Choosing DO vs MD; not like choosing ketchup vs. mustard.
The DO vs MD question has elicited some of the most heated debates on Premedfaq.com, and while there are some subjective differences between DO and MD degrees/physicians, I’m going to try to keep this objective. There are some subtle and not-so-subtle differences in the admissions practices and educational paths of DO vs MD schools, as well as the percentages of MD vs DO physicians in different specialties. Let’s dive in!
First, a couple of reasons someone might consider the DO route:
You’re into alternative medicine, public health, or preventative care. Osteopathic medical training is becoming increasingly popular as U.S. lawmakers are concerned about the high cost of care and therefore, much more interested in preventative care and alternative methods of reducing such costs. In fact, research centers are popping up at some of the most prestigious schools (Harvard, UConn, Princeton) and are receiving serious funding from the NIH to study and apply alternative medical treatments. So, any of that sounds compelling, you might want to explore the DO route, since your training will likely introduce you to a range of alternative therapies and theories MDs won’t focus on as much during med school. That’s not to say you can’t get into preventative, alternative or manipulative care if you go the MD route. MD grads are free to explore fellowships and masters degrees in these fields after—or even before, in the case of MD/MPH joint degree programs—they graduate. It just means you aren’t as likely to be exposed to it during medical school. Here’s an excellent book I found that’s truly as comprehensive as you can get: “The DOs: Osteopathic Medicine in America.”
What does the DO vs MD admissions process entail?
Generally, the academic markers are lower for applicants to DO programs. If your MCAT score and/or GPA is out of range or at the low end of what most MD programs are looking for, it may still be competitive enough to get you into a DO program. That said, DO schools don’t accept just anyone. The average overall GPA of those who matriculated into DO programs was a 3.56, and the average MCAT score was a 502.44 (from AACOM 2016 matriculate data). Those who matriculated into MD programs averaged an overall GPA of 3.7, with an average MCAT score of 508.7 (from AAMC 2017 matriculate data). This points to significant differences in GPA and especially MCAT scores for MD/DO candidates.
When it comes to the rest of your application (which is just as important as your GPA and MCAT score), there are subtle differences. MD programs seem to value research and publications more than DO programs, while DO programs place more value on clinical and volunteer experience. What I am not saying here is that MD programs don’t care about clinical and volunteer experiences (they do), or that DO programs don’t look for research hours and publications (they do). What I am saying is that research carries more weight on your AAMC (MD) application, and clinical experiences, especially with DO physicians, carry extra importance on your AACOMAS (DO) application. DO programs often cite their holistic approach to medicine when talking about their admissions practices, which means they are looking for applicants with a variety of experiences, not just great GPA and/or MCAT scores. MD schools seem to be adopting this approach more and more as time goes on, but the GPA and MCAT numbers I shared don’t lie.
Given that you’ll be taking the MCAT for either program, you’ll want to consider whether to give yourself that extra bump by taking an MCAT prep course.
Another important difference is that DO programs prefer that at least one of your letters of recommendation come from a DO physician (some DO programs require it).
All things considered, MD programs are academically more demanding of their applicants, and MD programs like to see research and publications in an applicant’s file. DO programs look for well-rounded individuals that have a diverse list of clinical and volunteer experiences. Check out the 2016 MSAR, which you can pick up on Amazon.
How does schooling differ between DO vs MD programs?
Whether you choose to pursue a DO vs MD degree, you’ll spend four years in medical school. Your residency program will be very similar, ranging from 2-7 years, depending on your specialty. In the past, the residency options have been different for DO’s, but the accrediting organizations that oversee the MD and DO residencies are merging, which means all medical students will have the same options when it comes to residency choice after medical school.
With either MD vs DO training, physicians are well prepared to thrive in any specialty. The main difference lies in the focus of each degree. DO programs tend to emphasize preventative medicine and a holistic approach to patient care, while MD programs stick to a more biomedical approach. Most MD schools focus heavily on clinical and bench (laboratory) research, both in funding and in education. DO programs, generally, do not.
Another major difference in a DO physician’s training is the study of osteopathic manipulative treatment or “OMT” (think chiropractic techniques). Most schools require every student to complete a 200-hour course on OMT during the first two years of medical school. MD programs have no analogous class.
