When I was applying to medical school, I had a bunch of questions about types of schools and figured you might too, so I decided to write and answer 10 FAQs you need to know when choosing M.D. or D.O.. These frequently asked questions may be things that you have considered when researching medical schools.
In your research you have most likely come across allopathic and osteopathic medical schools and wondered what the difference was. It’s fairly important that you understand this distinction, and make sure you are pursuing the type of medicine that you want, so you get the most out of your learning.
I hope I asked and answer the majority of FAQs you need to know when choosing M.D. or D.O. If there is something I missed, please shoot me a tweet, ask me on Instagram, or comment below. I would be more than happy to answer it, or point you in the right direction, at least. So, without further ado, here are 10 FAQs you need to know when choosing MD or DO.
1. What is allopathic medicine?
Allopathic medicine is the traditional practice of medicine. Any school that awards a Doctor of Medicine (M.D.) degree is an allopathic school. Any physician that has an M.D. after their name graduated from an allopathic medical school. So, when looking at programs, most likely, they will not designate allopathy in their school name, because for a majority of time, that was the only type of medicine widely recognized by the United States. Therefore, no need to make the distinction. If you don’t see osteopathic in their school name, then assume they are an allopathic school. Also research their credentials and see the degree they award if you still aren’t sure.
Allopathic medicine focuses on treating symptoms and diseases. According to Columbia College, healthcare workers treat these ailments by using radiology, pharmaceuticals, surgery and other forms of treatment. The focus is majorly on repairing the issue the patient is having by using a variety of methods. Those who graduate from allopathic medical schools require further training in a specialty, before they can begin practicing in a number of settings.
2. What is osteopathic medicine?
Osteopathic medicine was officially initiated by Dr. A.T. Still in 1870s. He opened the first school in Kirksville, MO, designated to training physicians in a different approach. Osteopathic schools are always designated with and osteopathic label in their name. Physicians who graduate from an osteopathic medical schools receive a degree in Doctor of Osteopathic Medicine (D.O.). Any physician with D.O. after their names are certified to practice osteopathic medicine.
The main difference in osteopathic medicine is the focus on holistic care. Their practices largely emphasize prevention and treatment of the entire patient, not simply the symptoms or illnesses. The tenets of osteopathy focus on the body’s ability to self-heal and encourages physicians to help keep all the systems in line, because if one is off, then the entire system is off. Osteopathic medicine also teaches how to treat patients through touch, or manual manipulation. You must be trained in Osteopathic Manual Manipulation, but it is an alternative treatment to help regenerate movement in patients’ bodies and realign systems.
DOs can enter any specialty, although an overwhelming amount practice in primary care and rural areas. To learn more about osteopathic medicine, please visit the site Osteopathic.org.
3. Is one school harder to get into than the other?
This question is tricky because the answer is, it depends. To start with, medical school, in general, is hard to get into. If you think you’re going to waltz into any school with mediocre grades and MCAT scores, then I invite you to check out my post on 10 Things to Know Before Applying to Medical School. After doing that, and deciding you meet the criteria, then you can focus on the stats.
The biggest difference between the two schools is that there are 155 accredited M.D. schools in the country, and 36 accredited D.O. schools in the US. The means that D.O. schools may be a little more competitive, simply because there are less of them. Although there are new medical schools popping up all over the place to meet the shortage of physicians, these numbers are still pretty intimidating.
The other thing to consider when choosing M.D. or D.O., is that more people are applying to M.D. schools than D.O. schools. About 53,000 individuals applied to M.D. schools* in 2019, and only about 21,000 individuals applied to D.O. schools* in 2019. So the competition evens out. About 41% of M.D. applicants matriculated into medical school and only 35% of D.O. applicants matriculated into medical school.
So neither of them is more competitive than the other. The deciding factor, is who would make a good osteopathic doctor and who would make a good allopathic doctor. If you’re one of those lucky people that would make both, then awesome! If you make neither, then you probably have some work to do, and can take a look at my post about taking a Gap Year!
*Does not include information from TMDSAS
4. Does one degree make more money than the other?
I know people say doctors shouldn’t do what they do for the money. And it’s true. But let’s just be honest, compensation is important. It costs a lot of money and takes a really long time to be a physician. So if you’re going to go through all of that, then you absolutely want to make sure that it is worth it in the end. So I totally understand if salary discrepancies make a difference to you.
