.” Currently, I am seeing a Naturopathic doctor that I respect considerably and have found her to be “head-and-shoulders” above ANY of the M.D.’s I’ve had to deal with for the last 30 years! I am a real, whole person and treated with respect, care and compassion and am not having more pills shoved at me in the allotted 15 minute time slot I have been crammed into. The question is, how did the bad rap get stamped on D.O.’s and why can’t M.D.’s be more concerned with treating the whole person rather than making us feel like we just intruded in their life and time to contribute to their bank account? Doesn’t make any sense. In all 30 years of being a patient I have only known, with great pleasure, one doctor who who called us to say he was leaving the practice to move to a small town somewhere in the Rocky Mountains to become the “REAL” doctor he had invested so much of his time and money to become! He was very much saddened by being “forced” to keep time with his patients to 15 minutes or less, feeling like a legal “drug dealer”, and not being able to develop real, personal working relationships with his patients. The last thing he said was , “I want to be a REAL doctor; like the good, old country doctors used to be. THAT is why I became one in the first place!” He was the only doctor I have known, until now with my Naturopath, that I have respected.” It is unfortunate that the “heart” and “art” of being a well-loved and respected community doctor has suffered to the point of near-exstinction. Is it possible that they will EVER come back from the brink?
    h

  • BA

    More applications into the DO spots does not equal more competitive. More less qualified applicants does not imply more competitive. I was accepted into every DO school I applied and only 2 MD programs. There is a reason for that. That does not mean DO is lesser, you just cant say it is more competitive and be accurate.

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