Is There a Difference Between an MD and DO?
The choice between an MD or DO physician often depends on personal preferences, philosophical alignment and the type of health care experience you seek as a patient.
Navigating the sea of health care professionals can be overwhelming, especially when choosing a doctor. But there’s more to complicate the selection process: Should you see an MD or DO?
While both types of doctors have similar medical school admission requirements and basic curriculum, MDs and DOs differ in their approach to medicine. Traditionally focused on primary care, DOs are now breaking new ground in specialty areas, offering patients a wider range of options to consider across the board.
Explore the unique philosophies that set MDs and DOs apart to discover what type of doctor may be your perfect match.
What Is an MD Doctor?
MD is the abbreviation for doctor of medicine, which comes from the Latin term Medicinae Doctor. This type of doctor makes up a majority of practicing physicians in the U.S. today.
MDs typically follow an allopathic, or conventional, Western medicine approach. This relies on evidence-based practices that use medicine, surgery and other medical interventions to diagnose and treat patients. Allopathic physicians generally take a more targeted approach to care, focused on diagnosing and treating your symptoms.
Doctors with an MD degree undergo extensive medical education and clinical training, with four years of medical school and three to seven years of residency training, which is a requirement for all medical student graduates and typically takes place in a hospital or clinic. They provide comprehensive medical care to patients across various specialties and subspecialties.
What Is a DO Doctor?
Though doctors of osteopathic medicine, or DOs, account for approximately 11% of all physicians in the U.S., the osteopathic medicine profession has seen enormous growth over the last decade. According to the American Osteopathic Association’s most recent report, the number of osteopathic physicians in the U.S. climbed to nearly 179,000, seeing an 81% increase from 10 years ago.
Like MDs, DO physicians complete four years of medical school after their undergraduate education, followed by three to seven years of residency training. Additionally, in medical school, DOs receive extensive training in the neuromusculoskeletal system – the body’s interconnected system of nerves, muscles and bones – and osteopathic manipulative medicine, which is a hands-on therapeutic application of pressure to one or more parts of the body.
What’s different in osteopathic training is the distinct philosophy behind osteopathic practice and principles. Traditionally, a DO physician takes a more holistic approach to medicine, focusing on prevention and wellness rather than symptoms alone.
According to the American Association of Colleges of Osteopathic Medicine, osteopathic physicians’ approach includes working closely with their patients; considering the connection among body, mind and spirit; and recognizing the role of a doctor’s hands in diagnosis and treatment.
“We actually learned the hands-on effect of using your hands to treat patients, where it’s appropriate to be used in many different areas,” says Dr. Ira P. Monka, president of the American Osteopathic Association for the 2023-2024 year and an osteopathic physician specializing in family medicine in New Jersey.
Osteopathic manipulative medicine
Osteopathic manipulative medicine, also called osteopathic manipulative treatment, refers to a number of manipulation techniques that could be used to treat structural and functional issues in your body. The therapeutic application of manual pressure could be used to address issues in your bones, joints, tissues or muscles, such as headaches, muscle aches and arthritis.
For example, Monka discussed how he used osteopathic manipulation on a recent patient of his. The patient offhandedly mentioned that the lower part of his neck was bothering him. Monka spoke with his patient further – discussing a range of questions about lifestyle, duration of pain or any prior injuries – and examined him from there.
Primary care is a major focus area for DO physicians. However, that’s slowly changing.
“Years ago, we were more centered around primary care,” Monka says. “As more doors opened and osteopathic students were able to apply and get into residency programs in specialty areas, we have more osteopathic students now diversifying into the specialty areas.”
According to the AOA, approximately 57% of DOs practice in primary care specialties, while 43% practice in non-primary care specialties, such as emergency medicine, anesthesiology and general surgery.
MDs, on the other hand, span a range of specialty areas. In a 2022 report from the American Medical Association, the specialties with the highest percentage of active physicians with an MD degree were ophthalmology (89.6%), otolaryngology (88.9%) and dermatology (88.5%).
Where Each Practice
Still, with such a presence in primary care, osteopathic schools take on a unique role in serving rural areas. There’s been a lot of growth in the osteopathic medicine profession, and with that, new schools are opening across the U.S.
“A lot of our new schools are opening up in states that really don’t have a lot of medical schools,” Monka says. “We’re really servicing parts of the country that did not have good health care.”
This is particularly true for underserved communities in rural neighborhoods. In fact, in U.S. News & World Report’s 2023 medical school rankings, three of the four top medical schools with graduates practicing patient care in rural areas were osteopathic medical schools.