According to Payscale, there is a slight difference. On average, M.D.s make about $206,270 a year while D.O.s make $213,605. But these numbers are slightly misleading because there is such a wide range for physicians. There are a number of other factors that you should consider; specialty, location, and years of training, to name a few. When it comes to individual specialty, there is no difference between M.D. vs. D.O. M.D.s tend to specialize more and work in metropolitan areas, while D.O.s work mostly in primary care and rural areas. So any information you may find while researching should be taken with a grain of salt because of these other factors.
5. Is the application process different?
As you’re choosing M.D. or D.O., you’ll find the application process is slightly different, but not by much. I actually have an entire blog post that goes further in depth about this topic. What you need to know, is that there are two different application services (really three, but for the sake of this post, two that we’ll focus on). AMCAS is the application service for a majority of allopathic medical schools in the US and a few overseas schools. AACOMAS is the application for a majority of the osteopathic medical schools in the US.
The only difference between them is what site you go to. You fill out the same information on both, pay similar fees, and follow individual schools’ instructions for secondary applications. As frustrating as it might be to have to fill out the same information twice, maybe even three times, the repetitiveness of it makes it easier.
6. Is there a difference in residency placement or specialty?
Once again, the answer to this question is, it depends. There are a few things to note. The first thing, is that because the merger in June 2020 between osteopathic and allopathic medical schools under a single GME (graduate medical examination), everyone is under one umbrella.
This means that regardless which type of school you graduate from, D.O.s and M.D.s can apply to the same residencies. The COMLEX should be just as accepted as the USMLE and vice versa. D.O.s should have a fair shot at traditional M.D. specialty residencies and M.D.s can apply to traditional D.O. residencies. Allopathic physicians may need to meet some additional prereqs and train in osteopathic manual manipulation.
At the end of the day, where you end up in residency is based on you. Regardless which school you went to, you need good grades and good board exam scores. The merger may especially hurt D.O.s because M.D.s may be vying for spots that were traditionally held for D.O.s, even if they had lower stats. So now they cannot afford to slack off because they don’t have that safety net anymore.
Currently the USMLE is pass/fail and the COMLEX still gives scores (praying that changes soon) but you still have to do well to get a shot. Building your resume with research, volunteer, extracurricular activities, and good recommendation letters are also factors that boost your competitiveness. This shouldn’t be a deciding factor when choosing M.D. or D.O. The letters behind your name aren’t the determining point, your individual application is.
7. Does one medical school cost more than the other?
Let’s just be frank here, medical school is super expensive. Money is a huge factor when choosing M.D. or D.O.. Unless the Gods have blessed you with full scholarships, or you have decided to do a service exchange, be prepared to drop some major coins.
When it comes to average cost, they both are very similar. The major factors to consider are whether or not you are an in-state or out-of-state resident, and if you are going to a public or private school.
According to Shemmassin Academic Consulting, allopathic public schools for in-state residents cost on average $38,000. For M.D. schools, the cost for out-of-state residents averaged about $62,000. This is the same price, regardless of residency, for the average cost of a private allopathic medical school.
A downloadable file on the AACOM website listed their average costs. Osteopathic public schools for in-state residencies cost about $34,000, on average, and $53,000 for out-of-state residences. There are only a few public osteopathic schools, so the majority of them are actually private schools. The average cost, regardless of residency, for private D.O. schools is also $53,000.
8. Are the board exams different?
Yes, there are different board exams. They both happen in four parts, and both test different competency levels, but there are a few differences.
Allopathic schools take the USMLE
They complete Step 1 after their second year. It is a one-day 8-hour exam that is divided into 7 60-minute blocks testing fundamental knowledge of basic science principles and their application to clinical situations. It is pass/fail.
Step 2 CK tests clinical knowledge, and most students complete it during their fourth year when clinical knowledge is still fresh. It is important to take it before residency applications, but it is a one-day, 9-hour exam with 8 60-minute blocks testing application of clinical knowledge.
