Yes. A Doctor of Osteopathic Medicine (DO) is a fully licensed physician with the same legal authority, training structure, and patient outcomes as a Doctor of Medicine (MD). Both can prescribe medications, perform surgery, and practice any medical specialty in all 50 U.S. states. The differences between the two degrees are real but narrow, and they don’t translate into a measurable gap in the quality of care you receive.
Training Is Nearly Identical
MD and DO students follow the same basic path through medical school. The first one to two years focus on classroom instruction in the foundational sciences: anatomy, physiology, pharmacology, biochemistry. The remaining time is spent in clinical rotations, where students work directly with patients in hospitals and clinics. The curricular structure is largely the same for both degrees.
The one meaningful addition in osteopathic programs is training in osteopathic manipulative treatment (OMT), a set of hands-on techniques used to diagnose, treat, and prevent musculoskeletal problems. This means DO students spend extra time studying the musculoskeletal system and learning manual therapy skills. It doesn’t replace any of their standard medical training. It’s layered on top of it.
Licensing and Legal Authority
Every U.S. state requires physician candidates to hold either an MD or a DO degree before they can be licensed. The license itself is identical: it grants the general, undifferentiated practice of medicine. That means a DO can legally do anything an MD can do. There is no specialty, procedure, or prescription that is restricted to one degree over the other. Physicians in the United States are not licensed based on their specialty or degree type.
The licensing exams differ slightly. MD students take the USMLE, a three-step series covering basic sciences, clinical knowledge, and clinical decision-making. DO students take the COMLEX-USA, which covers the same ground but also tests osteopathic knowledge. Many DO students choose to take both exams, particularly if they’re applying to competitive residency programs.
Residency Programs Are Now Unified
Until recently, MDs and DOs trained in separate residency systems with different accrediting bodies. That changed in 2020, when a merger created the Single Accreditation System under the Accreditation Council for Graduate Medical Education (ACGME). All residency programs, whether they previously trained MDs or DOs, now follow the same set of standards.
This merger opened doors for DO graduates. In otolaryngology (ear, nose, and throat surgery), for example, osteopathic students went from matching into fewer than one ACGME residency spot per year before 2014 to 26 spots in 2024, a 53% increase in just the post-merger years alone. That growth came without any decline in the number of MD students matching. The unified system expanded access for DOs rather than creating a zero-sum competition.
Today, DO and MD residents train side by side in the same programs, learning from the same attending physicians and treating the same patients.
Patient Outcomes Are Virtually the Same
The most direct way to compare any two types of doctors is to look at what happens to their patients. A study reviewed hospital data from 2016 to 2019 covering 329,500 Medicare patients aged 65 and older. The results were striking in how little they differed. Patient mortality was 9.4% for those treated by MDs and 9.5% for those treated by DOs. Hospital readmission rates were 15.7% with MDs and 15.6% with DOs. Average length of stay was four and a half days for both groups, and Medicare spending per patient differed by exactly one dollar ($1,004 vs. $1,003).
In practical terms, there is no detectable difference in the quality of hospital care based on degree type.
What OMT Actually Adds
The extra training DOs receive in hands-on manipulation isn’t just a philosophical difference. It has measurable clinical applications, though it works better for some conditions than others.
A systematic review of randomized controlled trials found moderate-quality evidence that osteopathic treatment effectively reduces pain and improves physical function in people with chronic non-specific low back pain, acute neck pain, low back pain during pregnancy, and chronic non-cancer pain. It also appears to shorten hospital stays for premature infants. There’s promising but less certain evidence for chronic neck pain, postpartum back pain, migraines, and irritable bowel syndrome.
OMT doesn’t help with everything. It showed no benefit for acute low back pain, fibromyalgia, or mixed-cause headaches. Manipulative techniques appear to be particularly effective for musculoskeletal conditions, which makes sense given the training’s focus. Not every DO uses OMT regularly in practice. Many DOs in specialties like cardiology, psychiatry, or emergency medicine rarely perform manual techniques, while those in primary care or sports medicine may use them frequently.
One Area Where the Degrees Differ
International recognition is the one practical area where MDs still have a clear advantage. DOs have full practice rights in more than 65 countries, but the situation gets complicated because many countries outside the U.S. train osteopaths as manual therapists rather than physicians. A DO trained in the United States is a fully licensed doctor, but explaining that distinction to a foreign licensing board can be an extra hurdle.
If you’re considering a career in international medicine or plan to practice abroad, this is worth researching for the specific countries you’re interested in. Within the United States, the distinction is irrelevant to your scope of practice.
How to Choose Between an MD and DO
If you’re a patient, choose your doctor based on their training, experience, communication style, and specialty expertise. The two letters after their name tell you almost nothing about the quality of care you’ll receive. A board-certified DO in family medicine and a board-certified MD in family medicine have passed equivalent exams, completed equivalent residencies, and produce equivalent outcomes.
If you’re a prospective medical student, the choice is more nuanced but still not about quality. MD programs tend to have more research funding and slightly higher average board scores among admitted students, which can matter for the most competitive surgical subspecialties. DO programs offer OMT training and often emphasize primary care and a holistic approach to the body’s interconnected systems. Both paths lead to the same destination: a full medical license and the ability to practice any specialty.