Similarities of MDs and DOs
The medical school admissions requirements for MDs and DOs are virtually the same. All students are required to complete a 4-year undergraduate education and take the Medical College Admission Test (MCAT). Both osteopathic and allopathic medical schools consider a student’s grade-point average and scores on the MCAT for entrance to the program.
Similarly, the baseline curriculum for both types of medical schools hardly varies. All future doctors are required to take the fundamentals of medicine, including basic science principles and clinical skills. Medical schools are typically structured the same way, with the first 1 to 2 years spent in the classroom followed by training in a clinical setting.
Every medical student must complete four years of medical education, followed by three to seven years of residency training, depending on their specialty.
DO vs. MD
There are a few differences in DOs and MDs, but the most notable difference is between their philosophical approaches to medicine.
The osteopathic philosophy uses a whole-person approach to medicine, focusing on prevention and wellness. The allopathic approach to medicine focuses on diagnosing and treating illnesses by using pharmaceutical therapies, surgeries and other interventions to target specific symptoms or underlying causes.
Additionally, MD and DO students take different licensing exams. MDs take the United States Medical Licensing Examination, while DO students take the Comprehensive Osteopathic Medical Licensing Examination of the United States.
Many students are starting to take both examinations, as DO students may feel it gives them a competitive advantage in the residency interview process. However, the National Board of Osteopathic Medical Examiners, which develops and administers the COMLEX-USA exams, does not recommend this practice, as the COMLEX-USA exam is designed to better align with the unique ways that DO students are trained and educated. Plus, the exam is accepted for licensure in all 50 states.
Merging the Medical Profession
DOs often feel the pressure to get a competitive advantage because of a long-standing stigma attached to the profession. Particularly within the medical field itself, skepticism around alternative holistic therapy approaches and misinformation largely contributed to the notion that DOs were “inferior” to MDs. Case in point: when comedian Hasan Minaj remarked on the Tonight Show that “a DO is like an off-brand doctor.”
But that’s simply not true.
Historically, there’s been an effort in the media to differentiate between DOs and MDs, but there are actually more similarities between the two than there are differences.
“One of the great equalizers was insurance companies,” Monka says. “All of a sudden, you’d be listed under family practice – you’d see MD and DO listed together.”
Adding to the bias was the process in which students were matched into residency training programs. Historically, MD and DO students were matched into residency training programs through separate processes, which meant that not all residency programs – particularly specialty training programs – accepted DO students. However, efforts to streamline the process for graduate medical education programs have emerged in recent years.
In 2020, a single accreditation system was implemented. The initiative was part of a five-year transition, beginning in 2015.
The Accreditation Council for Graduate Medical Education became the sole accrediting body for all graduate medical education programs. Under this single accreditation system, all residency and fellowship training programs, regardless of whether they are MD or DO programs, follow a unified set of standards and undergo the same accreditation process.
The ACGME points to a number of benefits of a single accreditation system:
- Uniform graduate medical education accreditation.
- Increased collaboration among the medical education community.
- Consistency across programs in evaluation methods and accountability standards.
- Reduced costs and increased inefficiencies.
- Opportunities for all medical school graduates to receive formal osteopathic training and/or neuromusculoskeletal medicine training during residency/fellowship.
The Evolving Field of Medicine
MD training in the United States continues to evolve.
“It has to evolve because clinical care and the expectation of physicians is also evolving,” says Katherine McOwen, senior director of educational and student affairs at the Association of American Medical Colleges.
Medical education, in general, is moving away from a traditional “time-based model” where students learn in the classrooms in lecture-based courses with exams at the end of the course, she says. It’s becoming much more focused on “competency-based models” where students are asked to apply knowledge, and education is more integrated.
With that, students are observed frequently, and they receive small bites of feedback each time.
“Over time, competency-based medical education will provide the opportunity to really understand an individual student’s strengths and weaknesses so that they can be addressed and benefited from,” McOwen says.
Medical education brings together some of the brightest people in our nation who are very committed to serving their community, she adds.
The social mission of medicine – regardless of how the public might consider it – is a critical part of the conversation among medical schools.
“What we’re all trying to do is improve the health of the nation by improving the education of the people who are becoming physicians and who are physicians,” McOwen says.
The U.S. News Health team delivers accurate information about health, nutrition and fitness, as well as in-depth medical condition guides. All of our stories rely on multiple, independent sources and experts in the field, such as medical doctors and licensed nutritionists. To learn more about how we keep our content accurate and trustworthy, read our editorial guidelines.
McOwen is the senior director of educational and student affairs at the Association of American Medical Colleges.
Monka is president of the American Osteopathic Association for the 2023-2024 year and an osteopathic physician specializing in family medicine in New Jersey.