Physicians can hold two different degrees of medicine that reflect the kind of medical school training they received. Doctors can complete training and get their medical licenses as M.D’s or D.O.’s. Here, we will outline the differences and similarities of M.D. vs. D.O. school requirements, length, residencies, match rates, and frequently asked questions.
What is the difference between an MD and DO? What is allopathic vs. osteopathic?
Both M.D. and D.O. physicians can prescribe medicine and treat diseases. However, their approach to licensing and patient care is different. Although their credentials are different, both M.D. and D.O. physicians can train to work in the same specialties. Understanding what both types of medical training have to offer is important for you to choose the program that is the absolute best fit for you.
M.D. vs. D.O. Similarities
First off, both MD and DO physicians can be licensed to diagnose, treat, prescribe drugs, and perform surgery across the United States. The application process, training curriculum, and prerequisites for these programs are very similar. Both kinds of physicians treat patients with methods based on scientific conclusions but they are free to employ slightly different philosophies when it comes to patient care.
- Both M.D. and D.O. programs require 4 years of medical school
- Residencies span from 3 to 7 years
- Licensure is based on the same requirements with similar exams.
- As of 2020, osteopathic and allopathic medical students have access to the same pool of residency programs.
- M.D. and D.O. physicians can practice in every specialty
- Premedical requirements to apply for M.D. and D.O. medical programs are the same (premedical prerequisites, MCAT, bachelor’s degree, etc)
M.D. vs D.O. Differences
Let’s start with the M.D.:
- Students who train in allopathic medicine receive an M.D. (Doctor of Medicine) degree.
- Allopathic medicine is a science-based system in which healthcare professionals focus on using drugs and/or surgery to treat symptoms and diseases. Other names for allopathic medicine include modern medicine, western medicine, biomedicine, or orthodox medicine.
- To apply to M.D. programs, students must use the American Medical College Application Service (AMCAS).
- For acceptance into residency programs, M.D. students take the United States Medical Licensing Exam (USMLE).
- Since M.D. students are not trained in OMT (described below), they cannot obtain D.O. residencies.
- M.D.’s focus on observing and treating a patient’s symptoms directly
Next, let’s discuss D.O. programs. Usually, the require additional training prerequisite for students.
- Students who train in osteopathic medicine earn a D.O. (Doctor of Osteopathic Medicine) degree.
- D.O. physicians learn to treat a patient holistically. This means they focus on the body as a whole system and do not isolate a symptom to one area. This treatment philosophy is often referred to as the “structure affects function” or “mind, body, spirit,” philosophy. Additionally, D.O.’s aim to promote the body’s innate self-healing mechanisms whenever possible.
- D.O. training is the same as M.D. training, with additional osteopathic manipulative treatment (OMT) training. OMT requires an extra 200 hours of hands-on therapy on the musculoskeletal system so that students can learn how to move muscles and joints in a way that promotes healing. This training allows D.O.’s to practice osteopathic manipulative medicine or OMM.
- To apply to D.O. programs, students must use the American Association of Colleges of Osteopathic Medicine Application Service (AACOMAS).
- For acceptance into residency programs, D.O. students take the Comprehensive Osteopathic Medical Licensing Examination (COMLEX) and the USMLE.
- D.O.’s can obtain the same residencies as M.D. physicians.
- D.O.’s focus on the patients’ symptoms, entire body, and lifestyle to diagnose, treat, and prevent disease.
- According to the American Medical Association (AMA), D.O.’s more than 50% of D.O.’s pursue specialties in primary care such as family practice, internal medicine, and pediatrics.
Cost of M.D. vs. D.O. School
Yearly tuition for medical school can range from $22k to $100k. This is a wide range! Annual tuition depends on two main factors. The first factor is student residency status. Students who plan to attend schools outside of their home state must pay out-of-state tuition, which is more expensive. The second factor that determines your cost of tuition is whether you attend a public or private school. Typically, private schools have smaller cohort sizes and charge the same tuition to in- and out-of-state students, but the tuition is noticeably more expensive than public institutions.
Is DO school more expensive than MD? Or is DO school cheaper than M.D.?
