A DO school is a medical school that grants the Doctor of Osteopathic Medicine (DO) degree. Graduates are fully licensed physicians who can practice in every medical specialty, prescribe medications, and perform surgery, just like their MD counterparts. The United States has over 40 accredited colleges of osteopathic medicine, and DOs now make up about 11% of all licensed physicians in the country, roughly 119,000 out of 1.08 million total.
What sets DO schools apart is an additional layer of training in the musculoskeletal system and hands-on treatment techniques, built on a philosophy that treats the whole patient rather than isolated symptoms. In practical terms, though, the day-to-day education looks very similar to what students get at MD-granting (allopathic) schools.
How DO School Differs From MD School
Both DO and MD programs are four-year medical schools that require similar prerequisites: a bachelor’s degree, competitive GPA, MCAT scores, clinical experience, and letters of recommendation. The classroom curriculum covers the same core sciences: anatomy, physiology, biochemistry, pharmacology, pathology, and more. The real difference is philosophical and practical.
Osteopathic medicine is built on four core principles: the body functions as a single unit of body, mind, and spirit; the body is capable of self-regulation and self-healing; structure and function are deeply connected; and effective treatment should be grounded in all three of those ideas. These aren’t just abstract concepts. They shape how DO students are taught to evaluate patients, with an emphasis on how the musculoskeletal system influences overall health and how lifestyle, environment, and mental health factor into diagnosis and treatment.
The most tangible curricular difference is training in osteopathic manipulative medicine, or OMM. This is a set of hands-on techniques that DO students learn and practice throughout all four years. More on that below.
What the Four Years Look Like
The traditional structure splits into two phases. The first two years (sometimes compressed to 12 to 15 months at some schools) are primarily classroom-based. Students learn the foundational medical sciences alongside their OMM coursework. Exams, lab sessions, and small-group problem-solving fill most of this period.
The third and fourth years shift to clinical rotations, often called clerkships. Students rotate through hospital departments and outpatient clinics in fields like internal medicine, surgery, pediatrics, psychiatry, obstetrics and gynecology, and family medicine. These rotations are essentially identical to what MD students experience. Students work directly with patients under the supervision of attending physicians, gradually taking on more responsibility.
Osteopathic Manipulative Medicine Training
OMM is the signature component of DO education. It involves using the hands to diagnose, treat, and prevent illness or injury by moving muscles, joints, and tissues. The techniques range from gentle and indirect to more forceful adjustments.
Common techniques include:
- Muscle energy: the patient actively contracts specific muscles against resistance from the physician to improve range of motion
- Myofascial release: sustained pressure on connective tissue to relieve tension and pain
- High-velocity low-amplitude (HVLA): quick, targeted thrusts to restore joint movement, similar to what people associate with “cracking” adjustments
- Lymphatic pump: rhythmic pressure designed to improve the flow of lymph fluid and support immune function
- Rib raising: mobilization of the rib cage to improve breathing and reduce muscle tension along the spine
Not every DO uses these techniques daily in practice. Some specialties lend themselves to OMM more naturally, particularly family medicine, sports medicine, and physical medicine and rehabilitation. But the training gives all DOs an additional diagnostic and treatment tool that MDs don’t receive.
Licensing Exams
DO students take the COMLEX-USA, a three-part licensing exam series that covers the same medical knowledge as the USMLE (the MD licensing exam) plus osteopathic principles and OMM. DO schools require their graduates to pass the first two parts of COMLEX as a condition of accreditation. COMLEX is accepted for physician licensure in every U.S. jurisdiction.
Many DO students also choose to take the USMLE. In 2020, roughly 60% of osteopathic medical students sat for at least one portion of the USMLE, largely because some residency programs have historically been more familiar with USMLE scores. Only six states specifically require COMLEX for initial DO licensure: California, Florida, Oklahoma, Michigan, Pennsylvania, and West Virginia. All other state boards accept either exam. Notably, MD students are not permitted to take COMLEX.
Residency and Specialties
After graduation, DOs enter residency training through the same Match system as MD graduates. Since 2020, a single accreditation system under the ACGME (Accreditation Council for Graduate Medical Education) governs all U.S. residency programs for both MDs and DOs. Before this merger, osteopathic and allopathic residencies operated under separate accrediting bodies, which sometimes created confusion and limited options for DO graduates.
The unified system means DO graduates can apply to any ACGME-accredited residency. Some programs carry an “Osteopathic Recognition” designation, meaning they’ve demonstrated a commitment to teaching osteopathic principles alongside standard training. In the 2025 Match, 92.6% of U.S. DO seniors matched into a residency position.
DOs can specialize in anything: cardiology, dermatology, orthopedic surgery, neurology, emergency medicine, psychiatry, or any other field. There are no restrictions on specialty choice based on degree type.
Admissions and Getting In
DO school admissions are competitive, though average MCAT scores tend to run slightly lower than at MD schools. For the 2024 entering class, the average matriculant MCAT section scores ranged from about 125 in critical analysis and reasoning to nearly 127 in the behavioral and biological sciences sections. For context, each section is scored from 118 to 132, with 125 representing roughly the 50th percentile per section.
Beyond numbers, DO schools often place significant weight on clinical experience, community service, and evidence that applicants understand the osteopathic philosophy. A letter of recommendation from a practicing DO is strongly encouraged, and at many schools essentially expected. Shadowing a DO physician before applying gives candidates both a practical understanding of the degree and a stronger application.
DO vs. MD in Practice
Once training is complete, the day-to-day work of a DO and an MD in the same specialty is virtually indistinguishable. Both hold full prescribing authority, full surgical privileges, and unrestricted medical licenses. Patients in a hospital or clinic may not even notice whether their physician’s white coat reads “MD” or “DO” after their name.
Historically, DOs have been more concentrated in primary care fields like family medicine, internal medicine, and pediatrics. This partly reflects the osteopathic philosophy’s emphasis on whole-person care and partly reflects the rural and community-oriented missions of many DO schools. That pattern is shifting as more DO graduates pursue competitive subspecialties.
The practical stigma that once existed around the DO degree has faded considerably, especially since the merger of residency accreditation systems. Employers, hospitals, and insurance networks treat the two degrees equivalently. For patients, the most important factor remains the individual physician’s training, experience, and communication skills, not the two letters after their name.