If you’re trying to determine the difference between an MD and a DO, you almost certainly fit into one of two categories. You’re either a student considering a career in medicine or a patient wondering if a doctor with DO credentials is equally qualified to treat you as MD. Regardless of which category you fit in, this article will explain how D.O.’s differ from M.D.’s. But first, let’s quickly define a few terms.
What is an MD?
When most people think of a physician, they’re thinking of an M.D. – standing for Medical Doctor or Doctor of Medicine. MD’s practice a form of medicine called allopathic. James Whorton, the man credited with coining the phrase, explained that Doctors of Medicine [M.D.’s] use treatments that affect someone who’s ill differently than someone who’s healthy. For example, an antibiotic taken by someone without a bacterial infection would not improve his or her health.
Medical Doctors [MDs] in the United States attend medical schools accredited by the Liaison Committee on Medical Education [LCME].
What is a DO?
Short for Osteopathic Doctor, DO’s receive their medical degree from a U.S. osteopathic school. Unlike MD’s, a DO is accredited by the American Osteopathic Associate Commission within the Osteopathic College Accreditation [COCA].
D.O.’s are trained to have a more holistic approach to medicine and follow a medical philosophy called osteopathic medicine. DO’s are trained to consider a patient’s environment, nutrition, and body system as a whole when diagnosing and treating medical conditions.
For example, they’re required to take an additional 200 hours of training in osteopathic manipulative medicine – the practice of manipulating musculoskeletal tissue to relieve pain – versus an MD which would, in theory, suggest taking pain relievers.
Similarities between MD’s & DO’s
- Both MD and DO physicians base diagnosis and treatment recommendations on scientifically-proven conclusions.
- Attend 4 years of medical school, plus a residency program ranging from 3-7 years
- Are licensed by the same state licensing boards, i.e. both MDs and DOs must meet the same requirements to practice medicine
- Can practice medicine in all 50 states.
- Are found in every type of specialty medicine.
- Follow the same undergraduate academic path – a bachelor’s degree, Pre Med coursework, and taking the MCAT
Primary Differences between DOs & MDs
- Medical students attending osteopathic schools [DOs] must take an additional 200 hours of training learning manipulation techniques of the musckeloskeltial system.
- DO physicians tend to be primary care physicians, whereas U.S.M.D.’s tend to specialize in more specific types of medicine [Dermatology, Cardiology, Orthopedics, etc.]
- In the United States, 67.4% of active physicians are M.D.s vs. 7.3% which are D.O.s [The remaining 24.2% received their degree from a medical school outside of the United States.]
- DO students take the Comprehensive Medical Licensing Examination [COMLEX]. MD medical students take the United States Medical Licensing Exam [USMLE].
- MD.’s tend to practice medicine in urban, metropolitan areas. D.O.’s are most prevalent in rural areas.
DO vs MD Salary: Do MDs Make More Money Than DOs?
Technically, a DO’s salary is no less than an MD’s salary. In other words, a doctor’s annual salary is determined by a number of factors, primarily their field of specialization [radiologists, plastic surgeon, cardiologists, family medicine, etc.]. Whether or not a practicing physician is a DO or MD is not one of these factors.
However, if you look at the raw data, you’ll notice the average annual wages of an MD are slightly higher than a DO. This statistic is misleading. MD’s tend to earn larger salaries, because they tend to specialize, attend school for several additional years, and live in metropolitan areas where the cost of living is much higher; not because the initials after their name are MD rather than DO.
This map explains the DO vs MD salary debate. As you can see, DOs tend to practice in states dominated by rural communities. The cost of living in a particular city is one of the biggest factors in determining one’s salary. So, by nature, if MDs tend to live in large, metropolitan areas [near major hospitals], then they will generally have higher salaries.
Residency for MDs vs Residency for DOs – Do MDs or DOs Have Higher Acceptance Rates?
Generally speaking, the acceptance rates of DOs to highly competitive MD residency programs are lower. The exception to this is highly competitive primary care residency programs, where DOs have equal acceptance rates as MDs. Although some MD residency programs will accept the COMLEX test scores, most require DO students also take the USMLE in addition to the COMLEX.
DO vs MD FAQs Answered by Doctors
People seem to have a lot of specific questions about the differences between MDs and DOs. If you have any additional questions, ask them in the comments and a doctor will answer you directly!
