MD vs. DO: The Biggest Differences (And Which is Better)
/What is a DO vs. MD? Learn the truth about how allopathic and osteopathic medical programs can impact your residency, career, and salary
Learn the differences between DO vs. md
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Part 1: Introduction
There are countless articles online that will tell you the following:
At the end of the day, it doesn’t matter whether you receive an MD vs. a DO degree.
DO and MD are merely letters behind your name.
All that matters is that you’re a physician.
You’ll have access to the same opportunities either way.
And so on. But if you’re reading this guide, you’re probably less interested in political correctness or the history of the degree programs, and more interested in real talk about questions like:
What is the difference between an MD and a DO?
What kind of doctor is a DO?
Is getting a DO easier than an MD?
How competitive are you for getting into MD vs. DO programs?
How will a DO vs. MD degree impact your residency, career, and salary options?
Therefore, this guide will focus on the information you actually care about.
(Note: If you’re reading this as someone seeking the right healthcare option, you may also be wondering, “Should I see a DO or MD?” and “DO vs. MD—which is better?” This guide will answer your questions, too.)
Before we dive into these juicy questions, here’s a brief overview of the two types of medical degrees in the United States.
What is a DO vs. MD?
Doctor of Medicine (MD): Physicians with an MD degree train in allopathic medicine, which focuses on the diagnosis and treatment of disease. MD physicians attend med schools accredited by the Liaison Committee on Medical Education (LCME). When most people think of a physician, they’re thinking of an MD.
Doctor of Osteopathic Medicine (DO): Physicians with a DO degree train in osteopathic medicine, which takes a more holistic approach. According to the American Osteopathic Association, a holistic medical approach places additional focus on the following:
How the interrelated systems within the human body work together to bring healing
How lifestyle and environmental factors (including nutrition) influence a patient’s health and quality of life
How to prevent disease before its onset
The American Osteopathic Association (AOA) Commission on Osteopathic College Accreditation (COCA) accredits DO programs.
(Note: Many MD physicians also take a holistic approach to their patient care. Nevertheless, the training focus differs between MD and DO programs.)
DO vs. MD: Similarities
Both DO and MD physicians:
Must complete the same requirements in order to get into medical school (e.g., bachelor’s degree, MCAT, extracurricular activities).
Must gain certain extracurricular experiences for medical school during their undergrad and post-bacc years (e.g., clinical shadowing, patient exposure, community service, volunteering).
Attend four years of accredited medical school.
Base diagnostic and treatment decisions on science.
Can be licensed to practice medicine in all 50 states.
Can write the same prescriptions.
Can practice any medical specialty.
DO vs. MD: Differences
Medical students in DO programs must complete 200 hours of training in osteopathic manipulative treatment (OMT; physically manipulating body tissue to treat patients) beyond the typical medical curriculum. MD students do not receive OMT training during medical school.
Whereas MD students have to pass the United States Medical Licensing Exam (USMLE) to obtain licensure, DO students must pass the Comprehensive Medical Licensing Examination (COMLEX) to obtain their medical license.
MD physicians tend to specialize (e.g., cardiology, neurology, ophthalmology) and work in urban areas. DO physicians tend to practice as primary care physicians and work in rural areas (more on this later).
As of January 2024, there are 158 accredited MD programs but only 37 accredited DO programs in the United States.
There is a roughly 9:1 ratio of MD vs. DO physicians in the United States.
DO programs are more likely than MD programs to accept medical students from nontraditional backgrounds, including applicants who are older and pursuing medicine as a second career.
Now that we’ve covered the basics, let’s dive into your most pressing questions.
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Part 2: DO vs. MD: Admissions questions
Is getting a DO easier than MD? Is it easier to get an MD or DO?
Technically, it is harder to get into a DO program because there is a lower overall acceptance rate. While this may come as a shock to you, the primary reason behind this fact is that there are far fewer accredited DO programs (37) than accredited MD programs (158) in the U.S. In other words, because more MD programs exist, you are statistically more likely to get into an MD program vs. a DO program.
Practically speaking, however, it is more difficult to get into an MD program vs. a DO program. During the 2023–2024 academic year, the average MCAT and GPA for students entering U.S. MD programs were 511.7 and 3.77, respectively. Yet, in 2020, the averages for individuals entering U.S. DO programs in the 2022-2023 academic year (the most recent year for which this data is available) were a total MCAT score of 504.77 and a total GPA of 3.61. These data clearly suggest that students must aim to achieve at a higher level academically to be competitive for MD program admissions.
