Osteopathic medicine is a fully legitimate branch of medical practice in the United States. Doctors of Osteopathic Medicine (DOs) are licensed to prescribe medication and perform surgery in all 50 states, complete residency training alongside MDs, and make up roughly 11% of all physicians in the country, totaling over 157,000 practicing doctors. The question usually stems from confusion about how DOs differ from MDs and whether the training is equivalent. Here’s what the evidence shows.
What DOs Actually Are
A DO is a fully licensed physician who has completed four years of medical school followed by residency training, just like an MD. The difference is historical: osteopathic medicine was founded as a separate tradition emphasizing the musculoskeletal system and whole-body approaches to care. Over time, the two tracks have converged almost entirely in terms of curriculum, licensing, and clinical practice.
DOs work in every medical specialty. They perform heart surgery, deliver babies, treat cancer, run emergency departments, and prescribe the same medications as their MD counterparts. The practical difference between seeing a DO and seeing an MD, for most patients, is nonexistent.
How DO and MD Training Compare
DO schools are accredited by the Commission on Osteopathic College Accreditation (COCA), while MD schools fall under the Liaison Committee on Medical Education (LCME). These are separate bodies, but their standards have converged significantly. Both require board-certified clinical faculty, structured curricula with educational objectives, clinical rotations in teaching hospitals, and faculty development programs.
A few differences remain on paper. COCA requires students to pass the first two levels of a licensing exam before graduating, while LCME technically does not (though about 85% of individual MD schools require it anyway). COCA also requires osteopathic manipulative medicine faculty and a primary care physician in a leadership role. LCME places slightly more emphasis on faculty research productivity. These are institutional distinctions, not gaps in clinical training quality.
Where admissions statistics differ more noticeably is in average MCAT scores and GPAs, which tend to be somewhat lower at DO schools than at MD schools. This reflects broader applicant pool dynamics and the fact that there are more DO schools (many newer) than there were a decade ago. It does not mean DO graduates are less capable physicians. Both groups must pass rigorous licensing exams and complete the same residency programs to practice independently.
The Residency Merger Changed Everything
Until recently, DOs and MDs trained in separate residency systems. That ended in June 2020 when a five-year transition merged all graduate medical education under a single accreditation system run by the Accreditation Council for Graduate Medical Education (ACGME). Now every DO and MD resident trains under the same standards, in the same programs, evaluated by the same criteria.
This merger was a major milestone. Since the transition began in 2015, filled positions in programs that were previously osteopathic-only grew 22% to over 10,400 by 2020. DOs now match into competitive specialties like orthopedic surgery, dermatology, and emergency medicine through the same application process as MDs. The playing field, structurally, is level.
Licensing and Exam Equivalence
DOs take a licensing exam called COMLEX-USA, which is accepted by all U.S. licensing jurisdictions. MDs take the USMLE. Both exams serve the same gatekeeping function: proving a physician is competent to practice medicine independently.
In practice, some residency programs still prefer or request USMLE scores from DO applicants, which has led many DO students to take both exams. In 2019, DO students sat for the USMLE at a rate equal to about 57% of their COMLEX first-time test volume. This is a residency strategy issue, not an indication that COMLEX is inadequate. The shift to pass/fail scoring for USMLE Step 1 has reduced some of this pressure, since programs can no longer use numerical Step 1 scores to screen applicants.
The Part That’s Actually Debatable
The one area where legitimate scientific skepticism exists involves osteopathic manipulative treatment (OMT), a hands-on technique that is unique to DO training. OMT involves using the hands to diagnose, treat, and prevent illness by moving muscles and joints. It’s the component that most clearly separates osteopathic philosophy from conventional allopathic medicine.
The clinical evidence here is mixed. A 2024 systematic review with meta-analysis, covering over 1,100 patients across multiple trials, found that OMT was not statistically superior to sham (placebo) treatments for reducing pain intensity or disability in patients with neck or low back pain. The effect sizes were small and not significant. Earlier research had shown OMT was better than no treatment at all, but that’s a lower bar, since many interventions outperform doing nothing.
This doesn’t mean OMT is harmful or that DOs who use it are practicing bad medicine. It means that when tested against a convincing placebo, the specific manual techniques haven’t shown clear superiority for common pain conditions. Many DOs rarely use OMT in their daily practice, particularly those in specialties like cardiology, psychiatry, or surgery. For the average patient, whether your doctor has a DO or MD after their name has no bearing on the quality of evidence-based care you receive.
Recognition Beyond the U.S.
Within the United States, DOs have had full practice rights since well before most people alive today were born. DOs were incorporated into the military medical corps in 1967 and have held equal legal standing with MDs for decades. Internationally, U.S.-trained DOs have full practice rights in more than 65 countries.
One important distinction: U.S.-trained DOs are not the same as osteopaths in Europe, Australia, or other countries. In many places outside the U.S., “osteopath” refers to a non-physician practitioner who performs manual therapy, similar to a chiropractor or physical therapist. A U.S. DO is a medical doctor with a different degree title. If you encounter skepticism about osteopathic medicine from someone outside the U.S., this naming confusion is usually the source.
What This Means for You as a Patient
If you’re choosing a doctor and see “DO” after their name, you’re looking at someone who completed medical school, passed national licensing exams, and finished residency training under the same accreditation system as MDs. They can prescribe any medication, perform any procedure within their specialty, and admit patients to any hospital. Twenty-eight percent of all current U.S. medical students are training at osteopathic schools, so DOs will only become a larger share of the physician workforce in coming years.
The quality of any individual doctor depends on their training, experience, and clinical judgment, not on whether their diploma says DO or MD. The two degrees lead to the same destination through slightly different doors.