DO vs. MD - True Differences

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eartharte

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I feel like I've seen a lot of posts scattered here and there about the differences between the DO and MD path. While DO seems like it might be easier to be accepted into, what other differences are there in the long-run? Does DO vs. MD affect your chances of matching (are DO and MDs placed in the same residency programs)? Will it affect your income or success as a physician in the long run? How different is a DO and MD education? Is it still the same career path (med school --> residency --> fellowship if you want to specialize)? Can you still hold private practices as a DO? Lots and lots of questions, as I'm still not sure about the specifics of the differences between the two. Thanks in advance!
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PigsHaveWings said:
1 If you are going to be in private practice , no difference between MD and DO.

2. Competitive residency specialties (dermatology, ent, opthalmology, neurosurgery, plastic surgery, orthopedics, radiation oncology) are harder to get in as a DO.

3. More prestigious residency programs in internal medicine (top 20 etc) easier to get in as MD

4. Research--- Basic science and Translational science research is limited to MD schools. Clinical research is available in both MD and DO, but generally more in MD schools.

5. Quality of education---- Most MD schools ( probably 90%) you will get a good quality education (good clinical rotations, mentors, clinical staff) and you will not have to worry about coming out fully rounded . Some DO schools (all the well established DO schools (about 25 of them) will give you a comparable education to any MD school ie PCOM , DMU-COM etc ) you will get a good quality education. There are some (about 15-20) DO schools, which have extremely poor clinical facilities ( community hospital as compared to academic hospital), lack of full time faculty with heavy dependence on part time , disproportionate ratio between number of students and the facilities available to train them (some of them are upwards of 300), limited availability to train/rotate in some of the more competitive specialties, heavily profit motivated which you have to wary about.
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Agree with all of your points except number 4. While research is historically easier to access and more robust at MD schools, basic, translational, and clinical research routinely occurs at DO schools. There are only a few with robust programs, but it is now an accreditation requirement from COCA that DO schools participate in research.
 
Real McCoy said:
Agree with all of your points except number 4. While research is historically easier to access and more robust at MD schools, basic, translational, and clinical research routinely occurs at DO schools. There are only a few with robust programs, but it is now an accreditation requirement from COCA that DO schools participate in research.
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Thank you, agree with your point. Changed the wording on my posting, shortly after I wrote it.
 
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Main downside of DO is OMM. Like goro says, it’s a tax for screwing up your gpa/mcat. While my MD peers are doing research or studying for boards, I have to use that time to figure out how to move cranial bones.
 
gonnif said:
The one difference is that MD tends to position you better for residency in both what speciality and specific programs. This would follow as MD are more selective, therefore have higher stat students. And the point here is you apply to medical school based on your stats and overall record, not on what you prefer to do. Both MD and DO are highly competitive, each with about 40% acceptance. You apply to the best school you can get into and you apply broadly.

The only people who ever notice or care about MD or DO are premeds
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I honestly don't mean to seem dense, but you lost me with the two statements I excerpted above, which seem to contradict each other.

I totally get that there is nothing wrong with DO if it's the best you can get, and you are a physician either way, but either they are equivalent or they aren't. You are saying both!!! If MD is more selective and better positions you for your future career, then clearly it is NOT true that the only people who notice or care are premeds.
 
drducky. said:
Main downside of DO is OMM. Like goro says, it’s a tax for screwing up your gpa/mcat. While my MD peers are doing research or studying for boards, I have to use that time to figure out how to move cranial bones.
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And a second set of boards
 
gonnif said:
There is no requirement that DO take the USMLE. The Osteopathic equivalent is accepted
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There is no requirement per se, but not all residency programs will accept COMLEX scores, or at least consider them equally. In 2018 about 60% of osteopathic medical students took USMLE Step 1, which is a marked increase over the past couple of decades.

Ahmed, Harris MPH; Carmody, J. Bryan MD, MPH Double Jeopardy: The USMLE for Osteopathic Medical Students, Academic Medicine: May 2020 - Volume 95 - Issue 5 - p 666 doi: 10.1097/ACM.0000000000003180
 
gonnif said:
If you read my posting I never say that that they are equivalent. In terms of the practice of clinical medicine and all factors that entails, there is NO difference. You are a physician and that is that.

In terms of selection for schools and subsequent followup for residency (which of course is now under one Graduate Medical Education system), MD is more selective, therefore more competitive, typically has great opportunity/access to academic medical centers, and thus positions graduates for more competitive specialties and more prestigious programs within those specialties. For premeds, MD and DO should be considered a spectrum of the same training. The differences in "prestige" and frankly any discussion of this by premeds is such a useless topic. As an applicant you do not pick a school based on whether its MD or DO. You target schools that fit your GPA/MCAT and overall record. You apply broadly and take the best offer you can get. Considering that some 60% of applicants get rejected and another 20% get accepted to a single MD school and DO isnt far behind those numbers. Thus this hyped up difference is really meaningless to most applicants.

