Anyone who dreams of becoming a doctor should understand that there are two types of med schools: allopathic and osteopathic schools. While allopathic schools offer a traditional medical curriculum, osteopathic schools supplement lessons in standard medical sciences and practices with instruction on how to provide touch-based diagnosis and treatment of various health problems, such as circulatory issues and musculoskeletal conditions.
While both allopathic and osteopathic med schools provide preparation for a career as a doctor, the academic credentials awarded are different. Graduates of allopathic schools receive Doctor of Medicine, or M.D., degrees. Osteopathic school alumni have Doctor of Osteopathic Medicine, or D.O., degrees. Someone holding either degree can call himself or herself a physician.
Dr. Kenneth Steier, a pulmonologist with a D.O. degree and executive dean of the Touro College of Osteopathic Medicine in New York, warns that becoming a doctor is not easy, regardless of whether you take the M.D. or D.O. path. Steier suggests that, because of the extraordinary competitiveness of med school admissions, those determined to become a doctor should consider applying to both M.D. and D.O. programs to increase their chances of acceptance.
The Distinction Between Allopathic and Osteopathic Medicine
Both allopathic and osteopathic medicine are designed to heal the sick and to ensure that healthy people stay well, so these two branches of medicine share that mission. However, there is an important distinction between osteopathic and allopathic philosophy.
Dr. Robert A. Cain, president and CEO of the American Association of Colleges of Osteopathic Medicine, says osteopathic medical education is designed to train physicians to treat each patient as a whole person.
Cain, a board-certified pulmonologist with a D.O. degree who previously saw patients for 14 years, notes that osteopathic medical principles “emphasize the mind-body-spirit connection and the body’s ability to heal itself.” He adds that the practice of osteopathic medicine began in the late 19th century during “a time of crisis and uncertainty in health care in the United States.”
The origins of the M.D. curriculum can be traced back to the ancient Greeks, says Molly Johannessen, a Ph.D.-trained physiologist who has taught at both allopathic and osteopathic medical schools.
“This style of medicine is rooted back to Hippocrates and students who complete their MD degree adhere to the Hippocratic Oath to guide their practice,” she wrote in an email.
The Hippocratic Oath is a vow to “do no harm” to health care patients that M.D. students sometimes learn, though the oath they take is often a modernized version rather than a verbatim translation of the original Greek oath.
“Theoretically, Allopathic medicine focuses on alleviating the symptoms of the disease while Osteopathic medicine is oriented to treating the patient not the disease,” wrote Edwin S. Purcell, who has a Ph.D. degree in anatomy and has taught at both osteopathic and allopathic med schools.
“Osteopathic physicians theoretically have a more hands-on approach while Allopathic physicians are more cerebral,” explains Purcell, an associate dean of academic affairs with the University of Medicine and Health Sciences in St. Kitts, a Caribbean medical school. “But, these lines are blurred by the commonality of modern medicine.”
How M.D. and D.O. Classes Compare
The coursework in M.D. and D.O. programs is similar, experts say. Steier emphasizes that med school is extraordinarily difficult, regardless of whether it is taught using an M.D. or D.O curriculum.
Both M.D. and D.O. programs include science classes on topics like anatomy, biochemistry and physiology, Steier says, but one distinction is that about a tenth of the D.O. coursework focuses on hands-on therapies. “It’s similar to chiropractic (care), but not as aggressive as chiropractic care,” he says, noting that osteopathic manipulative techniques can be used as an alternative to prescribed medication.
Dr. Marc Kahn, dean of the University of Nevada–Las Vegas School of Medicine, an allopathic medical school, describes osteopathic and allopathic medical training as “virtually identical” with the caveat that osteopathic medical students devote a couple hundred hours to learning hands-on therapeutic skills.
D.O. and M.D. Career Trajectories
No matter which type of med school an aspiring doctor attends, he or she can expect to complete a residency after earning a medical degree, and that residency will supplement his or her general medical education with training in a specific specialty such as obstetrics and gynecology.
“M.D. and D.O. degrees afford graduates the same opportunity to apply for the same residencies,” Dr. Samuel Sandowski, vice president of medical education at Mount Sinai South Nassau hospital in New York and director of the Icahn School of Medicine at Mount Sinai‘s South Nassau family medicine residency program, wrote in an email. “During residency and upon graduation, the scope of care and privileges permitted are the same.”
