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DO vs MD: The Ultimate Guide for Future Doctors

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If you’re looking into becoming a doctor, you might be wondering whether you should pursue DO or MD medical schools.

DO stands for “doctor of osteopathy,” which emerged as a differentiation from allopathic medicine.

  • Unlike allopathy, osteopathy focuses its treatment system on more holistic approaches, taking into account the lifestyle and environment of a patient during diagnosis and treatment, working on preventative treatments, and considering methods other than medication and surgery for treatment.

MD stands for “medical doctor,” or doctor of medicine.

  • This is also known as allopathic medicine. Allopathic medicine emerged as a differentiation from the homeopathic medicine, a system based on the belief that “like cures like”, or that something that brings on certain symptoms can also treat similar symptoms in small enough doses.
  • Allopathic medicine, on the other hand, focuses on treating disease and illness by drugs or surgery that produces effects incompatible with the symptoms of the disease.

DO vs MD: Differences in roles

Unlike homeopathy, which can be considered by some to be pseudoscience, both allopathy and osteopathy are respectable medical systems in the United States.

Both medical systems employ practices that are based on scientific study, and there are benefits to treatment from both kinds of physicians. 

Functionally, both an MD and a DO are physicians at the end of the day. They can write the same prescriptions and pursue any medical speciality.

They also must complete the same undergraduate prerequisites, attend 4 years of accredited medical schools, and obtain a license to practice medicine. It only affects which two letters follow your name in signatures. 

  • That being said, choosing an MD or DO program can affect your school options and career path. You should keep in mind which one best suits your aspirations, as well as which one better aligns with your beliefs in patient care and treatment.

Medical school prerequisites and differences

For prospective MD and DO students, the process is quite similar. You must fulfill the same amount of pre-med undergraduate prerequisites in math and science, and particularly in biology and chemistry.

You must take the MCAT and earn a competitive score, and you must keep your GPA high to be considered by high-ranked med schools.

  • The main difference between the two is the personal statement in your application.
  • For the AMCAS application (for prospective MD students), the personal statement is limited to 5,300 characters.
  • In comparison, the AACOMAS (for prospective DO students) personal statement must be less than 4,500 characters. The character limits roughly approximate to 800 and 600 words, respectively.

It means that, for the AACOMAS, you need to be much more economical in your word choice – if applying for both MD and DO programs, you may have to cut some examples of your achievements or ambitions to make room for the rest.

That being said, make sure that your personal statement for the AMCAS application reflects a strong belief in the allopathic medical system, and that your personal statement for the AACOMAS application reflects conviction in the osteopathic medical system.

Admission to MD programs are more competitive

While both are physicians at the end of the day, there are noticeable differences in the average GPA and MCAT scores between the two.

  • In 2017, the average MD student admitted received a 510.4 on the MCAT and graduated from an undergraduate program with a 3.71 GPA.
  • On the other hand, the average DO student received a 503.1 on the MCAT and had a 3.53 GPA. In other words, a score that may be considered competitive in DO programs may be significantly below average in MD programs.
  • This may be something to consider if you want to be a physician or surgeon, but your test scores don’t reflect your best work.

However, you may be surprised to find that DO programs have a lower acceptance rate than their MD counterparts.

That seems counterintuitive since MD programs tend to be more competitive in test scoring, but there’s actually a more practical reason:

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There are far more MD programs

Colleges with MD programs are far more prevalent than ones with DO programs. In the United States, there are currently 141 accredited MD programs compared to 31 DO programs.

As mentioned, this affects the number of seats available to prospective medical students, but it can also affect the variety of schooling options for a DO degree.

  • For instance, most colleges and universities that offer a DO degree are located on the eastern coast; some states, such as North Dakota, have zero colleges with DO programs. On the other hand, every state has at least several options for MD programs.

If you reside in a place with limited DO program options, this can greatly affect your ability to apply, as out-of-state tuition can really rack up your student loan debt.

Osteopathic Manipulative Treatment

For the most part, the education between the two is very similar.

However, DO students must complete 200 training hours of something called osteopathic manipulative medicine – or the practice of manipulating musculoskeletal tissue to relieve pain.

Also known as OMT, or osteopathic manipulative treatment, includes moving a patient’s muscles and joints to improve blood flow, relieve joint restriction, and treat muscle tissue abnormalities.

While this treatment is often used to relieve pain, such as back pain, it can also ameliorate symptoms for common ailments such as asthma, carpal tunnel syndrome, migraines, and sinus disorders.

  • A DO physician may use OMT to complement or even replace more traditional treatments such as painkillers or surgery, which can make it a less invasive approach to patient care.
  • MD students, on the other hand, do not have to complete training in OMT, nor do they have any other equivalent training requirements.

Matching with residency programs is harder for DO students

In order to get your medical licensing, you need to complete 3-7 years of residency training at a program accredited by either the ACGME (Accreditation Council for Graduate Medical Education) for MD’s or the AOA (American Osteopathic Association) for DO’s.

  • To do that, you must take a licensing exam and apply to residency programs that fit into your desired field.

MD students must take the USMLE (United States Medical Licensing Exam), while DO students must take the COMLEX (Comprehensive Medical Licensing Exam).