And I will stand by my statement that except for premeds, no one cares about whether you are an MD or DO. The differences in selection for residency follow the differences in selection for medical school. That is lower status students, less opportunity for research, audition rotations, and networking for both specialty and program selection.
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Thanks for clearing that up. It makes perfect sense, EXCEPT, again, to the extent lower status students have fewer opportunities, it appears that SOMEONE besides premeds cares whether you are MD or DO! 😎

Your overall point is very well taken -- the discussion is pointless because everyone applies where they are a fit, based on, among other things, stats, and people take the best opportunity they have, whether it is MD or DO. And, so few people have more than one choice that the conversation is irrelevant to the vast majority of people. And, if you have a choice between MD and DO, unless that MD is in the Caribbean, it almost always makes sense to choose MD. Got it!!! 😎
 
gonnif said:
There is no requirement that DO take the USMLE. The Osteopathic equivalent is accepted
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True, but in general, the more competitive the specialty, the less likely the PD is to accept COMLEX alone.


and HUSTLE to get research and make connections. Crush boards (2 sets) and match to mid-tier program. Ultra competitive specialties? for get about it.
For the first part, this is true, but can also apply to MD students as well. For the latter, not true. Should be " Ultra competitive specialties? Really difficult, but not impossible.
Check out CUSOM's match list for the past two years.
 
KnightDoc said:
Thanks for clearing that up. It makes perfect sense, EXCEPT, again, to the extent lower status students have fewer opportunities, it appears that SOMEONE besides premeds cares whether you are MD or DO! 😎

Your overall point is very well taken -- the discussion is pointless because everyone applies where they are a fit, based on, among other things, stats, and people take the best opportunity they have, whether it is MD or DO. And, so few people have more than one choice that the conversation is irrelevant to the vast majority of people. And, if you have a choice between MD and DO, unless that MD is in the Caribbean, it almost always makes sense to choose MD. Got it!!! 😎
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The fewer opportunities are because the established academic medical centers have established medical schools which are almost uniformly MD. PI's tend to have medical students from their own institution helping with research.
 
Go to an MD school if you can. Ive had to bust my butt as a DO student applying for academic IM programs. The sad thing is despite having 250+ Step, honors in third year, great evals etc my ceiling is mid tier academic Internal medicine no matter how hard I work or how good my app is where as if I was an MD student I could most likely be applying to MGH Hopkins etc with an actual chance of matching there as my letters would be from academic faculty from people that matter. At least try for MD no matter what specialty you want to do-it will always under all circumstances open more doors and make life easier. So within medicine and applying for residency DO vs MD does make a difference. However, to the lay public and salary-wise there is zero difference
 
Goro said:
True, but in general, the more competitive the specialty, the less likely the PD is to accept COMLEX alone.


and HUSTLE to get research and make connections. Crush boards (2 sets) and match to mid-tier program. Ultra competitive specialties? for get about it.
For the first part, this is true, but can also apply to MD students as well. For the latter, not true. Should be " Ultra competitive specialties? Really difficult, but not impossible.
Check out CUSOM's match list for the past two years.
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To add to your CUSOM comment and for DO applicants that would like to hear this, there was a CUSOM kid that matched UNC Ophtho which is a HUGE deal in the DO world. Even for an MD this kind of match is impressive. But Goro is right kids the surgical subs are insanely competitive for DO applicants AND MD applicants but even more so for DO applicants
 
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i am a DO student and I absolutely regret it. I would have spent another year improving my application for the MD rather.
 
KnightDoc said:
Why???
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I have already noticed a significant decrease in research opportunities, and I want to specialize. That dream is decreasing everyday especially with Step 1 being Pass/Fail. A residency program director literally told me to my face that he has never accepted a DO student before. OPP is like the holy grail of Osteopathic medicine. Most people I know go to a DO school because they didnt get into an MD school. Therefore there is a huge disconnect with motivation to learn this, when in fact, I know people really dislike it. Even in today's age, with the media recently bashing on Trump's doctor being a DO, that is something we will have to deal with a defend for the rest of our lives.
 
Deecee2DO said:
To add to your CUSOM comment and for DO applicants that would like to hear this, there was a CUSOM kid that matched UNC Ophtho which is a HUGE deal in the DO world. Even for an MD this kind of match is impressive. But Goro is right kids the surgical subs are insanely competitive for DO applicants AND MD applicants but even more so for DO applicants
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That there are PDs who have never have, and will never take a DO should not be a surprise. In fact, anyone surprised by this fact didn't know what they were getting into.

