An osteopathic physician is a fully licensed medical doctor who holds a Doctor of Osteopathic Medicine (DO) degree instead of the more commonly known Doctor of Medicine (MD) degree. DOs can prescribe medications, perform surgery, and practice in every medical specialty across all 50 states. There are roughly 167,000 practicing DOs in the United States today, with another 40,000 osteopathic medical students enrolled for the 2025-26 academic year. The profession now represents about 11% of all physicians and more than 25% of all medical students in the country.
How DO Training Compares to MD Training
The path to becoming an osteopathic physician looks almost identical to the path for an MD. Both require a bachelor’s degree, pre-med coursework, and a passing score on the MCAT. Both attend four years of medical school followed by a residency program lasting three to seven years depending on the specialty. Both are licensed by the same state boards and held to the same legal requirements for practicing medicine.
The key difference is what happens inside those four years of medical school. Osteopathic programs place a stronger emphasis on holistic medicine, disease prevention, and the musculoskeletal system. DO students complete an additional 200 hours of coursework beyond the standard medical curriculum to learn osteopathic manipulative treatment (OMT), a set of hands-on diagnostic and therapeutic techniques. This training teaches students to use their hands to identify problems in muscles, bones, and joints, and to treat them through manual manipulation.
On the exam side, DO students are required to take the COMLEX-USA licensing examination. Many also choose to take the USMLE, the same exam MD students take, particularly if they’re applying to competitive residency programs or certain specialties. Since 2020, all DO and MD graduates complete their residency training in the same unified system overseen by the Accreditation Council for Graduate Medical Education (ACGME), meaning they train side by side in the same hospitals and clinics.
The Whole-Person Philosophy
Osteopathic medicine is built on four core principles that shape how DOs approach patient care. The first is that the body functions as a single unit connecting body, mind, and spirit. The second is that the body has a natural ability to heal and regulate itself. The third is that the body’s structure and function are deeply connected: when one part is out of alignment or injured, it affects how other systems work. The fourth principle ties the others together: effective treatment should account for all of these relationships rather than focusing narrowly on a single symptom.
In practice, this means a DO treating chronic back pain might look beyond the spine itself, considering how posture, stress, sleep, and work habits contribute to the problem. This philosophy doesn’t replace conventional medicine. It layers on top of it. DOs order the same imaging, prescribe the same medications, and refer to the same specialists that MDs do.
Osteopathic Manipulative Treatment
OMT is the most distinctive tool in a DO’s clinical toolkit. These are hands-on techniques where the physician uses stretching, gentle pressure, and resistance to diagnose and treat problems in the musculoskeletal system. The goal is to improve blood flow, reduce muscle tension, and help the body’s own healing mechanisms work more effectively. OMT targets not just muscles and bones but also the nervous, lymphatic, and vascular systems.
One common technique, called muscle energy, involves the patient actively pushing against the physician’s resistance in specific positions. This creates controlled muscle contractions that can correct joint misalignments, relieve tension in tight muscles, and restore range of motion. Research has shown this approach can be effective for conditions like low back pain by correcting pelvic alignment and reducing stress on the joints connecting the spine to the pelvis. The same technique has been studied for conditions beyond pain, including chronic lung disease, where improving the mobility of the rib cage and surrounding muscles can help with breathing.
Not every DO uses OMT regularly in practice. Surgeons and specialists who work primarily in hospitals may rarely perform it. But the training in musculoskeletal anatomy and hands-on assessment informs how they examine patients and think about problems, even when they aren’t using manual techniques directly.
What Specialties DOs Practice In
Osteopathic medicine has strong roots in primary care, and that tradition continues. In 2025, 53% of osteopathic residency candidates matched into primary care programs, including family medicine, internal medicine, and pediatrics. But the profession has diversified substantially. About 45% of practicing DOs now work in non-primary care specialties, and 47% of the most recent graduating class matched into specialties outside primary care. DOs practice in every field of medicine: emergency medicine, psychiatry, cardiology, orthopedic surgery, anesthesiology, and dozens of others.
Patient Outcomes: DO vs. MD
A large retrospective study published in JAMA Surgery compared outcomes for over 2.3 million surgical procedures performed by DO and MD surgeons using Medicare data. The results were essentially identical. The 30-day mortality rate was 1.61% for DO surgeons and 1.58% for MD surgeons, a difference that was not statistically significant. Readmission rates and hospital length of stay were also the same between the two groups. After adjusting for patient characteristics and practice settings, there was no measurable difference in surgical outcomes based on whether the surgeon held a DO or MD degree.
This finding aligns with what the unified training system would predict. DOs and MDs complete the same residency programs, pass the same licensing standards, and are held to the same board certification requirements. The degree on the diploma differs, but the clinical competency does not.
Practice Rights and Recognition
Within the United States, DOs have full and unrestricted practice rights identical to MDs. They can practice in any state, prescribe any medication, perform any procedure they’re trained for, and hold medical staff privileges at any hospital. Internationally, DOs have full practice rights in more than 65 countries. The situation varies elsewhere, and some countries distinguish between osteopathic physicians (who completed medical school) and non-physician osteopaths (who completed a more limited manual therapy program). In the U.S., all DOs are fully trained physicians.
A Growing Profession
Osteopathic medicine has been one of the fastest-growing segments of the U.S. physician workforce. The profession traces its origins to 1874, when Andrew Taylor Still, a frontier physician who had grown disillusioned with the medical practices of his era after losing three children to spinal meningitis, developed a new approach focused on the body’s structural integrity and natural healing capacity. He founded the American School of Osteopathy in Kirksville, Missouri, in 1892.
What began as a small alternative movement in rural America has become a major part of mainstream medicine. With more than a quarter of all current medical students pursuing DO degrees, osteopathic physicians will make up an increasingly large share of the physician workforce in the coming decades. The number of accredited osteopathic medical schools has expanded significantly, and the 2020 merger of DO and MD residency training into a single accreditation system cemented the profession’s integration into the broader medical establishment.