Step 2 CS tests students ability to actually practice their clinical knowledge by giving them a standardized patient and marking how they do in that setting. Again, most students take it in their fourth year as they are getting ready to apply for residencies.
Finally, Step 3 is the final exam and is taken during your intern year. It tests whether or not you are equipped to practice medicine without supervision. This is a two-day exam that is broken down into Foundations of Independent Practice for day 1, and Advanced Clinical Medicine for day 2. Day 1, consists of 232 multiple-choice questions divided into 6 blocks. You have an hour to complete each one. Day 2 consists of 180 multiple-choice questions divided into 6 blocks with an 45 minutes to get each block done. This is followed up with 13 case simulations, all of which have 10-20 minutes allotted for each one.
Osteopathic schools take the COMLEX
COMLEX Level – 1 also tests students’ fundamental understanding of basic sciences. It evaluates their ability to integrate basic medical knowledge while providing osteopathic care to patients. The COMLEX website describes it as a problem and solution based exam. It is not pass/fail, and is students take it at the same time as the USMLE, after their second year. The exam is 400 multiple-choice questions, divided into two four-hour blocks with a lunch break in the middle. Each of the 8 sections has 50 questions and individual sections are not timed.
COMLEX Level – 2 CE (clinical evaluation) is similar to Step 2. It is a computer-based test that tests your clinical skills. Most students take this during their fourth year, right after their first year of clinical rotations. Currently, it is 352 multiple-choice questions that test makers divided into two four-hour blocks. Each of the 8 sections contains 44 questions and the individual sections are not timed.
COMLEX Level – 2 PE (performance evaluation) is also a clinical evaluation. Students are in standardized rooms with standardized patients, demonstrating their knowledge in working with patients and diagnosing them after a medical interview. They show the skills they have learned while working in the clinic to show their competency to continue into residency.
COMPLEX Level – 3 is a two-day computerized test. Completion of this is necessary for physicians to be able to independently practice medicine, specifically as it pertains to osteopathic medicine. There are four sessions, each 3.5 hours long (2 per day), and students have a 14-day window to complete both days. There are 420 multiple-choice questions and 26 clinical decision making questions, each with 2-4 questions, for students to answer.
9. Are the curriculums different?
The curriculums are going to be different at every school you choose. Many medical schools do a system-based curriculum. This is where they break up the information on organ systems, in their entirety, before moving on to the next. For example, a school will focus on the gastrointestinal system, how it functions, its pathology, pharmacology, and anatomy. Other schools, are symptom based. They look at different symptoms and break down what could be causing them, and how to treat them. Remaining schools are still using the traditional approach of only focusing on one subject at a time. For example, only looking at physiology, then anatomy, then pathology of the entire body.
For more information on the types of curriculums, check out Medical School Insider, and check with individual schools. The main thing you need to know, when choosing M.D. or D.O., is that in addition to regular curriculum, D.O.s take one more class. All osteopathic schools incorporate osteopathic manual manipulation into their curriculum. OMM is where you learn how to treat patients with your hands and also the fundamental principles behind osteopathic medicine. For more on what OMM is, please check out AACOM.
10. Which one should I choose?
When choosing M.D. or D.O., the final decision is entirely up to you. I have provided you with a beast of information here. This took me a really long time to put together and I have my first test in 6 days from the time I’m writing this blog post. However, if the information here helps you make a more informed decision, then I’m happy to give you my time. A lot of the information here probably just confused you more because there aren’t too many differences between the two.
The main thing to keep in mind is what kind of medicine you want to practice. If you prefer a more holistic approach, then I would say lean towards osteopathic medicine. If you are more interested in treating symptoms and doing research, then allopathic medicine may be more up your ally. Either way, you’ll need a solid justification for why you want to be a doctor when you write your personal statement and go for interviews. Prepare yourself to answer “why DO?” if you choose that route, and make sure your reasonings are rooted in osteopathic principles.
If you have anymore questions that I haven’t answered, or more information about the information I have provided, please drop them in the comments section. I would love to hear your feedback and remember, informing our community takes a village. Honestly, I don’t have all the answers and won’t pretend to. I invite feedback and corrections, so don’t be shy!
That was a very informative blog. I relish all the research you’ve done & have learned so much. Great job Darian!