(Suggested reading: Average GPA and MCAT Score For Every School)
Is it mandatory to shadow DO physicians to get into a DO program?
Regardless of whether or not every DO program lists shadowing a DO physician as an admission requirement, you should treat it as such if you’re even remotely interested in attending an osteopathic medical program. And if you’re having a tough time finding a DO physician to shadow, the American Osteopathic Association maintains a directory of all practicing DO physicians.
(Suggested reading: How to Ask to Shadow a Doctor)
Do I need to submit a letter of recommendation from an osteopathic physician to get into a DO program?
Again, while this may technically not be required, you should aim to receive a recommendation letter from a DO physician if you’re considering an osteopathic medical career.
It’s worth discussing why we strongly encourage shadowing a DO physician(s) and obtaining a medical school letter of recommendation from one if you’re interested in getting into a DO program.
Beyond the obvious (i.e., you should have an idea of how a DO actually practices), you should consider the DO programs’ admissions committees’ perspective: DO schools want to know that you’re applying to their programs because you’re actually interested in practicing osteopathic medicine, rather than because they’re “easier” to get into. If you haven’t shadowed a DO physician or don’t have a recommendation letter from one, DO adcoms will be skeptical of your interest in osteopathic medicine.
How should I approach my personal statement differently for the MD application (AMCAS) vs. the DO application (AACOMAS)?
Let’s cover the similarities before we get into the differences. Both MD and DO personal statements should provide information about:
Why you want to pursue medicine
Your journey to medicine
Why you’ll be an effective and dedicated medical student and physician
Additionally, in 2019 AACOMAS increased its personal statement limit from 4,500 characters to 5,300 characters to match AMCAS, so both personal statements are the same length.
Because most physicians in the U.S. are MDs and practice allopathic medicine, this approach is more strongly reflected in most premed students’ academics, extracurricular experiences, and insights about medicine. Combined with the fact that most medical school applicants will apply to at least some MD programs, personal statements tend to also be written from an allopathic perspective.
Typically, students applying to MD and DO programs will write their AMCAS personal statement first, and then modify it as necessary for AACOMAS. Most applicants will attempt to simply add words like “holistic” and phrases like “whole person” to demonstrate their interest in osteopathic medicine. This constitutes a weak approach to revising your personal statement for DO programs.
The better approach to modifying your personal statement is to demonstrate ways you have applied the osteopathic care model during your clinical and research experiences throughout your personal statement. That way, when you do use words like “holistic” or “comprehensive” in your essay, DO adcoms will be more likely to accept your passion for osteopathic medicine.
(Suggested reading: Medical School Personal Statement: The Ultimate Guide)
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Part 3: DO vs. MD: Residency and career questions
Are there any differences in DO vs. MD residency opportunities?
It used to be the case that MD students could only match to residencies accredited by the Accreditation Council for Graduate Medical Education (ACGME), whereas DO students could match to residencies accredited by ACGME or the AOA. However, those accreditation councils merged in July 2020, allowing both MD and DO students to train at any residency site.
In the past, a number of ACGME-accredited residencies required that students pass USMLE to be considered for their program. Now USMLE and COMLEX are officially recognized as equivalents, meaning that DO students theoretically don’t have to pass USMLE in order to match into residencies.
Nevertheless, it’s still too early to say if residencies will recognize this equivalency in practice. As such, the safest way for current DO students to expand their residency options is to pass both COMLEX and USMLE.
Notably, as of May 2022, Step 1 of both COMLEX and USMLE are now administered Pass/Fail, and schools are likely to move toward using COMLEX Level 2 scores and Medical Student Performance Evaluation letters as some of the primary criteria in selecting DO students as candidates for medical residency interviews.
What are the differences in MD vs. DO residency match rates?
The 2023 NRMP Main Residency Match Results reflects just the fourth time that all MD and DO students participated in the same residency matching process. The PGY-1 match rate for U.S. MD seniors was 93.7 percent while the match rate for U.S. DO seniors was 91.6 percent.
While these match rates are fairly comparable, it’s worth also considering the match rates within individual specialties. While both MD and DO seniors matched into the primary care specialties—family medicine, internal medicine, and pediatrics—at high rates, DO seniors faced more difficulty matching into highly competitive specialties.
For example, when looking at students who matched into their preferred specialty, MD seniors matched into thoracic surgery residencies at a rate of 83.7 percent while DO seniors matched at a 2 percent rate. In neurological surgery, the difference was even greater: 86.8 percent for MD seniors vs. just 1.2 percent for DO seniors.
