Getting into medical school is not easy. In 2018, only 41% of all applicants were accepted, with a low MCAT score listed as the “biggest application deal-breaker” in the application. For students who are applying to medical school with a lower-than-average GPA or MCAT score, they might be weighing their options to see if there are is another way to earn the title of “doctor.”
There are dozens of medical specialties out there and various degrees associated with the medical field. There is more to the name “doctor” then you might realize. However, the terms “doctor” and “MD” are often used as synonyms, but this is not always the case. Licensed physicians can hold either an MD or DO degree. For students who are debating which path into medicine they want to take, they might be wondering why one is right for them and is one better than the other?
MD vs DO: Which is right for you?
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MD Vs. DO: Different Approaches
Both allopathic (MD) and osteopathic (DO) medical schools instruct their students in the necessary scientific foundations to become licensed physicians. However, the approaches the two schools take are very different. To obtain your medical doctor degree (MD), you must attend an allopathic medical school. Allopathic medicine uses science to diagnose and treat any medical conditions.
Osteopathic medicine is a little less-known and takes a more holistic approach. Doctors who receive their DO degree study something called osteopathic manipulative treatment (OMT), a method that involves moving muscles and joints to promote healing. When OMT fits within a patient’s treatment plan, it can be used to complement drugs or surgery, adding another dimension to medical care.
Physicians with both an MD and a DO are licensed in all 50 states to practice medicine, perform surgeries and prescribe medication.
MD Vs. DO: Education
There are more than 152 accredited U.S. allopathic colleges, whereas there are just 35 accredited colleges of osteopathic medicine. Naturally, that means that there are more MDs than DOs, with roughly 25% of all doctors receiving their degree from an osteopathic medical school. The National Resident Matching Program surveyed all active medical school students who participated in the 2018 Main Residency Match. The number of seniors who attended allopathic medical school in 2018 numbered at 18,818 whereas the students of osteopathic medical schools numbered at just 4,275.
There is a stigma surrounding DOs and the level of work and academic success you must have achieved to be accepted. Years ago, it was believed that earning a degree in osteopathic medicine versus allopathic medicine was the more easily-accessible path to becoming a doctor.
As the gap has lessened, it can be just as difficult to be admitted into a DO program compared to an MD one. The average MCAT score for matriculants into a medical school was a 510.4, on the other hand, the average MCAT scores for matriculants into a college of osteopathic medicine averaged around 502.2.
Once they enter into their respective medical schools, the path to becoming a doctor is very similar. Both MDs and DOs have earned bachelor’s degrees and then attend a four-year medical school. While in med school, they both learn the same basic knowledge regarding anatomy, physiology and pharmacology.
DOs spend an additional 200 hours learning about nerves, muscles, bones and how the connection between them will affect their patients’ overall health. When doctors of osteopathic medicine enter into the workforce, they can incorporate that training into their day-to-day patient interactions if they choose.
MD Vs. DO: Exams
The allopathic and osteopathic paths to becoming a doctor begin to split once the students take their licensing exams. Students at allopathic schools take the USMLE series, while osteopathic students often take the COMLEX sequence. Both of these exams are three-step exams and prospective doctors take them between the end of their second year of medical school and their first year of residency.
However, DOs can take the USMLE exam as well as the COMLEX sequence. While it does add considerably to the student’s workload, it is worth it if they are considering a residency program that requires the USMLE.
These two exams might cover similar topics, but they are a bit different in the testing style. In general, allopathic students are better prepared for taking the USMLE examinations and tend to do better than osteopathic students. The mean USMLE Step 1 Score for all matched U.S. allopathic seniors was 233 while the mean USMLE Step 1 Score for all matched US osteopathic seniors was 227.
Ultimately, the student needs to assess their own individual goals and interests when deciding if they should take the USMLE. The USMLE will increase the number of programs the student can apply to and will give them greater access to more specialized programs. However, depending on the residencies the student is interested in, the USMLE might not be necessary for an osteopathic student.
Osteopathic students should be confident that they will do well on the USMLE before committing to taking it. According to the 2018 NRMP (National Resident Matching Program) Program Director, of the 1,333 programs surveyed, only 2% said that the USMLE was not required. Thirty percent of the program directors said they would never admit a student who failed the USMLE on their first attempts, and 58% said they would seldom admit a student who failed.
Of those schools, 46% of programs said that they do use the COMLEX-USA exam when considering which applicants to invite for an interview. Taking the USMLE helps put the students on an even playing field; the directors can compare the students more easily if they have all taken the same exam.
MD Vs. DO: Residency
According to the National Resident Matching Program, allopathic seniors preferred the specialties of radiology, neurological surgery, orthopedic surgery, and plastic surgery. They least preferred to match with a residency in pathology, family medicine, or internal medicine.
On the other hand, osteopathic medical seniors preferred family medicine, pathology, physical medicine and rehabilitation, and psychiatry more than other specialties. They were less likely to apply for a residency in otolaryngology, plastic surgery, radiation oncology, and orthopedic surgery.
Overall, 91.8% of US allopathic seniors matched with their preferred specialty. 82.6% of US osteopathic seniors paired with their preferred specialty.
As of 2019, MD students could only match with programs that were accredited by the Accreditation Council for Graduate Medical Education (ACGME) and DO students could match with residencies that are accredited by either the ACGME or the American Osteopathic Association (AOA). However, this is all about to change. In July of 2020, the accreditation councils will merge to form a single GME Accreditation system, allowing MD and DO students to apply to any residencies.
The purpose of this merger is to create a more consistent method of evaluating residencies. It will affect both current and future DO students, who no longer will have a safe haven of residencies that only DO students can apply to. That means that allopathic students will have more opportunities open to them, perhaps at the expense of weaker DO students.
When choosing between DO and MD, you should consider what you want your future specialty to be, as your chances of matching with your desired program can increase depending on if you go to an allopathic or osteopathic medical school. Being a DO does not make you any worse or better of a doctor. Your residency and your action will determine that, not what letters follow your name.
Research for this article was contributed by Moon Prep college counselor, Lindsey Conger.
