A Doctor of Osteopathic Medicine (DO) and a Doctor of Medicine (MD) are both fully licensed physicians in the United States, trained to practice medicine, perform surgery, and prescribe medication. The distinction lies not in the authority to practice, but primarily in the foundational philosophy and the path taken through medical education. This article aims to clarify the distinctions and similarities between these two medical degrees, providing context for the modern healthcare landscape.
Educational Requirements and Training
The path to becoming either an MD or a DO physician requires a nearly identical commitment to foundational science and clinical experience. Both types of medical schools require applicants to complete a four-year undergraduate degree, including prerequisite science coursework, and to take the Medical College Admission Test (MCAT).
Medical school itself is a four-year program for both degrees, covering the same core subjects such as anatomy, physiology, pharmacology, and pathology. The curriculum includes two years of classroom and laboratory instruction followed by two years of clinical rotations in various medical and surgical specialties. After graduation, both MDs and DOs must complete a residency, a period of supervised, on-the-job training that typically lasts three to seven years depending on the chosen specialty.
A notable difference in the educational phase is the inclusion of specialized training for DO students. Colleges of Osteopathic Medicine include approximately 200 hours of additional coursework focused on osteopathic philosophy and Osteopathic Manipulative Treatment (OMT) within the four-year curriculum. While MD students take the United States Medical Licensing Examination (USMLE) for licensure, DO students take the Comprehensive Osteopathic Medical Licensing Examination (COMLEX), though both exams fulfill licensing requirements across all 50 states.
The Core Difference: Osteopathic Philosophy and Treatment
The most significant distinction between the two degrees rests in the philosophical approach to patient care, which stems from the origins of osteopathic medicine in the late 19th century. Osteopathic medicine is founded upon four core tenets that guide the physician’s diagnostic and therapeutic decisions.
The first tenet states that the body is a unit of body, mind, and spirit, emphasizing a holistic approach to health. This means that a DO physician looks beyond the immediate symptoms to consider how all systems of the body, as well as a patient’s lifestyle and environment, are interconnected. A second principle is the recognition that the body is capable of self-regulation, self-healing, and health maintenance.
The third tenet is that structure and function are reciprocally interrelated. The physical structure of the body, particularly the musculoskeletal system, directly influences how the body functions. This philosophical foundation leads to the fourth tenet, which holds that rational treatment is based upon an understanding of these three basic principles.
The application of these tenets is most evident in the use of Osteopathic Manipulative Treatment (OMT), a hands-on diagnostic and therapeutic tool unique to DOs. OMT involves using the hands to diagnose, treat, and prevent illness or injury by moving a patient’s muscles and joints with techniques like stretching, gentle pressure, and resistance. This manipulative care is intended to restore structural freedom in the tissues and enhance fluid flow, assisting the body’s natural tendency toward self-healing.
Practice Rights and Professional Equivalence
In the context of the American healthcare system, the professional equivalence between MDs and DOs is now nearly complete, with both types of physicians holding the same practice rights. Both are fully licensed to practice the entire scope of medicine and surgery in all 50 U.S. states, and they possess equal authority to prescribe medications.
This professional parity is reinforced by the fact that MDs and DOs work side-by-side in all medical settings, including hospitals, clinics, and academic medical centers. They pursue all medical specialties, ranging from family medicine and pediatrics to highly specialized fields like neurosurgery and cardiology.
A major step toward formalizing this equivalence was the implementation of a single accreditation system for graduate medical education (GME), which was fully completed in 2020. This unified system means that all residency and fellowship programs in the country are now accredited by the Accreditation Council for Graduate Medical Education (ACGME). This change ensures a consistent standard of training for all graduates, regardless of whether they hold an MD or a DO degree.