Understanding the Difference: Is a MD Higher Than a DO?

September 30, 2025 •

4 min read

According to the American Medical Association, more than one-quarter of medical students in the U.S. are now enrolled in osteopathic medical schools. This growing representation in medicine has many people wondering, “Is a MD higher than a DO?” The simple answer is no, but the training differences and history behind each degree are worth exploring.

Quick Summary

MDs and DOs are both fully licensed physicians with similar training, though they follow different philosophical approaches to medicine. Their degrees are equivalent in authority.

Key Points

Equivalent Licensing: Both MDs and DOs are fully licensed physicians with the same practice rights in all 50 states, including the authority to prescribe medicine and perform surgery.
Philosophical Differences: MDs practice allopathic medicine, focusing on disease, while DOs practice osteopathic medicine, emphasizing a holistic, whole-person approach.
Additional DO Training: DOs receive additional hours of training in Osteopathic Manipulative Treatment (OMT), a hands-on technique for diagnosis and treatment.
Unified Residency System: Since 2020, MD and DO graduates compete for the same residency spots through a single national match system.
Salary Dependent on Specialty: Any salary differences are primarily due to specialty choice; a DO and MD in the same specialty typically have comparable salaries.
Focus on the Individual Physician: For patients, the most important factors when choosing a doctor are communication style and individual approach, not the degree type.
Comparable Training: Despite minor differences, the core medical school curriculum and residency requirements are largely the same for both degrees.

MD vs. DO: Two Paths to Becoming a Physician

In the United States, there are two distinct and equal paths to becoming a licensed physician: earning a Doctor of Medicine (MD) degree or a Doctor of Osteopathic Medicine (DO) degree. While MDs are more widely known, the number of practicing DOs has been steadily increasing, blurring the lines in the modern healthcare landscape. Both degrees require a rigorous four-year medical school program, followed by a residency of three to seven years, and both grant the holder the legal right to prescribe medication, perform surgery, and practice in any specialty across all 50 states.

The Philosophical Divide: Allopathic vs. Osteopathic Medicine

The core difference between the two degrees lies in their underlying philosophies toward patient care. The MD path is based on allopathic medicine, which traditionally focuses on diagnosing and treating specific diseases and conditions using evidence-based interventions like medication and surgery. The DO path is founded on osteopathic medicine, which emphasizes a holistic, whole-person approach to healthcare. DOs are trained to view the body as an integrated system and focus heavily on preventive care and promoting the body's natural healing abilities.

Additional Training for DOs: OMT

Another key distinction in training is the additional coursework DO students receive in osteopathic manipulative treatment (OMT). OMT is a hands-on method for diagnosing and treating patients by applying pressure to muscles, joints, and tissues to address structural imbalances. This specialized training, which typically involves an extra 200-500 hours during medical school, gives DOs an additional toolset for addressing patient issues, particularly those involving the musculoskeletal system. Many MDs also incorporate a holistic approach into their practice, and not all DOs use OMT extensively, but this training remains a defining part of osteopathic medical education.

Training, Licensing, and Residency

The journey to becoming a practicing physician is nearly identical for MD and DO candidates. Both must complete the following steps:

Undergraduate Education: Earn a bachelor's degree, including a standard set of pre-med coursework.
Medical School: Complete a four-year curriculum covering basic sciences, anatomy, and clinical rotations.
Licensing Exams: MD students take the United States Medical Licensing Examination (USMLE), while DO students take the Comprehensive Osteopathic Medical Licensing Examination (COMLEX-USA). Importantly, many DO students also take the USMLE to remain competitive for all residency programs.
Residency: Complete a residency program of 3 to 7 years in their chosen specialty. Since 2020, MD and DO graduates apply through a single, unified residency matching program, allowing them to compete for the same positions.
Licensure: Receive state licensure, which is governed by the same state medical boards for both MDs and DOs in most cases.