DO students, in general, have a more difficult time matching with ACGME-approved programs, at a rate of 70 percent, compared to 95 percent for MD students.

While this is sometimes due to the difference in reputation between the degrees, well-respected medical schools with DO degrees tend to be less competitive and prestigious than high-ranking medical schools with MD degree pathways. 

That being said, big discrepancies only occur in specialized residency programs. Residency programs in primary care have equal acceptance rates between MD and DO med students.

DO physicians tend to specialize less frequently

Despite the fact that DO physicians can specialize in any medical branch, many DO’s practice primary care.

Specifically, 45 percent of DO physicians are general practitioners, and they currently make up 10 percent of all primary care physicians.

The difficulty many DO’s have in matching with a residency program with a specialization may factor into this tendency.

  • However, a far more likely reason is the osteopathic belief system itself: Since the focus is to look at the body as a whole and practice preventative treatments, a DO may feel better equipped to work as a primary care physician, a family doctor, or an internist than other kinds of specialties.
  • However, this can affect your prospective salary.

DO vs MD: Salary differences?

MD physicians as a whole tend to make more than their DO counterparts, but not due to any preferential treatment.

In fact, MD’s and DO’s make very similar salaries when compared based on specialization, location, and years of experience. 

  • Specialized medical fields yield a far higher salary, so on average DO physicians, who tend to practice primary care or unspecialized medicine, make less than MD students, who are more likely to specialize.

DO physicians are also more likely to practice in rural areas, while most MD’s tend to practice medicine in urban areas. The difference in the cost of living of these places contributes to the overall salary averages.

  • Practicing osteopathic medicine is also a slightly newer medical system, and it continues to grow in popularity. So, MD’s also tend to be older and more experienced than DO’s.

Thus, differences in salary aren’t because of the two letters following your name, but rather the various other factors that go into practicing medicine.

As long as you practice a field of medicine you are comfortable in, you should receive a competitive salary compared to other physicians in your speciality, location, and experience.

DO or MD: Which program should you pursue?

All in all, once you’re a licensed physician, the practical differences between an MD and a DO are very few.

You can specialize in any field, become licensed to practice medicine in any state, and prescribe the same medication. The only real difference is the path to that doctor’s office. 

  1. When considering whether you’d like to be an MD or DO, first consider your personal beliefs in treatment and patient care.
  2. If you believe more in allopathy, the treatment of diseases and illnesses using drugs and surgery to negate the symptoms, then you should prioritize MD programs.
  3. However, if you have a more holistic outlook on healthcare, in which you’d like to initially prescribe alternative treatments than medication or surgery, or focus on preventative care, then you should consider pursuing a degree in osteopathic medicine.
  4. Also, make sure to consider your desires for specialization. Did you always hope to be a cardiologist and work with the heart, or an oncologist and find a cure or better treatment for cancer?
  5. Did you want to be a general practitioner or practice family medicine (and want to be the first contact point for your patients)?

While both MD’s and DO’s can specialize in any field, DO’s have a harder time being accepted to competitive, specialized MD programs, and most end up practicing primary care.

If your goal is to specialize in a specific branch of medicine, it may behoove you to choose an allopathic program.

On the other hand, people who want to be primary care physicians may find that DO training may best suit their vocational goals.

And, finally, if you are already in an undergraduate program, watch your grades and study hard for the MCAT (remember, you can only take the MCAT three times a year and only seven times in a lifetime).

What do other experts and medical professionals think?

Dr. Jill Stocker, DO of The Body Well USA:

The medical training of MD’s and DO’s is similar as far as the base courses (anatomy, physiology, pharmacology, etc), as well as all the medical training post-medical school (internship/residency).

The main difference comes with the DO philosophy, which is more of a holistic approach to medicine, addressing the person as a whole, not simply placing bandaids over each individual ailment.

The DO curriculum also incorporates a component of osteopathic principles and manipulation, with the base principle being that all ailments stem from the spine and it’s corresponding “activations” of the nerve roots stemming from each level.

Board certification is available to both MD’s and DO’s, and are up to the same standards, just different qualifying boards(American Medical Association for MD’s and American Osteopathic Association for DO’s).

Dr. Raymond Oenbrink, DO of Appalachian Wellness:

The simplest answer is that we do everything that an MD does and everything that a chiropractor does but have a LOT more education than a DC.

We tend to go into primary care fields more than MD’s do as a percentage of practitioners. We’re selected from our medical school interview to be geared more towards primary care. Our educational process is heavily focused on that area as well.

From Dr. Jack Springer, MD:

These days there are minimal differences between MDs and DOs. Today the basic and clinician training in MD and DO schools are almost identical and even the post-graduate training programs are the same and merging with the allopathic training scheme to become one.

DOs and MDs can both seek training in any specialty or subspecialty of medicine.

Conclusion: DO vs MD

If you want to pursue an MD program, remember that your GPA and MCAT score must be higher to be considered competitive.

Before you commit to years of medical school, know the differences between DO and MD. 

  • That being said, if your only concern between the two medical degrees is the average GPA/MCAT score, it doesn’t hurt to apply to both MD and DO programs.
  • Even if you preferred the MD route, becoming a DO physician is still becoming a physician.

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