In the U.S., there are two distinct pathways to becoming a licensed doctor: the Doctor of Medicine, or M.D., and the Doctor of Osteopathic Medicine, or D.O.
While philosophical approaches and training differ, both can lead to a fulfilling career in medicine, experts say.
The Difference Between Allopathic and Osteopathic Medical Education
Allopathic programs, which grant M.D. degrees, focus on diagnosing and treating diseases. Osteopathic programs, which grant D.O. degrees, emphasize a more holistic approach to patient care. Both pathways produce licensed physicians who can prescribe medications and specialize in medical fields, experts say.
“There’s an overlap in what we do, but there are some unique differences as well,” says Dr. Lisa Warren, dean of the College of Osteopathic Medicine of the Pacific and COMP-Northwest at Western University of Health Sciences.
Applying to M.D. and D.O. Programs
Medical school admissions is competitive, regardless of the degree program. M.D. and D.O. applicants need strong GPAs, MCAT scores, personal statements, extracurriculars and letters of recommendation.
Many D.O. programs prefer or require that applicants shadow an osteopathic physician before applying, experts say. Typically, this physician should also provide a letter of recommendation.
In the U.S., there are 42 accredited D.O. programs compared to more than 150 accredited M.D. programs. Generally, allopathic med schools tend to be more competitive, according to Dr. Jessica Freedman, founder and chair of MedEdits Medical Admissions, which provides med school, residency and fellowship consulting services.
How M.D. and D.O. Curricula Compare
M.D. and D.O. programs have similar curricula, experts say. Students learn foundational science, like biochemistry and physiology, and prepare for clinical practice.
The main distinction is the philosophical approach to medicine. Osteopathic programs emphasize a whole-person approach, viewing the body as an interconnected system of mind, body and spirit.
“It’s not just ‘what’s the disease’ but ‘who’s this person and what’s going on in their life …'” says Dr. Joyce deJong, dean of the College of Osteopathic Medicine at Michigan State University.
Holistic care is not just an “abstract philosophy,” she says. In addition to the standard medical curriculum, D.O. students complete training in Osteopathic Manipulative Treatment, or OMT.
What Is OMT?
The American Osteopathic Association defines OMT as “a set of techniques used by Doctors of Osteopathic Medicine to diagnose, treat and prevent illness and injury.” The hands-on approach, which treats musculoskeletal and digestive issues, pain, congestion and more, can complement conventional medical treatments.
“I look at it like one more tool that we have in our arsenal,” deJong says.
While OMT is generally associated with primary care, Warren says it can be applied across all fields.
“There’s an opportunity with every single patient, no matter what specialty,” Warren says.
[Read: How to Become a Doctor: A Step-by-Step Guide]
M.D. and D.O. Career Trajectories
After medical school, M.D.s and D.O.s must complete a residency program and pass a licensing exam.
Licensing Exam Requirements
M.D.s are required to take the U.S. Medical Licensing Exam (USMLE), which is administered by the National Board of Medical Examiners. D.O.s are required to take the Comprehensive Osteopathic Medical Licensing Examination of the U.S. (COMLEX-USA), which is administered by the National Board of Osteopathic Medical Examiners.
Both the USMLE and COMLEX comprise three standardized exams, with the first two typically completed during med school.
Many D.O. students take the USMLE in addition to the COMLEX, experts say. Although it’s not required, it can help D.O.s maximize their career opportunities.
Residency and Choosing a Speciality
Both M.D. and D.O. students participate in the National Resident Matching Program (NRMP).
D.O. programs, like COMP, tend to graduate students who match into primary care specialties, Warren says. According to the 2025 NRMP report, a large percentage of D.O.s matched into internal medicine and family medicine.
“There are going to be certain specialties in medicine — certain programs within any specialty — that are going to be more competitive for osteopathic students than for allopathic students,” Freedman says. Surgical subspecialties, for example, tend to have a much higher percentage of allopathic graduates.
“Even though it’s a centralized system, not everything is created equally,” Freedman says. Some specialties and programs are more osteopathic-friendly than others. For this reason, she recommends researching school and residency program match lists.
“If you’re looking at a residency class for an orthopedic surgery residency program, and you don’t see a single osteopathic medical school graduate, that is going to be a program that is not friendly for osteopathic graduates,” she says.
Ultimately, D.O.s are qualified physicians who can specialize in any field, just like their M.D. counterparts, experts say. While most D.O.s gravitate toward primary care, according to the American Medical Association, a growing number are entering M.D.-dominated specialties like anesthesiology, general surgery and emergency medicine.
How Allopathic and Osteopathic Doctors Compare
Allopathic and osteopathic doctors have equivalent practice rights and work side by side across a range of settings and specialties.
While M.D.s have historically been more familiar and widely recognized, the osteopathic field continues to grow. The number of D.O.s in the U.S. has increased by more than 70% over the past decade, according to a 2024 report by the American Osteopathic Association.
Currently, osteopathic physicians make up around 11% of all physicians.
When deciding between allopathic and osteopathic training, you should consider your personal values and long-term professional goals, experts say. Ultimately, both programs produce doctors equipped to provide quality care.
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The Difference Between M.D. and D.O. Degrees originally appeared on usnews.com