Can DOs write prescriptions?
A DO is licensed just like an MD. As such, a DO can write any prescription an MD can.
Which is more difficult to obtain, a D.O. or an M.D.?
Becoming an MD or a DO both require an exceptional amount of drive, tenacity, and intelligence. D.O. programs actually have lower acceptance rates than M.D. programs. And, DO’s are required to take an additional 200 hours of coursework. But, in all honesty, neither track is more or less difficult. It’s more important to determine which is most inline with your personal and professional goals.
Do DOs have lower MCAT scores?
The average matriculant MCAT score for DO’s is 25.31, whereas the average MCAT score for MD matriculants is 31.4.
You can find an interesting spreadsheet on the average MCAT scores and preference of DO vs MD by state here.
What do all of these Acronyms Mean?
AAMC – Association of American Medical Colleges
ACGME – Accreditation Council for Graduate Medical Education
AMA – American Medical Association
AOA – American Osteopathic Association
COCA – Commission on Osteopathic College Accreditation
D.O. Doctor of Osteopathic Medicine
GME Graduate medical education
IMG International medical graduate
LCME – Liaison Committee on Medical Education
M.D. Doctor of Medicine
History of MDs & DOs
Early medical education wasn’t as formalized as you might think. For example, surgeons and physicians were considered entirely different careers.
Also interesting, medical students were taught almost exclusively through lectures [without any real interaction with patients].
However, medical education eventually became more structured, giving way to formalization of the Medical Doctor [MD] and Osteopathic Doctors [DO] as we know them today.
History of MDs
Some argue the history of the medical doctor degree started began when the American Medical Association was founded [1845]. The AMA is credited with establishing modern educational standards and curriculum for the degree of Doctor of Medicine, including:
- 3 year curriculum
- 2 six month lecture-based semesters
- 3 month medical dissection lab
- 6 month attendance at a hospital
However, most historians assert the formal model of MD education was established at John Hopkins – nearly 80 years later – when Dr. William Osler introduced the idea of clerkship. For the first time, medical students were given real, hands-on experience under the eye of an experienced doctor. Over the years, the MD program continued to evolve into the current, four-year degree program for MDs.
When this article was written, there were 141 accredited, MD-granting university and 31 DO-granting medical schools in the United States. Today there are three additional DO-granting schools.
History of Osteopathic Medicine [DOs]
Andrew Taylor Still was the father of osteopathy. A frontier physician, Still became disillusioned with allopathic medicine when his children died from meningitis.
Still developed a theory based on the comparison of the human body to a machine. He argued that the human body functions well if it’s mechanically sound. And, it’s the physician’s role to improve its mechanical functioning.
Only five years after forming the American School of Osteopathy in 1892, Still had over 700 students. [Unlike MD’s, women and minorities were encouraged to become professional physicians from the start.]
During the 1900s, Still and his disciples continually proved the validity of the osteopathic approach. In 1973 their persistence was rewarded, and DOs were officially given full rights to practices in all states.
Today, DOs are respected among MDs as equally capable and educated medical professionals.
Additional Facts & Statistics MDs & DOs
- DOs historically have been concentrated in the Northeast and Midwest.
- DOs tendency to practice in rural areas as can be seen by the states with the largest growth in DOs – South Dakota, Wyoming, Utah, North Carolina, Minnesota, Oregon, Louisiana, Tennessee, and Idaho.
- 4% of DOs are women and 49% of DOs actively practicing medicine for less than 9 years are women.
- 17,937 DOs are enrolled in postdoctoral training, 46% of which are in AOA programs and 54% of which are in AGME programs
Summary: Understanding DO vs MD
In the United States, doctors are either an MD [allopathic doctor] or DO [osteopathic doctor]. For patients, there’s virtually no difference between treatment by a DO vs MD. In other words, you should be equally comfortable if your doctor is an M.D. or a D.O. For those pursuing a career in medicine, hopefully this article has helped your quest to become a licensed physician.
Additional Resources
//www.aamc.org/download/471786/data/2016physicianspecialtydatareportexecutivesummary.pdf
//members.aamc.org/iweb/upload/Results_of_the_2017_Medical_School_Enrollment_Survey.pdf
//www.aacom.org/docs/default-source/data-and-trends/2012-EntandGradStSurv-CompRpt.pdf?sfvrsn=6