MD students must pass the United States Medical Licensing Examination (USMLE) in order to enter a residency and work as a physician in the United States. DO students must take the Comprehensive Osteopathic Medical Licensing Examination (COMLEX) to become physicians. DO students can take the USMLE if they plan to enter an allopathic (MD) residency (this is all about to change, see below).
What are residency options for MD vs DO students?
In the past, residency options for DOs were different than those for MDs. Only if a DO student took the USMLE would they be able to apply both to osteopathic and allopathic residencies, giving them more opportunities to match into a residency. But, the accrediting organizations that oversee the two are merging, which means all medical students will have the same options when it comes to residency choice. (The examinations for MDs and DOs will continue to remain separate.) That said, acceptance rates are indeed lower. If you’re a 4th year student in a DO program and decide to apply for an allopathic residency, your chances of matching are around 70%. For the same 4th year student in an MD program, his/her probability of matching is 95%.
Because it is well-known that DO schools are somewhat less competitive than MD schools, residencies may take into account the fact that you were a slightly less competitive applicant as a pre-med student. Generally speaking, DO residents tend to place into primary care specialties at a higher rate. Whether this is because the focus of their DO education has been on primary care or because they are less competitive when it comes to matching into more specialized residencies is up for debate, but it seems to be a little bit of both.
As a DO candidate, your grades and extracurricular work during medical school, plus the strength of your letters of recommendation will have a much stronger bearing on where you get your first job. After that, the jobs you get will have little (to nothing) to do with the letters behind your name, as long as you’re licensed to practice as physician in your state.
Will my DO practice differ from that of an MD?
On the whole, not really. DOs use all of the same treatments, tools, and technologies that MDs do. In fact, DOs can choose from any of the specialties MDs can, from emergency medicine to cardiovascular surgery, geriatrics to psychiatry. As previously mentioned, DO schools do focus on preventative care and holistic medicine more so than MD programs, and they teach osteopathic manipulative therapy, but the standards and protocols of care are the same across degrees.
DO-trained physicians and MD-trained physicians are held to the same standards of patient care. They practice in all specialties, but DO-trained physicians specialize in primary care specialties at a higher rate than their MD counterparts. Having been trained in a medical school that focuses on preventative care and holistic medicine, DO-trained physicians may also be more likely to offer more, non-pharmaceutical care options to a patient, but rest assured that both MDs and DOs alike are competent, skilled physicians.
Why are there more MD schools than DO schools in the U.S.?
Osteopathy, as a field of medicine, exists as an alternative to the traditional medical care model. Whereas allopathic (MD) medical training tends to focus on medication and surgical procedures, osteopathic (DO) study includes basic training in various naturopathic treatments and preventative measures. The first osteopathy school wasn’t founded until 1892; the first allopathic school was founded more than a century before. Since then DO schools have increased in number, and factors that distinguish them from M.D. schools have diminished substantially. DOs are licensed to practice medicine in any setting or specialty, so far as they have received the proper training and certification.
DO vs MD: The verdict
All that said, since DOs and MDs have essentially the same privileges and opportunities, it seems like choosing DO vs MD shouldn’t really be that big of a deal. If you love the city where a DO school you are accepted to is located, but you hate the city where the MD school you got into sits, it’s probably important to think about your priorities, and ask yourself if the “prestige” of the MD degree is worth a rough 4+ years. However, it’s a fact that DO schools focus on preparing docs for practice in primary care fields including family practice, internal medicine and pediatrics, making it tougher to get into a competitive residency program as a DO student, unless you’re at the very tip-top of your class. You can do a check of the school(s) you’re applying to, to find out how many students get into the specialty you’re interested in each year using the latest MSAR.
If you’re visiting this page, you’re probably trying to figure out whether the whole med school thing is for you, or you already have and you’re trying to chart a path for yourself to get there. (Other than this website) one of the best resources I’ve come across is On Becoming a Doctor: Everything You Need to Know about Medical School, Residency, Specialization, and Practice, and you can get it for 10 bucks or so on Amazon. Anyway, it calmly and thoroughly walks you through each academic, physical, and emotional step you’ll take on your way to a successful career in medicine, and includes interviews with many different specialists to help you choose a medical path. And just in case you’re considering going the Caribbean/foreign med school route, read this first!
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