MD vs. DO Comparison Table


Feature	Doctor of Medicine (MD)	Doctor of Osteopathic Medicine (DO)
Medical Philosophy	Allopathic (focus on disease treatment)	Osteopathic (holistic, whole-person approach)
Specialized Training	No required OMT training	Additional 200-500 hours in Osteopathic Manipulative Treatment (OMT)
Licensing Exam	United States Medical Licensing Examination (USMLE)	Comprehensive Osteopathic Medical Licensing Examination (COMLEX-USA)
Patient Focus	Treats disease and symptoms	Emphasizes prevention and body’s self-healing mechanisms
Residency Match	Competes in unified NRMP system	Competes in unified NRMP system
International Practice	More widely recognized internationally	Can be less recognized outside the U.S.
Specialty Distribution	Higher percentage in non-primary care specialties	Higher percentage in primary care specialties

Challenging Perceptions and Career Outcomes

Despite the equivalence in licensing, a historical perception of MDs having more prestige has persisted, partly because MD programs have traditionally been more competitive in terms of average GPA and MCAT scores for admission. However, this is largely attributed to the applicant pool rather than the quality of education, and many successful, highly-regarded physicians hold DO degrees. The quality of care provided by MDs and DOs is considered comparable, and research has found similar patient outcomes.

Salary differences, where they exist, are typically due to specialty choice rather than the degree itself. Since a higher percentage of DOs choose primary care fields, which have lower average salaries than more specialized fields like surgery, the overall average salary for DOs appears lower. However, an MD and a DO in the same specialty and geographic location can expect comparable compensation.

The Right Choice for You as a Patient

Ultimately, the choice between a DO and an MD comes down to personal preference and philosophy, rather than a hierarchy of competence. Both are fully capable, well-trained, and legally permitted to provide a full spectrum of medical care. When seeking a new doctor, patients should focus on the individual physician's approach, communication style, and rapport rather than the letters after their name. Many MDs practice a holistic style of medicine, and many DOs do not emphasize OMT in their daily practice, so the philosophical difference is not always apparent in a clinical setting.

Conclusion: No Degree Is 'Higher'

To definitively answer the question, "Is a MD higher than a DO?", the answer is a clear no. Both MD and DO degrees represent fully licensed, highly-trained physicians with equal authority to practice medicine in the United States. While their educational paths differ slightly in philosophy and supplemental training, their core medical curriculum and residency requirements are very similar. The distinction is not one of quality or rank, but of approach. Whether a physician follows an allopathic or osteopathic path, their shared purpose is to provide the best possible care for their patients, and both sets of credentials signify that they have met the rigorous standards required to do so. For further reading on the differences between the medical paths, visit the American Medical Association website for more information.

Frequently Asked Questions

Yes, MD and DO degrees are equivalent qualifications that both lead to full licensure as a physician. There is no hierarchy between the two degrees.

The main difference is their philosophical approach to medicine. MDs practice allopathic medicine, focused on treating disease, while DOs practice osteopathic medicine, which emphasizes a holistic, whole-person approach.

Yes, a DO can become a surgeon. Both DOs and MDs can pursue any medical specialty and complete the necessary residency and fellowship training to practice as a surgeon.

Historically, MD programs have been slightly more competitive based on average GPA and MCAT scores of accepted applicants, but DO programs have been increasing in popularity and competitiveness.

OMT is a hands-on technique taught to DO students that involves manipulating a patient's muscles and joints to help diagnose and treat illness or injury.

While the underlying philosophies differ, the practical care a patient receives is often very similar. Many MDs use a holistic approach, and not all DOs emphasize OMT in their practice.

Yes. Since 2020, the residency match system has been unified, and graduates from both MD and DO medical schools compete for the same residency positions.

Any average salary differences are generally due to the specialties chosen by each group, not the degree itself. DOs are more likely to enter lower-paying primary care fields, while MDs are more likely to specialize in higher-paying areas.