Sandowski, who has an M.D. degree, says a med student’s odds of obtaining a desirable residency match depend on many factors that have nothing to do with what type of med school he or she attended. Residency selection criteria include med school grades, research, leadership, community service and board scores.
While some residency program administrators might have a preference for M.D.-trained candidates, the prevalence of that sentiment could be dissipating, Sandowski says. “In my opinion, I think that bias is lessening,” he says.
Cain suggests that post-residency medical fellowship programs where M.D. grads were historically in the majority often grow more receptive to D.O. physicians in general once the program admits a single D.O. doctor. “While some programs may have a preference based on historical relationships and lack of familiarity with the D.O. degree, these preferences have been shown to evolve in many cases after the programs have accepted a D.O. and been exposed to their approach to patient care,” he says.
According to a 2019 report from the American Osteopathic Association, 56.4% of practicing D.O physicians in 2019 were primary care doctors who focused on either family medicine, internal medicine or pediatrics.
However, Dr. Mara Cvejic, a fellowship-trained pediatric neurologist and sleep medicine specialist who has a D.O. degree, cautions that it can be challenging for osteopathic med students to find mentors in medical specialties where allopathic medical degrees are the norm.
Cvejic’s husband, Dr. Nitesh Paryani, a radiation oncologist with an M.D. degree, says an advantage of allopathic med schools is that they are typically affiliated with large research universities. “As a result, you have more robust research opportunities as an allopathic medical student,” he says.
Dr. Ross Kopelman, who has a D.O. degree and intends to become an oculoplastic surgeon, says he consciously chose to attend a D.O. school. “I strongly believe in its holistic philosophy of how we should approach and take care of patients. To always look at patients through their lens and to not look solely at their disease state to solve their medical problem,” he wrote in an email.
Kopelman adds that patients are becoming increasingly receptive to doctors with D.O. degrees. “I think this is the golden age for D.O.s in terms of being respected by patients,” he says. “Patients are more educated and aware of the fact that there are both D.O.s and M.D.s and refer to both of these as doctors on equal footing.”
What Osteopathic Doctors Are and How They Compare to Allopathic Doctors
Medical experts say that the day-to-day work of osteopathic and allopathic physicians is similar. Some osteopathic doctors say that they make a point to use the “laying on of hands” technique when examining patients, since that is something they were specifically taught how to do in medical school.
Dr. Rebecca Levy-Gantt, an osteopathic obstetrician and gynecologist in California, says that before the coronavirus pandemic, she often used her hands when evaluating the lower-back muscle spasms of her pregnant patients.
According to Levy-Gantt, osteopathic medicine tends to heavily emphasize preventive strategies to avoid disease, and it frequently involves coaching patients on how to help themselves. Levy-Gantt notes that she sometimes teaches rehabilitative exercises to patients with chronic conditions like osteoporosis.
Osteopathic doctors tend to view the entire body as an interconnected system, which means that they don’t exclusively focus on a single component of the body, she says. For example, Levy-Gantt observes her patients’ posture and muscle tone when she is evaluating them for obstetric and gynecological concerns, she says.
Dr. Anastasia Katany, a vice president of consumer and clinical education for the AditxtScore medical technology company, notes that osteopathic physicians typically favor a “whole-person approach” to treating patients. “D.O.’s are trained not to merely treat the symptoms but to also address the root cause of the problem,” she says. “So, right from the beginning, we’re trained to listen to our patients and to really partner with them to help them get healthy and to stay well.”
Dr. Mike Martinez II, an osteopathic interventional pain physician and anesthesiologist in Texas, says osteopathic medicine often attracts people who are open to ways of treating people that don’t involve either medication or surgery.
Martinez, who owns the Way Out West Spine + Mobility clinic and a professor at the TCU and UNTHSC School of Medicine, emphasizes that either the osteopathic or the allopathic pathway into the medical profession can lead to a stellar career as a physician.
“The whole goal is to create great, empathetic doctors that take care of patients and try to do their best,” he says.
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Correction 11/11/19: A previous version of this article misstated Dr. Robert A. Cain’s current professional experience.
Correction 12/19/19: A previous version of this article used incorrect terminology to refer to Dr. Ross Kopelman’s current position.
Update 12/29/20: This article has been updated with new information.
Correction 12/30/20: In a previous version of this story, comments made by Dr. Rebecca Levy-Gantt and her medical specialty were wrongly attributed to another source.