MD vs DO: Differences in Medical School Training, Curriculum, and Career Paths

Of the many questions students face before entering medical school, a key decision is whether to pursue a Doctor of Medicine (MD) degree or a Doctor of Osteopathic Medicine (DO) degree. Both degrees qualify people to practice medicine, but the degrees follow different paths of medical school training. MD’s graduate from allopathic medical schools, while DO’s attend osteopathic medical schools. 

Allopathic medical schools focus on traditional approaches to diagnosis and treatment, including pharmacologic, surgical and procedural care. Osteopathic medical education emphasizes a whole-person approach to care as part of its medical school curriculum. Osteopathic medicine aims to heal the whole body—rather than a specific part—to fight a disease, and DO’s may prioritize physical therapy or manipulation over the use of medication or invasive procedures. Osteopathic training incorporates holistic principles alongside the full scope of modern medical practice.

The MD is a more established and traditional degree than a Doctor of Osteopathy. Historically, the MD degree has been more widely recognized, though the number of DO-trained physicians has grown in recent years. Approximately 11 percent of existing doctors in the United States are DO’s, but that number is growing. Right now, one out of four medical students are studying to become DO’s. DO-trained physicians practice across a wide range of medical settings and patient populations. This includes former U.S. President Joe Biden, whose personal physician—Dr. Kevin O’Connor—is a DO.

If you are uncertain which path to take when it comes to choosing between a DO vs MD, consider these training related preferences:

• Do you prefer to practice traditional or osteopathic medicine?
• Do you believe medicine is largely a matter of diagnosis and treatment?
• Do you think medicine is linked to a mind-body-spirit relationship?
• Are you compassionate and believe in a “healing touch?”
• Are you curious about using manipulative medicine to treat illnesses or injuries?
• Are you fascinated by the musculoskeletal system—the muscles and bones and their connecting tendons and ligaments?

How Osteopathic and Allopathic Training Differ in Medical School

In medical school, osteopathic training includes all aspects of traditional medicine while placing additional emphasis on the musculoskeletal system as a key to the successful operation of all other body systems. DO’s use osteopathic manipulative treatment (OMT) of the musculoskeletal system as a diagnostic and treatment tool. (OMT is also called osteopathic manipulative medicine, or OMM.) A hands-on technique, OMT may include pressure, resistance, or stretching to move a patient’s bones, joints, muscles, and tissues. OMT is used to treat such ailments as arthritis, headaches, sports injuries, stress injuries, and pain in the lower back, neck, shoulders, or knees. OMT may also treat hypertension and cardiac, kidney, and respiratory ailments—even COVID-19. Some key tenets of osteopathy are:

• The body is a unit, and a person is a combination of body, mind, and spirit
• The body is capable of self-healing, self-maintenance, and self-regulation
• Structure and function are reciprocally interrelated

Medical School and Residency Training Differences Between MD and DO Programs

So exactly what is the difference between MD and DO training? The requirements to enter medical school are nearly identical whether you want to become an MD or DO. Both programs insist on high grade-point averages and high scores on the Medical College Admission Test (MCAT). When considering programs, however, students must be aware that many four-year medical schools—such as American University of the Caribbean School of Medicine (AUC)—only have MD programs. 

Choosing a DO program may affect the range of medical schools and residency pathways available as there are only about 40 accredited colleges of osteopathic medicine in the United States, while there are more than 150 schools with traditional MD programs. If students are unsure which path to take, they should apply to both types of schools to increase their chances of acceptance. Students can then decide which is the better personal fit.

MD vs DO Medical School Curriculum

Both MD and DO programs follow a rigorous, structured medical education model that includes classroom learning and clinical rotations. Allopathic and osteopathic curriculums are similarly structured, with students spending their first year or two in classes before diving into clinical training. At the AUC School of Medicine and most other MD programs, students spend two years studying medical sciences in the classroom before joining traditional clinical rotations at teaching hospitals. 

In a DO program, students learn the same medical science before moving on to hospitals, but osteopathic clinical education adds some 200 hours of musculoskeletal system training. DO training includes osteopathic manipulative treatment (OMT) and such treatments as acupuncture, herbal applications, homeopathy, hypnosis, and relaxation therapies.

Residency and Medical Licensing Differences

After graduation, both MD’s and DO’s must complete a residency, during which physicians usually take the third and final step of the examination for licensure. Medical students should also understand how licensing and board certification differ between MD and DO pathways. The licensing tests for MD’s and DO’s differ slightly. DO graduates take the Comprehensive Osteopathic Medical Licensing Examination (COMLEX), but they may also take the U.S. Medical Licensing Examination (USMLE). All MD grads take the USMLE. DO’s are certified by the American Osteopathic Association. MD’s may be certified by the American Board of Internal Medicine.

Nearly all medical specializations are available to both MD’s and DO’s, but MD’s are more likely to advance to specialized training. In 2019, the American Medical Association reported that more than half—57 percent—of new DO’s chose to practice primary care specialties, while the number of MD’s choosing primary care is declining—about 30 percent as of 2018.

When comparing being a DO vs MD, you may be thinking: which one is right for you? Obtaining either a Doctor of Medicine degree or a Doctor of Osteopathy degree gives people one great advantage—they are now physicians! From a medical education standpoint, neither degree is inherently better; the choice depends on a student’s training preferences and career goals. 

DO’s are less common and because people may not understand what they are, DO’s may have to explain their degree to patients. This lack of understanding may also lead some people to put less trust in a DO vs MD. MD’s and DO’s are highly qualified and capable physicians.

Take the Next Step in your Medical Education by Exploring AUC’s MD Program

The AUC School of Medicine has a strong history of placing graduating students in internal medicine or specialty residencies. In 2020, 92 percent of AUC graduates earned residencies throughout the United States and Canada. Take the next step on your path to become a physician: apply for admission to AUC.

Related resources:

• MD Magazine: International Medical Schools Play an Important Role and Produce Quality Doctors
• Is Pursuing a Career in Medicine Worth It?
• Advancing Women in Medicine