They’re both doctors, but allopathic, or M.D. doctors, and osteopathic, or D.O. doctors, have several significant differences that you should be aware of. In this post I’ll over the difference between the allopathic and osteopathic tracks in training and help you decide which one is best for you.
Overview of Osteopathic Medicine
Let’s first go over what an osteopathic doctor is. Osteopathy was started in 1874 by Andrew Taylor Still, an American doctor. He coined this practice of medicine as “osteopathy”, reasoning that the osteon, or bone subunit, was the primary originator of many pathological conditions.
Since its origin, the Doctor of Osteopahic Medicine, or D.O. degree, has always been less common than the M.D. counterpart. Today, it constitutes approximately 7% of all practicing physicians in the United States. D.O. doctors have equivalent rights, privileges, and responsibilities as those with the more traditional M.D. While less popular than allopathic M.D. schools, the popularity of D.O. schools has been on the rise. There are now over 30 D.O. schools in the U.S., compared to over 140 M.D. schools, constituting approximately 20% of all enrolled medical students.
The Differences Between M.D. and D.O.
Osteopathic medical school curricula are nearly identical to allopathic medical schools. Just like allopathic medical schools, the first two pre-clinical years are focused on building a core foundation of medicine in the classroom. The latter two years constitute a medical student’s clerkships, with training in similar specialties to allopathic medical schools, including internal medicine, OBGYN, pediatrics, family medicine, surgery, psychiatry, etc.
However, in addition, D.O. schools provide 300-500 hours in the study of hands-on manual medicine, referred to as osteopathic manipulative medicine, or OMM for short. The thought is that such body manipulation can bring about systemic healing. This is largely an antiquated idea, with many osteopathic physicians moving away from these pre-scientific ideas. Some of my friends are in D.O. medical schools, and while I can say that some of the manipulation is credible and impressive, some of it is absurd quackery, such as craniosacral therapy. In craniosacral therapy, the thought is that light touches by the practioner over certain bony prominences can alter the flow of cerebrospinal fluid.
To get into an osteopathic medical school, you still have to take the MCAT. However, in osteopathic medical school, you take the COMLEX exam rather than the USMLE. D.O. students can also opt to take the USMLE Step exams if they desire to enter an M.D. residency after completing medical school.
The more important thing to note when comparing MD and DO schools is not the exams during medical school, but rather the competitiveness of exam scores in getting into medical school. D.O. program matriculants have lower average MCAT scores and lower average GPAs. If you’re not competitive for traditional allopathic medical schools, osteopathic medical schools are a great option.
3) Future Training Options May Be Limited
Unfortunately, the a D.O. isn’t respected to the same degree as an M.D. Considering osteopathic medical schools cover the same content as allopathic medical schools, and then some more, there is no good reason for the D.O. to be less respected than the M.D. However, this is the reality of the situation.
I postulate that the lesser respect for D.O.’s originates from two factors: 1) it’s less competitive to get into D.O. schools, and as a result most of the strongest students opt for allopathic medical schools. 2) The second factor is the questionable or nonexistent scientific basis of some practices, such as the cerebrospinal fluid manipulation I mentioned earlier.
What this translates for you is your options may be limited when it comes to residency. In some specialties, such as plastic surgery, it is nearly impossible to match if you have a D.O. The year I matched into plastic surgery residency, only one osteopathic medical student matched into plastics, and it was considered a big deal.
That being said, if you are interested in primary care, it will make less of a difference, unless you’re shooting for top internal medicine programs. These top internal medicine programs are also very competitive and D.O.’s are at a sizable disadvantage
Who Should Apply to Osteopathic Medical Schools?
First, if you are interested in primary care or other less competitive specialties, a D.O. may be a good option. Be aware, however, that you may be limited from top programs.
Second, if you’re interested in osteopathic manipulative treatment, osteopathic medical school is the place to learn it.
And third, if your GPA and MCAT are suboptimal, it may be more challenging to gain acceptance to traditional allopathic medical schools. Osteopathic medical schools are a great option to increase your chances of receiving an acceptance.
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