According to AACOM, 37 schools teach osteopathic medicine, compared to 155 schools with allopathic medical training programs. Of these 37 D.O. programs, the majority are in private schools, which tend to be more expensive than public programs. Due to the higher number of M.D. programs and the percentage of them that are public, M.D. programs do average out to be more affordable than D.O. programs. A survey by the American Association of Colleges of Osteopathic Medicine (AACOM) in 2017 reported that medical school graduates from D.O. programs had an average of $247,218 in debt, in contrast with graduates from M.D. programs who reported an average debt of $190,694.
Here’s a further breakdown of the average annual costs of tuition for in-state residents and out-of-state applicants:
- Private M.D. programs for residents: $56k
- Private M.D. programs for non-residents: $57
- Public M.D. programs for residents: $32k
- Public M.D. programs for non-residents: $54k
- Private D.O. programs for residents: $53.6k
- Private D.O. programs for non-residents: $53.8k
- Public D.O. programs for residents: $34k
- Public D.O. programs for non-residents: $53k
(Keep in mind that the vast majority of D.O. programs will be private!)
D.O. vs. M.D. School Requirements
The undergraduate paths to M.D. vs. D.O. schools are the same. This entails a bachelor’s degree, a high GPA, and a competitive MCAT score. Students must complete two years of coursework and two years of clinical rotations in medical school, followed by a residency training program.
The undergraduate coursework requirements to apply to both programs are:
- 1 year of Biology with a laboratory,
- 1 year of English,
- 1 year of General Chemistry,
- 1 year of Organic Chemistry,
- 1 semester of Biochemistry,
- 1 year of Physics with a laboratory,
- 1-2 years of Math (calculus and statistics).
As mentioned earlier, the curriculum of D.O. and M.D. programs is vastly similar, with an osteopathic manipulation medicine (OMM) curriculum for D.O. programs. This requires 200 hours of hands-on OMT.
[[Further reading: Classes to take before the MCAT]]
AMCAS vs. AACOMAS vs. TMDSAS
Pursuing M.D. or D.O. medical school programs will require different application systems. This section offers a breakdown of what each application system entails.
For premeds applying to M.D. programs: AMCAS, the American Medical College Application Service
If you are applying to allopathic graduate medical programs, you will be using a centralized application called AMCAS. This application system allows you to upload and submit your materials to more than one school simultaneously. This way, AMCAS will verify and send all of your application materials (transcripts, letters of recommendation, and MCAT scores) to all the schools you want to apply. The application fee is $170 for one medical school, and each additional school costs $42.
The AMCAS application contains sections dedicated to:
- Background information
- College coursework
- Work and activities
- Letters of evaluation
- A list of all the medical schools you wish to apply
- Your personal statements and essays
- Your MCAT scores
After you submit your application, you can monitor it, but you can only make limited changes after you click submit, so review carefully! Deadlines for AMCAS applications can be either 1) the early decision date or 2) a date declared by individual schools. The Early Decision Program has a deadline of August 1st. To determine the deadline for programs outside of the early decision deadline, you must check their deadlines individually.
To read more about the AMCAS application, visit their official website.
For premeds applying to D.O. programs: AACOMAS, the American Association of Colleges of Osteopathic Medicine Application Service
If you are applying to osteopathic graduate medical programs, you will be using a different centralized application called AACOMAS. The required sections will be similar to that of the ACMAS application, except that the fee for this application is $196 for one medical school and $46 for each additional school. Students may only apply to one medical program through the early decision program.
To read more about the AACOMAS application, visit their official website.
For premeds applying to M.D. programs in Texas: TMDSAS, the Texas Medical and Dental School Application Service
Students applying to allopathic graduate medical programs in the state of Texas should apply using the TMDSAS. This is a system run by the University of Texas System to integrate all of Texas’s public medical, dental, and veterinary schools. The early decision program deadline is August 1st, and the application fee is $200
To read more about the TMDSAS application, visit their official website.
[[Further reading: The 3 medical school apps every premed must know]]
Is D.O. school easier than M.D.?
Once you understand the minor differences between D.O. and M.D. programs, you will see that they teach the same curriculums. With the addition of osteopathic manipulative medicine (OMM), D.O. students must complete 200 additional hours dedicated to training in osteopathic practices. One program is not necessarily easier or more complex than the other. Requirements for both programs are the same (competitive GPA, MCAT scores, glowing letters of recommendation, the same premedical course requirements, and passing a criminal background check). However, the statistics of accepted students into D.O. and M.D. programs differ slightly:
According to the AAMC, the average stats for accepted students in 2019 were:
- Average GPA: 3.72
- Average MCAT score: 511.2
- Average GPA: 3.54
- Average MCAT score: 503.8
M.D. vs. D.O. School Length
Medical school takes just as long for D.O. and M.D. programs, bringing the total time in medical school to four years. The first two years will require anatomy, biochemistry, physiology, pathology, pharmacology, and microbiology. As mentioned, the main difference between the D.O. and M.D. programs is OMM training, which is a total of 200 hours dedicated to hands-on training for osteopathic care throughout the remaining two years. In these last two years, students do clinical rotations to gain exposure to different specialties!
