MD vs DO – What are the Differences (and similarities)?

MD vs DO for premeds

Related Posts

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

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

DO’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 DO’s, while MD’s make up the remaining 750,000.  DO’s therefore make up less than 10% of practicing physicians in the USA today.

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

Related Podcasts




History

MD

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, MD’s were required to complete a 1-year internship following completion of medical school. MD 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 MD program today.[1]

DO

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, DO programs tend to produce physicians who go on to practice in primary care.  Today, 60% of practicing DO physicians work in Family Medicine, Internal Medicine, Pediatrics and Obstetrics and Gynecology.[2][3]

Breakdown of Training: Medical School and Residency

MD

  • 137 MD programs in the USA; 17 MD 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 MD/PhD and MD/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 DO 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 DO, and a letter of recommendation from a practicing DO)
  • 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 MD schools are like this as well, it is more common for osteopathic schools.
  • Few programs offer DO/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]
  • DO’s must pass the COMLEX to obtain a medical license

Reputation: MD vs DO

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.

DO 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 MD school!

When applying to residency programs, MD applicants are often considered to be more competitive than DO applicants.  If you are a 4th-year student in a DO 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 MD 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: MD vs DO

All things being equal, salaries between a DO and an MD 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 MD’s, DO’s  often go into primary care which is not as well compensated as many specialties.  MD’s are also more commonly in practice in busy urban areas where costs of living, and thus salaries, may be higher.

QUICK BULLETS:

  • Both MD and DO schools are 4 year degrees with similar basic curricula
  • 137 MD schools vs 26 DO schools in the USA
  • DO matriculants tend to have lower MCAT® score on average compared to MD matriculants (26.12 vs 30.9)
  • DO graduates and seniors who apply to the NRMP match about 70% of the time.  MD 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 MD’s and DO’s could practice. The MD degree has been recognized everywhere, but the DO 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 MD and DO 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

paperbackfront_245x245

DOWNLOAD FREE - Crush the MCAT with our MCAT Secrets eBook