A DO is not an MD, but both are fully licensed physicians who can practice every branch of medicine. The two degrees, Doctor of Osteopathic Medicine (DO) and Doctor of Medicine (MD), represent separate but parallel paths through medical school, residency, and board certification. Both can prescribe medications, perform surgery, and specialize in any field. In the United States, there are over 167,000 practicing DOs, and more than 25% of all current U.S. medical students are enrolled in osteopathic programs.
What the Two Degrees Actually Mean
MD stands for Doctor of Medicine, sometimes called an allopathic degree. DO stands for Doctor of Osteopathic Medicine. Both require four years of medical school after completing a bachelor’s degree, followed by three to seven years of residency training depending on the specialty. The core medical curriculum is nearly identical: anatomy, pharmacology, pathology, clinical rotations in surgery, internal medicine, pediatrics, and other fields.
The key difference is that DO students also learn osteopathic principles and practice. This includes hands-on techniques for diagnosing and treating musculoskeletal problems, along with a philosophical emphasis on the relationship between the body’s structure and its function. DO programs weave this training throughout all four years, sometimes integrating it into the same courses where students learn about organ systems and disease.
Same Residencies, Same Hospitals
Until recently, DOs and MDs trained in separate residency systems with different accrediting bodies. That changed in 2015 when a five-year transition began to merge everything into one unified system under the Accreditation Council for Graduate Medical Education (ACGME). By 2020, the merger was complete. Today, every DO and MD graduate applies through the same Match process and trains in the same ACGME-accredited residency programs.
This was a significant shift. It means a DO applying to a cardiology fellowship and an MD applying to that same fellowship are evaluated by identical standards. The ACGME also created a designation called Osteopathic Recognition for residency programs that want to continue offering training in osteopathic hands-on techniques, so DOs who value that part of their education can still access it during residency.
Different Licensing Exams, Same Result
MD students take the USMLE (United States Medical Licensing Examination). DO students are required to take COMLEX-USA, the osteopathic equivalent. Both exam series test the knowledge and clinical skills needed for safe patient care, and passing either one leads to the same unrestricted medical license.
DO students can also choose to take the USMLE in addition to COMLEX. Some do this because certain competitive residency programs have historically been more familiar with USMLE scores. This is optional, not required.
Board Certification Works in Parallel
After residency, physicians pursue board certification in their specialty. MDs certify through one of the American Board of Medical Specialties (ABMS) member boards. DOs can certify through the corresponding American Osteopathic Association (AOA) board. Both systems cover the same range of specialties: anesthesiology, dermatology, emergency medicine, surgery, pediatrics, internal medicine, radiology, and many others. Hospitals and health systems recognize both certifications for credentialing and privileges.
Where DOs and MDs Practice
DOs have a strong presence in primary care. In the 2023 residency Match, DO applicants made up about 22.5% of all matched applicants in family medicine, internal medicine, pediatrics, and combined medicine-pediatrics programs. This reflects a longstanding emphasis in osteopathic education on whole-person care and community medicine.
DOs also practice in every surgical and medical specialty, though competitive surgical subspecialties still show a gap in match rates. Between 2020 and 2023, DO applicants matched into selected surgical subspecialties at a combined rate of about 53%, compared to roughly 74% for MD applicants. The gap varies widely by field. In orthopedic surgery and general surgery, DO match rates were in the high 50s percentage-wise, while in plastic surgery they were notably lower at around 4%. These numbers reflect a combination of factors: differences in research resources at some osteopathic schools, historical biases in certain programs, and the relatively recent integration of the two training systems.
The trend is moving toward greater parity. DO representation in surgical fields has been growing each year since the single accreditation system took effect, and the number of DOs entering all specialties continues to rise.
Practical Differences for Patients
If you’re choosing between a DO and an MD as your doctor, the difference in your day-to-day care will likely be minimal. Both can order tests, diagnose conditions, prescribe any medication, and perform procedures or surgeries within their specialty. A DO who is a cardiologist does the same work as an MD cardiologist.
The one thing a DO might offer that an MD typically does not is osteopathic manipulative treatment, a set of hands-on techniques used to relieve pain, improve mobility, and support recovery. Not every DO uses these techniques in practice, especially those in specialties like radiology or pathology, but some primary care DOs and those in musculoskeletal fields incorporate them regularly.
Both types of physicians hold the title “Doctor,” and both have prescriptive authority in all 50 states. The letters after the name differ, but the license, the training pipeline, and the scope of what they can do for patients are functionally the same.