M.D. vs. D.O. residency
D.O. vs. M.D. residency merger
As of 2020, allopathic and osteopathic applications to residencies have unified into a single graduate medical education (GME) system. Now, the single GME system gives students from both medical school systems access to the same pool of residency programs. There are several benefits of a single accreditation system, including the following:
- A single GME system maintains a consistent evaluation of residents and fellow physicians across all programs, including accountability for their training quality.
- It gets rid of the need to get multiple accreditations.
- Creates an efficient and less costly system for institutions that sponsor both American Osteopathic Association (AOA) and Accreditation Council for Graduate Medical Education (ACGME) programs (or D.O. and M.D. programs).
- It makes it easier for medical students to apply to all of the accredited programs in the U.S. and to maintain comprehensive records that prevent the need to repeat training if they transfer from one program to another.
[[Resources: Single Accreditation System Accreditation Council for Graduate Medical Education (ACGME) and Single GME Accreditation System]]
Under this new system, ACGME programs can apply for Osteopathic Recognition. This means that a program can incorporate osteopathic principles into its curriculum even if the program was not originally an osteopathic residency program. These programs can give residents an osteopathic education in their chosen specialty. In such cases, both D.O. and M.D. residents will be able to complete an ACGME-accredited program. However, to receive the osteopathic training, M.D. residents must satisfy additional requirements that will vary by residency program and institution. To gain proper Osteopathic Recognition, a residency program must have one Director of Osteopathic Education and core faculty members based the following:
- the number of D.O. residents,
- total number of hours dedicated to osteopathic education,
- the depth of the educational program,
- the medical specialty,
- and designated sites that will integrate osteopathic education into their curriculums.
These guidelines are in place to assure that D.O. residents have a supportive and proper OPP learning environment.
Aside from this residency merger, it is a popular thought that obtaining M.D. residencies for D.O.’s may be more challenging. It is unclear whether residency programs favor M.D. graduates or if it seems that more M.D.’s are accepted because the vast majority of applicants are M.D. graduates.
D.O. vs. M.D. residency merger FAQs
Yes. To be eligible for ACGME residencies, candidates must have graduated from a medical school accredited by the Commission of Osteopathic College Accreditation (COCA), LCME, or a medical program with Osteopathic Recognition ousitde of the U.S. and Canada that meets separate eligibility for ACGME programs.
No. To apply for ACGME residencies, D.O. candidates must have graduated from a medical school in the U.S. that is accredited by the Liaison Committee on Medical Education (LCME), a school of osteopathic medicine accredited by the American Osteopathic Association (AOA), or must have graduated from an international medical school and meet more qualifications. However, the ACGME does not specify which licensing exam D.O. candidates must take (COMLEX or USMLE). D.O. candidates may be required to take both the COMLEX and USMLE to apply for specific residencies.
At this time, the ACGME Review Committee Staff seems to consider case-by-case exceptions, but has no official guidelines for transfers. Candidates must meet specific requirements and must contact the ACGME Review Committee for consideration of transfer while keeping their current training credit in the AOA program.
M.D. vs. D.O. Match rate
One of the concerns for medical school applicants when they consider D.O. and M.D. programs are whether they will be able to match at an equal rate with their counterpart classmates. However, match rates for both allopathic and osteopathic medical students are similar. According to the Results and Data report from the 2020 Main Residency Match of the 2020 National Resident Matching Program, M.D. students had a residency match rate of 90.2% and D.O. students had a match rate of 86.9%.
M.D. vs. D.O. fellowships
Another factor that you may be considering before applying to M.D. or D.O. programs is your ability to qualify for the same fellowships. As mentioned in the previous section, the new single accreditation system for graduate medical education allows training physicians access to the same pool of opportunities for residency, and this extends to fellowships as well!
