The question of MD vs. DO is one of the most common in pre-med advising, and it is surrounded by more misinformation than almost any other topic in healthcare education. Both degrees lead to fully licensed physicians who can practice in any specialty, prescribe medications, perform procedures, and treat patients independently. The differences are real but narrower than most students believe. This page provides an honest, evidence-based comparison of allopathic (MD) and osteopathic (DO) medical education so you can make an informed decision based on facts rather than prestige bias or outdated assumptions.
The Degrees: What They Mean
The Doctor of Medicine (MD) degree is awarded by allopathic medical schools accredited by the Liaison Committee on Medical Education (LCME). There are currently over 155 accredited MD programs in the United States. The Doctor of Osteopathic Medicine (DO) degree is awarded by osteopathic medical schools accredited by the Commission on Osteopathic College Accreditation (COCA). There are currently over 40 accredited DO programs across more than 60 teaching locations. Both degrees require four years of medical school followed by residency training, and both lead to full, unrestricted medical licensure in all 50 states.
Curricular Differences
The core medical curriculum (anatomy, physiology, pharmacology, pathology, clinical rotations) is essentially the same in both MD and DO programs. The primary curricular difference is that DO programs include training in osteopathic manipulative medicine (OMM), also called osteopathic manipulative treatment (OMT). OMM is a set of hands-on diagnostic and treatment techniques used to treat musculoskeletal disorders and, in osteopathic theory, to support the body’s self-healing capacity. DO students typically take OMM courses throughout all four years of medical school, in addition to the standard medical curriculum. The amount of emphasis placed on OMM varies by school; some programs integrate it heavily into clinical training, while others treat it as a supplemental skill.
Beyond OMM, osteopathic medical education emphasizes a holistic approach to patient care, the interrelationship of structure and function, and the body’s capacity for self-regulation and self-healing. In practice, these philosophical differences manifest most clearly in primary care, where many DO physicians incorporate musculoskeletal assessment and OMT into their patient encounters. In surgical and procedure-heavy specialties, the day-to-day practice of MD and DO physicians is functionally identical.
Residency and Specialty Access
Since the completion of the single accreditation system in 2020, all residency programs in the United States are accredited by the Accreditation Council for Graduate Medical Education (ACGME). Both MD and DO graduates apply to and match into the same residency programs through the National Resident Matching Program (NRMP). DO graduates match into every specialty, including competitive fields like dermatology, orthopedic surgery, ophthalmology, and plastic surgery, though match rates in the most competitive specialties remain somewhat lower for DO applicants as a group. This gap has been narrowing over time and reflects a combination of factors including application volume, research output, and residual institutional bias rather than any difference in clinical training quality.
The NRMP Charting Outcomes data shows that the overall match rate for DO seniors is approximately 91 to 93 percent, compared to 93 to 95 percent for MD seniors. For most specialties, the match rates are comparable. The gap is most pronounced in highly competitive specialties where research productivity, program prestige networks, and USMLE® Step 2 CK scores play outsized roles in selection. DO students interested in competitive specialties can strengthen their applications through strong board scores, robust research portfolios, and away rotations at programs that value osteopathic applicants.
Licensing Exams
MD students take the USMLE® (United States Medical Licensing Examination) sequence: Step 1 (now pass/fail), Step 2 CK (scored, the primary numeric exam for residency), and Step 3 (taken during residency). DO students take the COMLEX-USA® sequence: Level 1 (now pass/fail), Level 2-CE (scored), and Level 3. DO students may also choose to take the USMLE® in addition to COMLEX-USA®, particularly if applying to competitive ACGME residency programs where some program directors are more familiar with USMLE® scoring. Taking both exam sequences requires additional preparation time and fees, and the decision should be made in consultation with your school’s advising office. See our USMLE® Step 1, USMLE® Step 2, and COMLEX-USA® preparation guides.
Admissions and Competitiveness
MD programs generally have higher average MCAT® scores and GPAs for admitted students compared to DO programs, though there is significant overlap. The median MCAT® score for MD matriculants is typically around 511 to 512, while the median for DO matriculants is approximately 504 to 506. These are medians, not cutoffs; many students with MCAT® scores of 510 or above attend DO schools by choice, and many students with scores below 510 are admitted to MD programs. The admissions landscape for both types of schools considers the whole applicant, including clinical experience, research, leadership, personal statement, and letters of recommendation, not just numbers.
DO programs generally place greater emphasis on applicants who demonstrate genuine interest in osteopathic medicine, primary care, and community health. Applicants who apply to DO programs as a “backup” without understanding or articulating interest in osteopathic philosophy may face skepticism from admissions committees. If you are genuinely interested in the DO approach to medicine, convey that interest authentically in your application. See our AACOMAS® application guide and DO pathway page.
Salary and Practice Patterns
There is no meaningful salary difference between MD and DO physicians in the same specialty and practice setting. Compensation is determined by specialty, geographic location, practice type (academic vs. private), and patient volume, not by degree type. A DO orthopedic surgeon and an MD orthopedic surgeon working in the same city will have comparable incomes. DO physicians are disproportionately represented in primary care (family medicine, internal medicine, pediatrics), partly due to the osteopathic emphasis on primary care and partly due to historical patterns in residency matching. However, DO physicians practice across all specialties, and the distribution is becoming increasingly similar to that of MD physicians. See our physician career profile for salary data across specialties.
Which Path Is Right for You
Choose a DO program if you are genuinely interested in the osteopathic approach to medicine (holistic care, musculoskeletal emphasis, OMT), if you value the primary care and community health orientation of osteopathic education, or if a specific DO program offers a curriculum, location, clinical training, or culture that appeals to you. Choose an MD program if a specific MD program aligns with your goals, if you are planning a career in a highly competitive specialty where the MD credential still carries marginal advantages in some residency programs, or if you prefer a program without required OMM coursework.
Do not choose between MD and DO based on prestige. The prestige gap between the degrees has narrowed dramatically and continues to narrow. Your patients will not care which two letters follow your name; they will care whether you are competent, compassionate, and trustworthy. Focus on becoming an excellent physician, and the degree type will matter less and less as your career progresses.
For related comparisons, see our physician vs. PA vs. NP and cost comparison pages. For application guidance, see our AMCAS® and AACOMAS® guides.
References
American Association of Colleges of Osteopathic Medicine (AACOM). “2024-2025 Academic Year Entering Class Profile.” AACOM, 2025. https://www.aacom.org/. Accessed March 2026.
Association of American Medical Colleges (AAMC®). “AAMC Facts.” AAMC, 2025. https://www.aamc.org/data-reports. Accessed March 2026.
National Resident Matching Program (NRMP). “Charting Outcomes in the Match.” NRMP, 2025. https://www.nrmp.org/. Accessed March 2026.
Bureau of Labor Statistics. “Physicians and Surgeons.” BLS, 2025. https://www.bls.gov/ooh/healthcare/physicians-and-surgeons.htm. Accessed March 2026.