Is a DO as prestigious as an MD? Separating Fact from Perception

Over the past decade, the number of practicing Doctors of Osteopathic Medicine (DOs) has surged, yet the question remains for many aspiring students and patients: Is a DO as prestigious as an MD? The answer involves a deeper look beyond the letters.

Quick Summary

In the United States, DOs and MDs both complete rigorous medical training and hold equivalent practice rights. Any historical or public perception differences are largely due to outdated ideas, not modern medical standards or a difference in competence.

Key Points

• Equivalent Licensing: Both MDs and DOs are fully licensed physicians in the US with equivalent practice rights, able to prescribe medication and perform surgery.

• Similar Training Path: The educational journey for both degrees involves four years of medical school and participation in the same single, national residency accreditation program.

• Philosophical Difference: MDs follow a traditional allopathic approach focusing on disease, while DOs embrace a holistic approach emphasizing the whole person.

• Growing Acceptance: The perception gap between MDs and DOs is shrinking, particularly within the medical community where both are highly respected for their competence.

• Career Flexibility: Both MDs and DOs can enter any medical specialty, though DOs have historically shown a stronger inclination towards primary care fields.

Defining Medical Degrees: Allopathic vs. Osteopathic

At their core, the primary difference between a Doctor of Medicine (MD) and a Doctor of Osteopathic Medicine (DO) lies in the philosophical approach to patient care. An MD degree represents allopathic medicine, which traditionally focuses on diagnosing and treating symptoms using medication, surgery, and other medical interventions. A DO degree, on the other hand, represents osteopathic medicine, which emphasizes a more holistic, whole-person approach, considering the interconnectedness of the body's systems, lifestyle, and environment.

While this philosophical difference exists, it is more a matter of emphasis than a hard division in modern practice. Many allopathic physicians now incorporate a more holistic view, and osteopathic physicians are fully trained in the same evidence-based treatments used by their MD counterparts. Both are licensed physicians, and both are essential to the modern healthcare system.

The Training and Licensing Process

Both MD and DO candidates follow a remarkably similar and demanding path to become licensed physicians:

• Undergraduate Education: Both require a four-year bachelor's degree with a strong foundation in science courses.
• Medical School: Both attend four years of medical school. MDs attend allopathic medical schools, while DOs attend osteopathic medical schools. The curricula are nearly identical in the core sciences.
• Clinical Rotations: The final two years of both programs involve hands-on clinical rotations across various specialties, including internal medicine, pediatrics, surgery, and more.
• Residency: After graduation, both MDs and DOs enter accredited residency programs to receive specialized training in their chosen field. Since 2020, all residency programs in the United States have operated under a single accreditation system (ACGME), meaning DOs and MDs compete for the same residency positions.
• Licensing Exams: MDs take the United States Medical Licensing Examination (USMLE), while DOs take the Comprehensive Osteopathic Medical Licensing Examination (COMLEX-USA). Both are national board exams that ensure competence for practice.

The Osteopathic Difference: OMT

One key distinction in training is that DO students receive additional hours of training in Osteopathic Manipulative Treatment (OMT). OMT is a hands-on diagnostic and therapeutic tool used to treat musculoskeletal issues and aid the body's natural healing processes. While all DOs are trained in OMT, not all utilize it extensively in their practice, particularly those in non-primary care specialties like surgery.

Prestige and Perception: A Tale of Two Histories

Historically, the MD degree has enjoyed greater public recognition and perceived prestige. This is largely due to the longer history and greater number of MD programs, making the MD designation more familiar to the general population. For decades, separate residency systems for MDs and DOs also perpetuated a sense of division.

However, this perception is increasingly outdated:

• Within the Medical Community: Among practicing physicians, the MD vs. DO debate is largely a non-issue. Competence and bedside manner are far more respected than the letters after a doctor's name. They train and work together in hospitals and clinics across the country.
• The Single Accreditation System: The 2020 merger of residency accreditation systems solidified the equality of both paths. This change means both MDs and DOs are evaluated on the same criteria for the same programs, removing a significant source of historical bias.
• Patient Focus: Patients are more concerned with their doctor's skill, empathy, and ability to provide quality care, not their specific degree. A strong doctor-patient relationship is the true measure of success.

Comparative Insights: MD vs. DO

Feature	Doctor of Medicine (MD)	Doctor of Osteopathic Medicine (DO)
Philosophy	Traditionally allopathic (disease-focused)	Traditionally osteopathic (holistic, whole-person)
Extra Training	N/A	Osteopathic Manipulative Treatment (OMT)
Licensing Exams	USMLE	COMLEX-USA (Many also take USMLE)
Residency	Competes for ACGME-accredited spots	Competes for ACGME-accredited spots
Specialization	Higher percentage in competitive specialties	Higher percentage in primary care (historically)
Public Recognition	Higher due to familiarity	Growing, but still less widely known
Practice Rights	Same as DO in the US	Same as MD in the US

The Importance of an Informed Decision

For a prospective medical student, the choice between pursuing an MD or DO program is a personal one. Both paths lead to a fulfilling career as a fully licensed physician. The decision should be based on your personal values, learning style, and whether you resonate with the osteopathic philosophy of treating the whole person. Concerns about prestige should be low on your list, as the medical community increasingly values results and patient care over historical degree perceptions.

As the osteopathic field continues to grow and integrate fully with the allopathic system, the distinction in professional standing becomes less and less relevant. The focus is shifting where it should be: on the quality of the care provided, the dedication of the physician, and the health and well-being of the patient.

For more detailed information on the growth of the osteopathic profession, you can refer to statistics provided by the American Osteopathic Association (AOA).

Frequently Asked Questions

Do MDs and DOs earn the same salary?

Salaries for MDs and DOs in the same specialty are generally comparable. Historical salary differences were often a reflection of a higher percentage of DOs choosing lower-paying primary care specialties, not the degree itself.

Do all DOs perform Osteopathic Manipulative Treatment (OMT)?

No. While all DOs are trained in OMT, they are not required to use it in their practice. Its application depends on the physician's specialty and patient base, with many DOs in surgical or specialized fields not using it regularly.

Is it harder to get into a residency program as a DO?

With the 2020 single accreditation merger, DOs and MDs now compete for the same residency spots. While historical biases may still exist in some competitive programs, the field is increasingly focused on qualifications and performance rather than degree type.

Can a DO become a surgeon?

Yes, a DO can become a surgeon and practice in any specialty. They undergo the same rigorous surgical residency training as MDs and are equally qualified to perform surgery.

Do patients perceive DOs differently than MDs?

Many patients are unfamiliar with the DO designation, as MDs are more common and historically prominent. However, awareness is growing, and most patients prioritize a doctor's competence and rapport over their specific medical degree.

Are DOs considered 'alternative medicine'?

No. DOs are fully licensed and trained physicians who practice modern, evidence-based medicine. Their holistic philosophy is an integrated approach, not an alternative one. They can prescribe medication and perform surgery just like MDs.

Which degree is better for a prospective medical student?

Neither degree is inherently better. The best choice depends on a student's personal philosophy and career goals. Consider whether the holistic approach of osteopathic medicine resonates with your values. The key is to find the path that best fits your ambitions and learning style.