DO and MD are both fully licensed physicians who can practice medicine, prescribe medications, and perform surgery in all 50 states. The difference comes down to their training philosophy: an MD (Doctor of Medicine) follows what’s called the allopathic tradition, while a DO (Doctor of Osteopathic Medicine) follows the osteopathic tradition, which includes additional training in hands-on musculoskeletal techniques. In practice, the two degrees are more alike than different, and since 2020 they’ve shared the same residency training system.
How Medical School Training Compares
The structure of MD and DO programs is largely the same. Students in both tracks spend their first 12 to 24 months in the classroom studying anatomy, pharmacology, pathology, and other foundational sciences. After that, the majority of training happens in clinical settings: hospital rotations, outpatient clinics, and specialty departments. Both programs take four years to complete.
The key curricular difference is that DO students receive additional training in osteopathic manipulative treatment, or OMT. This is a set of hands-on techniques used to diagnose, treat, and prevent illness and injury, with a particular focus on the musculoskeletal system. Think of it as learning to use your hands to assess how a patient’s body structure relates to their symptoms. This training is woven throughout all four years of a DO program and isn’t part of the MD curriculum at all.
The Osteopathic Philosophy
Osteopathic medicine is built around four core tenets recognized by the American Osteopathic Association. The first is that the body is a unit of body, mind, and spirit rather than a collection of separate systems. The second is that the body is capable of self-regulation and self-healing. The third is that structure and function are connected: how your body is built affects how it works, and vice versa. The fourth is that treatment should be based on understanding all three of those principles together.
In practical terms, this means DO training emphasizes looking at the whole patient rather than focusing narrowly on a single organ system or complaint. That said, many MD programs also teach patient-centered, holistic approaches. The philosophical distinction is more pronounced in the classroom than in everyday clinical practice, where both types of physicians draw on the same evidence-based medicine.
Licensing Exams
MD students take the United States Medical Licensing Examination (USMLE), a three-step test required for medical licensure. DO students take the Comprehensive Osteopathic Medical Licensing Examination (COMLEX-USA), which serves the same purpose but also covers osteopathic principles. Many DO students choose to take both exams, particularly if they’re applying to competitive residency programs that traditionally attract more MD graduates.
Residency Training Is Now Unified
Until recently, MDs and DOs trained in separate residency systems with different accrediting bodies. That changed in June 2020, when a five-year transition merged everything under the Accreditation Council for Graduate Medical Education (ACGME). Now all U.S. medical school graduates, whether MD or DO, complete their residency and fellowship training in the same ACGME-accredited programs and are evaluated against the same competency milestones.
For DO graduates who want to continue developing their osteopathic skills during residency, the ACGME created a designation called Osteopathic Recognition. Programs with this designation integrate formal osteopathic training into their curriculum. But it’s optional. A DO graduate can match into any ACGME-accredited residency and train alongside MD graduates with no distinction in responsibilities or expectations.
Admissions Differences
MD programs are statistically more competitive on paper. The average MCAT score for students entering MD schools is around 511, compared to roughly 504 for DO schools. Average undergraduate GPAs follow a similar pattern: about 3.72 for MD matriculants and 3.54 for DO matriculants. These are averages, not cutoffs, and there’s significant overlap between the two applicant pools. Many students apply to both MD and DO programs simultaneously.
DO programs often place greater emphasis on non-academic factors like clinical experience, community service, and a demonstrated interest in primary care or underserved populations. A strong application to a DO school isn’t just about recovering from a lower GPA; many applicants are genuinely drawn to the osteopathic approach.
Specialty Distribution and Workforce
DOs make up a growing share of the physician workforce. According to the 2024 FSMB census, about 1.08 million physicians are actively licensed in the United States. Roughly 89% hold an MD degree and 11% hold a DO degree. But that 11% figure is changing fast: the number of licensed DOs has grown by 110% since 2010, compared to just 21% growth for MDs over the same period.
DOs have historically been concentrated in primary care fields like family medicine, internal medicine, and pediatrics. That pattern still holds to some degree, but it’s shifting. Today, DOs practice in every specialty, from orthopedic surgery to cardiology to psychiatry. The AAMC’s 2024 workforce data shows that U.S. DO graduates now account for about 25.6% of all active physicians tracked in their system, reflecting how rapidly osteopathic medical schools have expanded.
What Patients Actually Experience
If you’re a patient, you’re unlikely to notice a difference between seeing a DO and seeing an MD. Both can order the same tests, prescribe the same medications, perform the same procedures, and refer you to the same specialists. A DO in cardiology functions identically to an MD in cardiology. The only visible distinction might be that a DO is more likely to incorporate hands-on musculoskeletal assessment or OMT into your visit, particularly in primary care or sports medicine settings.
The letters after a doctor’s name matter far less than their training, experience, and specialty board certification. A board-certified physician, whether MD or DO, has passed the same specialty exams and met the same practice standards. If you’re choosing a doctor, their residency training, years of experience, and patient reviews will tell you more than whether their diploma says MD or DO.