MD vs. DO: What’s the Difference Between Allopathic and Osteopathic Physicians?

There are two types of fully licensed physicians in the United States: allopathic physicians (MDs) and osteopathic physicians (DOs). Choosing between the MD and DO tracks is a decision you typically make as part of the medical school application process during your undergraduate studies. When deciding which degree and career path to pursue, it’s important to understand the key similarities and differences between MD and DO doctors. While both types of physicians can be fully licensed to practice medicine in the United States, there are important distinctions to consider. 

In this guide, we’ll explore the similarities and differences between allopathic and osteopathic physicians to help you choose the medical career that aligns with your goals.

TABLE OF CONTENTS:

• MD vs DO: Quick Overview
• What is an MD (Doctor of Medicine)?
• What is a DO (Doctor of Osteopathic Medicine)?
• MD vs. DO: Key Similarities
• MD vs. DO: Key Differences
• MD vs. DO Salaries: What to Know
• Is it better to get a DO or MD degree?

MD vs. DO: Quick Overview

The table below shows an overview of some key differences and similarities between MDs and DOs.

	MD (Doctor of Medicine)	DO (Doctor of Osteopathic Medicine)
Education + Training	4 years of medical school	4 years of medical school + Osteopathic Manipulative Treatment (OMT) training
Licensing Exam	USMLE® exam	COMLEX-USA® exam, but may also take the USMLE® exam
Residency	Same unified ACGME® system; train side-by-side in hospitals	Same unified ACGME® system; train side-by-side in hospitals
Licensure	Fully licensed to prescribe and perform surgery in all 50 states	Fully licensed to prescribe and perform surgery in all 50 states
Specialty Trends	MDs may go into primary care, but many choose specialized fields	DOs have a strong leaning toward primary care

What is an MD (Doctor of Medicine)?

A Doctor of Medicine, or MD, is a professional doctoral degree that qualifies you to practice medicine as a physician in the US. MDs are licensed to prescribe medication, perform surgery, and manage comprehensive patient care across various specialties. To earn an MD, students must typically complete a four-year undergraduate degree, four years of medical school, and several years of residency training in a specific specialty. MD-granting schools are called allopathic medical schools. 

MDs are allopathic physicians. The term “allopathic medicine” generally refers to the broad system of conventional, science-based medicine that is the standard of care for Western medicine. Today, the allopathic label is mostly used in administrative and educational settings to identify which type of school a doctor attended.

What is a DO (Doctor of Osteopathic Medicine)?

Like an MD, a Doctor of Osteopathic Medicine (DO) is a fully licensed physician in the US. DOs can prescribe medication, perform surgery, and practice in any medical specialty. Like their MD counterparts, DOs complete four years of medical school and residency programs, but their medical school training includes a unique emphasis on the musculoskeletal system through Osteopathic Manipulative Treatment (OMT). DO-granting institutions are called osteopathic medical schools.

DOs are osteopathic physicians. Osteopathic medicine focuses on a whole-person approach to healthcare. This can include addressing additional factors, like a patient’s lifestyle, environment, and emotional state, rather than just treating symptoms or injuries. Osteopathic medicine is built on the philosophy that all body systems are interconnected and that the musculoskeletal system, the body’s framework of muscles, bones, and nerves, plays a central role in overall health. To that end, all DOs are taught Osteopathic Manipulative Treatments to maximize a patient’s health.

MD vs. DO: Key Similarities

MDs and DOs are functionally equivalent. Today, the education and day-to-day work of these physicians in the US are nearly identical.

Here is a quick list of the key similarities between MDs and DOs:

• Licensure: Both are fully licensed physicians in all 50 US states.
• Education: Both complete four years of medical school.
• Residency Training: Both undertake residency training for 3–7+ years after graduation.
• Practice Scope: Both can prescribe medication, perform surgery, and practice in any medical specialty.
• Reputation: Both are highly respected members of the healthcare system.

MD vs. DO: Key Differences

While DOs and MDs perform the same duties in modern hospitals, some differences occur between the two in training requirements, licensing exams, and specialty trends.

Here is a quick list of the key differences between MDs and DOs:

• Training: Unlike MDs, DOs receive 200–500 extra hours of training in Osteopathic Manipulative Treatment.
• Licensing Exam: MDs must pass the USMLE exams, whereas DOs must pass the COMLEX-USA exam, though some DOs choose to take both licensing exams.
• Specialty Trends: DOs often go into primary care (e.g., family medicine, pediatrics), while MDs often pursue specialized subfields or research-heavy roles.

Keep reading for an in-depth look at the key differences between MDs and DOs.

A key difference between MDs and DOs is the additional training DOs undergo in OMT. DO students must complete 200 to 500 hours of OMT training in addition to standardized medical training. OMT training is a hands-on technique that allows DOs to diagnose and treat systemic issues, offering a non-invasive alternative or complement to traditional medicine. This form of treatment aligns with osteopathic medicine’s holistic approach, which emphasizes the body’s interconnectedness. 

Licensing exams also vary between MD and DO students. MD students are required to take the three-step USMLE exam, which focuses heavily on the application of biomedical sciences, pathophysiology, and clinical reasoning. DO students, on the other hand, must pass the COMLEX-USA exam, which covers the same medical and clinical knowledge as the USMLE exam, but also rigorously tests Osteopathic Manipulative Medicine (OMM) and holistic philosophy. While DOs are only required to pass the COMLEX exam for medical licensure, many choose to also take the USMLE exam to remain competitive for certain highly specialized residency programs that are more familiar with USMLE scoring.

While both MDs and DOs can practice in any medical specialty, DOs have a stronger historical and philosophical lean toward primary care. DOs often choose primary care specialties like family medicine, internal medicine, and pediatrics, which align with their whole-person approach to medicine. MDs, while also prominent in primary care, are more evenly distributed across all specialties and have a higher representation in highly competitive, research-intensive surgical subspecialties and other specialized medical fields.

MD vs. DO Salaries: What to Know

MDs and DOs have the same earning potential. An employer will compensate both types of physicians equally when they work in the same specialty, at the same location, and with the same level of experience. While national averages often suggest that MDs earn more than DOs, this gap is primarily driven by career choices rather than the degree itself.

Here are the key factors that influence pay for MDs and DOs:

• Practice type 
• Specialty 
• Location 
• Volume and productivity

MDs historically enter high-paying surgical and diagnostic specialties, whereas DOs are more likely to pursue primary care and practice in rural areas, which typically offer lower compensation than urban private practices. Ultimately, a physician’s salary is determined by their practice type, specific field of medicine, location, and individual productivity, regardless of whether they hold an MD or a DO degree.

Is it better to get a DO or MD degree?

While MDs and DOs are different credentials, they are considered functionally equivalent in the eyes of the law, hospitals, and insurance companies. One is not better than the other. Ultimately, whether you choose to get a MD or DO degree depends on your goals. MD degrees are traditionally more competitive to obtain and hold a slight advantage for students pursuing ultra-competitive surgical specialties or international practice. On the other hand, DO programs offer a holistic philosophy and specialized training in musculoskeletal manipulation, making them an excellent choice for those dedicated to primary care or community-based medicine.

---

Written by Kaplan experts, reviewed by Jonathan Bruner, DO, Executive Director of Institutional Medical Programs and John Bloodworth, MD, Senior Director, Content Development, Kaplan Medical. Jonathan graduated from the Michigan State University College of Osteopathic Medicine before completing his residency in Osteopathic Neuromusculoskeletal Medicine (ONMM). John earned his MD from Ross University School of Medicine in 2010, joining Kaplan full-time soon after.