A DO, or Doctor of Osteopathic Medicine, is a fully licensed physician who can practice medicine, perform surgery, and prescribe medication in all 50 U.S. states. There are more than 167,000 practicing DOs in the United States today, making up roughly 11% of the country’s physician workforce. If you’ve seen “DO” after a doctor’s name and wondered what it means, the short answer is: they went through a different but equally rigorous medical training path than doctors with “MD” after their name.
What DOs Are Trained to Do
DOs complete four years of medical school followed by residency training, just like MDs. They learn the same core sciences: anatomy, pharmacology, pathology, and clinical medicine. They rotate through hospitals and clinics. They diagnose diseases, order tests, manage chronic conditions, and perform procedures. In practical terms, when you visit a DO for a sore throat, a broken bone, or a cancer screening, the experience is the same as visiting an MD.
The key difference is an added layer of training. DO students spend additional hours studying the musculoskeletal system and learning a set of hands-on techniques called osteopathic manipulative treatment, or OMT. This is a physical, manual approach where the physician uses stretching, gentle pressure, and resistance to move muscles and joints. The idea is to treat the body as an interconnected system, addressing structural problems that may contribute to pain or dysfunction elsewhere.
How DO and MD Education Differs
Both degrees require a bachelor’s degree, four years of medical school, and three to seven years of residency depending on the specialty. The curriculum overlap is substantial. The distinction comes down to philosophy and a specific skill set.
MD students attend schools accredited by the Liaison Committee on Medical Education. DO students attend colleges of osteopathic medicine accredited by the Commission on Osteopathic College Accreditation. DO programs weave OMT training throughout all four years, giving students regular practice in diagnosing and treating musculoskeletal issues by hand. This doesn’t replace anything in the standard medical curriculum. It’s layered on top of it.
Licensing exams also differ slightly. DO graduates must pass the Comprehensive Osteopathic Medical Licensing Examination (COMLEX-USA) to practice. However, about 60% of osteopathic medical students also take the United States Medical Licensing Examination (USMLE), which is the standard exam for MD graduates. Interestingly, while DO students can take either exam, MD students are not permitted to take COMLEX-USA.
Osteopathic Manipulative Treatment Explained
OMT is what makes osteopathic medicine distinctive in practice. It’s a hands-on therapy where the physician physically evaluates and treats the body, looking for areas of restricted movement, tissue texture changes, asymmetry, and tenderness. Not every DO uses OMT regularly in their practice, but all are trained in it.
The most commonly used techniques include myofascial release (working on the connective tissue that surrounds muscles), soft tissue manipulation, and counterstrain (positioning the body to relieve tender points). Other approaches include muscle energy techniques, where you actively push against the physician’s resistance, and high-velocity, low-amplitude manipulation, which involves quick, targeted thrusts similar to what a chiropractor might do. Some DOs also use craniosacral techniques, which involve very gentle pressure on the head and spine.
These techniques can be active, requiring you to participate by pushing or moving, or passive, where the physician does the work while you relax. DOs use OMT for a range of issues including back pain, headaches, joint problems, and recovery from injury. It’s typically done in the office during a regular visit and doesn’t require special equipment.
What Specialties DOs Practice In
DOs work in every medical specialty. While osteopathic medicine has historically been associated with primary care, family medicine, and general practice, DO graduates now match into residency programs across the full range of specialties: surgery, cardiology, dermatology, emergency medicine, psychiatry, and more. Since 2020, all residency programs in the U.S. operate under a single accreditation system, meaning DO and MD graduates compete for the same residency positions.
That said, DOs still make up a disproportionately large share of primary care physicians compared to MDs. The profession’s emphasis on whole-person care and prevention tends to attract students interested in family medicine, internal medicine, and pediatrics.
How DOs Are Recognized Internationally
In the United States, DOs and MDs have identical practice rights. Both are licensed at the state level, and both can practice any specialty, prescribe any medication, and perform any procedure they’re trained in. Patients in hospitals, clinics, and emergency rooms are regularly treated by DOs without necessarily knowing the difference.
Internationally, the picture is more complicated. U.S.-trained DOs have full practice rights in more than 65 countries. However, in some countries the title “osteopath” refers to practitioners trained only in manual therapy, not as full physicians. This can create confusion abroad. A U.S. DO is a complete medical doctor; an osteopath trained in certain European or Australian programs may have a more limited scope focused on manipulation. If you’re a DO considering practicing outside the U.S., the American Osteopathic Association maintains updated information on which countries recognize the full physician credential.
Origins of Osteopathic Medicine
Osteopathic medicine was founded in 1874 by Andrew Taylor Still, a physician in rural Missouri who became disillusioned with the medical practices of his era. Still developed a system based on the idea that the body’s structure and function are deeply connected, and that the body has an inherent ability to heal itself when its systems are properly aligned. He emphasized holism, treating the whole person rather than isolated symptoms, and believed that the musculoskeletal system played a central role in overall health.
For much of the 20th century, osteopathic and allopathic (MD) medicine operated as largely separate systems with their own schools, hospitals, and licensing boards. Over the past several decades, those systems have converged significantly. Today, the training and practice of DOs and MDs are far more alike than different, with OMT training being the primary remaining distinction.