Competitive residencies (i.e., those in desirable urban areas and/or desirable specialties) are competitive for everyone. Nevertheless, DO students have an even harder time matching to them, mostly because of differences in prestige or reputation. However, DO students who are at or near the top of their class and who ace USMLE will be competitive for desirable residency programs.
One reason why DO physicians tend to practice primary care is because of the osteopathic medical philosophy. Another reason is that DO students have a more difficult time matching to residencies offering specialty training. In 2023, 52 percent of DO seniors ended up in primary care specialties vs. 35 percent of MD seniors.
(Suggested reading: The Most Competitive Medical Residencies)
Are there differences in DO vs. MD salary?
MD and DO physicians make comparable salaries when equivalent on factors like specialty, position, years of experience, and location. However, MD physicians earn higher incomes than DO physicians on average because they:
Are more likely to specialize, and specialists typically have higher salaries than generalists.
Tend to practice more in urban areas (salaries are usually higher for city dwellers, who have to deal with a higher cost of living; moreover, specialists tend to practice in urban areas).
However, it isn’t always the case that physicians who work in urban areas make more than their counterparts in rural areas. Because living in urban areas is more desirable for many people—plus the fact that many cities contain numerous medical schools and academic medical centers, leading to high concentrations of doctors—employers may offer lower compensation to urban physicians. On the other hand, some employers in rural areas may offer higher compensation to attract talent.
(Suggested reading: How Much Do Doctors Make?)
Can U.S.-trained MD and DO physicians practice medicine internationally?
MD physicians have full practice rights worldwide, whereas DO physicians currently have them in roughly 50 countries and partial practice rights in many other countries. The AOA is working diligently to increase acceptance of DO degrees by more and more countries.
Working as Locum Tenens
If practicing internationally is a goal for you, you may want to consider an MD path and exploring your options for working as a locum doctor. Locum doctors take temporary assignments in locations where demand for physicians is high, and as such, travel will be a core part of the job.
One of the major benefits to working as a locum doctor is having more control over your work-life balance, as you’ll be free to choose your working hours and change locations or roles when you want.
Furthermore, locum doctors tend to be slightly better compensated than traditionally-employed doctors, as they fill roles in hospitals that are struggling to find qualified doctors. This means that the roles may be in rural areas, but with more free time on your hands, you can delve into hobbies such as learning a new language or exploring unique natural environments.
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Part 4: DO vs. MD: Where to apply
So how should you decide whether to apply to DO programs, MD programs, or both? The answer to this question depends on the following factors:
Preferred training modality
Career goals
Stats (i.e., GPA and MCAT score)
Preferred training modality
Both MD and DO physicians are highly skilled practitioners who undergo years of intense medical training. However, the allopathic and osteopathic approaches to care appeal differently to different people. If you prefer to train via a more holistic medical approach and/or want to study osteopathic manipulative treatment, DO programs could be a great fit for you.
Career goals
While both MD and DO physicians can practice any medical specialty, this ability is contingent on matching into one’s desired specialty. Although interests change during medical school and beyond, you should prioritize MD programs if you anticipate wanting to pursue a medical specialty. On the other hand, if you’re strongly considering working as a primary care physician, your preferred training modality should play a heavier role in your decision-making process.
Stats
Some students simply don’t have a high enough GPA and/or MCAT score to get into an MD program, but have the numbers to be competitive for DO programs. If your heart is set on pursuing a medical career but your numbers fall short of MD program expectations, DO schools may be your only option.
It’s important to note, however, that applying to MD vs. DO programs isn’t a black-and-white proposition. Many students apply to MD and DO programs because of their interest in both training modalities. Moreover, students whose GPA and MCAT scores are competitive for some, but not many, MD programs should apply to varying numbers of MD vs. DO programs.
We recommend certain percentage breakdowns of MD vs. DO program applications based on your stats in our guide on what MCAT score you need to get into med school.
Final thoughts
The allopathic (MD) and osteopathic (DO) approaches to medicine are highly valuable for treating patients. Therefore, neither an MD nor DO is objectively better than the other. Nevertheless, your preference for one training modality vs. the other, desire to practice as a specialist vs. primary care physician, and ability to get into MD programs (which are generally more difficult to get into) should be carefully considered when deciding where to apply to medical school.
About the Author
Dr. Shirag Shemmassian is the Founder of Shemmassian Academic Consulting and one of the world's foremost experts on medical school admissions. For nearly 20 years, he and his team have helped thousands of students get into medical school using his exclusive approach.
