Doctor of Osteopathic Medicine
Doctor of Osteopathic Medicine (DO or D.O., or in Australia DO USA[1]) is a medical degree conferred by the 38 osteopathic medical schools in the United States.[2][3][4] DO and Doctor of Medicine (MD) degrees are equivalent: a DO graduate may become licensed as a physician or surgeon and thus have full medical and surgical practicing rights in all 50 US states. As of 2021, there were 168,701 osteopathic physicians and medical students in DO programs across the United States.[5] Osteopathic medicine (as defined and regulated in the United States) emerged historically from the quasi-medical practice of osteopathy, but has become a distinct and proper medical profession.
This article is about physician qualifications and titles in the United States. For other uses, see DO (disambiguation).
As of 2014, more than 28% of all U.S. medical students were DO students.[6][7] The curricula at DO-granting medical schools are equivalent to those at MD-granting medical schools, which focus the first two years on the biomedical and clinical sciences, then two years on core clinical training in the clinical specialities.[8]
One notable difference between DO and MD training is that DOs spend an additional 300–500 hours to study pseudoscientific hands-on manipulation of the human musculoskeletal system (osteopathic manipulative technique) alongside conventional evidence-based medicine and surgery like their MD peers.[9][10][11]
Upon completing medical school, a DO graduate can enter an internship or residency training program, which may be followed by fellowship training.[8] DO graduates attend the same graduate medical education programs as their MD counterparts.[12]
Demographics
In 2018, there were 114,425 osteopathic medical doctors in the United States and 145,343 total DOs and osteopathic medical students. The proportion of females in the profession has steadily increased since the 1980s.[25] In 1985, about 10 percent of DO physicians were female, compared with 41 percent in 2018.[26] Between 2008 and 2012, 49 percent of new DO graduates were females.[25]
During the 2011–12 academic year, the osteopathic medical student body consisted of: 69 percent white/non-Hispanic, 19 percent Asian or Pacific Islander, 3.5 percent Hispanic, 3 percent African-American, and 0.5 percent Native American or Alaskan.[25] The remainder were listed as "other or not entered". The five-year change in osteopathic medical student enrollment by ethnicity has increased by 19 percent for white/non-Hispanic students, 36 percent for Asian-American students, 24 percent for Black/African American students, and 60 percent for Hispanic/Latino students.[27]
Licensing and board certification
To obtain a license to practice medicine in the United States, osteopathic medical students must pass the Comprehensive Osteopathic Medical Licensing Examination (COMLEX),[40] the licensure exam administered by the National Board of Osteopathic Medical Examiners throughout their medical training. Students are given the option of also taking the United States Medical Licensing Examination (USMLE) to apply for certain residency programs that may want USMLE scores in addition to COMLEX scores.[41] Those that have received or are in the process of earning an MD or DO degree are both eligible to sit for the USMLE.[42] Because of their additional training, only DO candidates are eligible to sit for the COMLEX.[41]
In February 2014, the American Osteopathic Association and the Accreditation Council for Graduate Medical Education agreed to unify standard and osteopathic graduate medical education starting in 2020.[43] Before 2020, DOs had the option to attend ACGME residencies or AOA residencies. From 2020, DOs and MDs attend the same ACGME residencies. Upon completion of internship and residency requirements for their chosen medical specialty, holders of the DO may elect to be board certified by either a specialty board (through the American Medical Association's American Board of Medical Specialties) or an osteopathic specialty board (through the American Osteopathic Association Bureau of Osteopathic Specialists certifying boards) or both.
Depending on the state, medical licensure may be issued from a combined board (DO and MD) or a separate board of medical examiners.[44] All of the 70 state medical boards are members of the Federation of State Medical Boards.[45]
Both "DOs and MDs require rigorous study in the field of medicine",[46] with similar entry requirements and curriculum structures that are "largely the same,"[42] and both produce graduates who are licensed and accredited as physicians in the United States.[46] Retired US Air Force flight surgeon and MD Harriet Hall,[47] one of the five founding editors of Science-Based Medicine,[48] has written that US Doctors of Osteopathic Medicine "must be distinguished from 'osteopaths', members of a less regulated or unregulated profession that is practiced in many countries" as "[o]steopaths get inferior training" that is not comparable to that undertaken by DOs.[49]