According to the ACGME, qualified medical trainees enrolled in an AOA-approved (American Osteopathic Association) residency program are completely eligible for ACGME fellowships as well. This means that medical students who graduate from allopathic and osteopathic medical training programs are eligible for the same training post-graduation, allowing D.O. and M.D. physicians to train in the same subspecialties. However, due to the nature of their training and medical philosophy, 60% of D.O. graduates tend to focus on primary care specialties, such as family practice, internal medicine, and pediatrics.
Can a D.O. be a surgeon?
Yes! Medical school graduates with osteopathic training can become surgeons. D.O.’s can pursue all specialties. Many prospective students ask whether or not a specialty is available to them because there may be a preconceived notion that D.O.’s are not eligible for the same specialties as M.D.’s. Statistics of D.O. acceptance to surgical programs may be skewed because the vast majority of D.O.’s pursue internal medicine specialties. However, with the recent 80-hour workweek limit, surgery is attracting more residents. Thus, it may be more common to see D.O. students apply to surgical residencies in the future.
Another reason why more osteopathic doctors pursue internal medicine or family practice is simply the nature of their interests and education–most medical students interested in osteopathic medicine end up wanting to practice in a holistic specialty where they can apply what they learned in OMM training. However, this does not mean that surgery and similar residencies cannot incorporate holistic practices for their patients.
Can a D.O. be a cardiologist?
Of course. An osteopathic physician can most definitely be a cardiologist! Remember that during medical school, both D.O. and M.D. medical training programs will have the same exact curriculums with the addition of OMT for D.O.’s. After graduating from medical school, students must excel in their licensing exams to pursue cardiology (typically the USLME).
As a subspecialty of internal medicine, students must complete a residency program in internal medicine, which takes three full years. During this time, residents must study, ask questions, and excel at building relationships with mentors and supervisors so that they are well-prepared to pursue a fellowship.
Whether you are a D.O. or an M.D., you must achieve excellent marks and obtain outstanding letters of recommendation for a cardiology fellowship. Additionally, you must get certified by the American Board of Internal Medicine and complete your cardiology fellowship in another three years.
M.D. vs D.O. salary
Before comparing M.D. and D.O. salaries to decide whether you should apply to one program only, consider that D.O. physicians are historically interested in patient-focused medicine. As such, most osteopathic doctors pursue primary care or internal medicine. In 2019, the American Osteopathic Association reported that almost 60% of osteopathic medical graduates choose to practice in primary care specialties compared to less than 30% of allopathic medical doctors, who typically pursue longer specialties in other areas.
Here is a breakdown of the average annual salaries for medical specialties. As you can see, primary, family, and internal medicine earn between $232-251k, while higher-paying specialties bring home salaries between $260-511k. If you hear that D.O.’s make less money than M.D.’s, it is most likely because most D.O.’s are interested in internal medicine or related specialties. This does not mean that D.O.’s are limited or restricted to these specialties, though. More and more D.O.’s are reaching out to other specialties, and ACGMT residency programs are integrating Osteopathic Recognition into their residency programs!
Can a D.O. become an M.D.?
A widespread question that premeds and medical students have is whether they can attend one kind of medical school and hold a license in another practice. For example, can a D.O. become an M.D. if they didn’t attend allopathic medical school? The short and direct answer is no.
M.D. and D.O. students must take the United States Licensure Examination (USMLE) and the Comprehensive Osteopathic Medical Licensure Exam (COMLEX-USA). These licensing exams are standardized tests of medical knowledge. Still, they cover slightly different topics related to allopathic or osteopathic clinical skills that physicians must know to practice without supervision. As such, students must take the respective licensing exams for the program they are graduating from. In the end, both D.O. and M.D. training is highly competitive and challenging and will both shape excellent physicians ready to practice medicine!
Which type of medical training program is the best fit for you?
The most important thing to consider when deciding between D.O. and M.D. programs is what kind of training you would like to have. How do you want to treat diseases and manage your patients? To assess your compatibility with a program, think about the school’s mission statement, its teaching approach, student resources, school location, and the learning environment you think you would thrive in the most. Other factors to consider may be the diversity and success of recent graduates.
You can always reach out to graduating classes of medical schools you are interested in to ask them about their experience and how the program has prepared them for their next steps. If programs are preparing students for a diverse set of specialties, you can tell that the program is very well-rounded in its training. Make a list of the factors most important to you, and decide from there!