Thanks to the PD's annual survey, we get a snapshot into the minds of PDs as to whether they will interview and rank a DO. Mind you, the data isn't perfect, the n's are small, but it's better than no data.

The data (%s of PDs willing to do the things in the headers) shown below are from the 2020 survey, with the exception of Thoracic Surgery, which is from 2018 (no data for 2020). #s are for DO seniors, not grads. I have found that these numbers are increasing favorably each year, and do not merely represent the GME merger. In addition, even the uber-specialties have an increase of accepting DOs by about 1%/year, based upon NRMP data.

1602525268816.png
 
Goro said:
That there are PDs who have never have, and will never take a DO should not be a surprise. In fact, anyone surprised by this fact didn't know what they were getting into.

Thanks to the PD's annual survey, we get a snapshot into the minds of PDs as to whether they will interview and rank a DO. Mind you, the data isn't perfect, the n's are small, but it's better than no data.

The data (%s of PDs willing to do the things in the headers) shown below are from the 2020 survey, with the exception of Thoracic Surgery, which is from 2018 (no data for 2020). #s are for DO seniors, not grads. I have found that these numbers are increasing favorably each year, and do not merely represent the GME merger. In addition, even the uber-specialties have an increase of accepting DOs by about 1%/year, based upon NRMP data.

View attachment 320323
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I actually have a question about this on a similar topic I personally emailed UNCs IM program coordinator and asked if they have ever accepted a DO and they said no but she said they often rank and interview DO applicants. am I missing something? why aren’t they matching then? Courtesy IIs?
 
Deecee2DO said:
I actually have a question about this on a similar topic I personally emailed UNCs IM program coordinator and asked if they have ever accepted a DO and they said no but she said they often rank and interview DO applicants. am I missing something? why aren’t they matching then? Courtesy IIs?
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They have one PGY-1 DO in their IM res program.
 
The only specialty where you’re not at a disadvantage as a DO is PM&R. That said, all that OMM does detract from boards studying. And MD’s typically have higher quality rotation sites —> higher quality clinicals
 
sloh said:
The only specialty where you’re not at a disadvantage as a DO is PM&R. That said, all that OMM does detract from boards studying. And MD’s typically have higher quality rotation sites —> higher quality clinicals
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Redundancy of info isn't helping. If people don't know this going in, shame on them.
 
One has an M the other has an O. One you might mix up with Maryland. One has the D after the other begins with D.
 
MDFUTURE123 said:
I have already noticed a significant decrease in research opportunities, and I want to specialize. That dream is decreasing everyday especially with Step 1 being Pass/Fail. A residency program director literally told me to my face that he has never accepted a DO student before. OPP is like the holy grail of Osteopathic medicine. Most people I know go to a DO school because they didnt get into an MD school. Therefore there is a huge disconnect with motivation to learn this, when in fact, I know people really dislike it. Even in today's age, with the media recently bashing on Trump's doctor being a DO, that is something we will have to deal with a defend for the rest of our lives.
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If you want to specialize why did you decide to apply DO ?

also this is the same media that believes Midlevels are equivalent to and/or better than doctors. So I wouldn’t stress about what people in social media are saying especially since they probably have been treated by a DO and didn’t notice.
 
drcardi said:
If you want to specialize why did you decide to apply DO ?

also this is the same media that believes Midlevels are equivalent to and/or better than doctors. So I wouldn’t stress about what people in social media are saying especially since they probably have been treated by a DO and didn’t notice.
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Its not like DO's cannot specialize. Most of the DO schools I interviewed at had pretty good match lists, so its not impossible, just a lot harder, and with taxes like OPP and OMT...
 
Deecee2DO said:
I actually have a question about this on a similar topic I personally emailed UNCs IM program coordinator and asked if they have ever accepted a DO and they said no but she said they often rank and interview DO applicants. am I missing something? why aren’t they matching then? Courtesy IIs?
Click to expand...
I seriously doubt PDs and their overworked residents would waste time on courtesy interviews. Rather, I suspect that the situation is very much like med school. While many people get interviews, not all can get accepts. At some point, someone will wow then and the glass open will be kicked open.
 
MDFUTURE123 said:
I have already noticed a significant decrease in research opportunities, and I want to specialize. That dream is decreasing everyday especially with Step 1 being Pass/Fail. A residency program director literally told me to my face that he has never accepted a DO student before. OPP is like the holy grail of Osteopathic medicine. Most people I know go to a DO school because they didnt get into an MD school. Therefore there is a huge disconnect with motivation to learn this, when in fact, I know people really dislike it. Even in today's age, with the media recently bashing on Trump's doctor being a DO, that is something we will have to deal with a defend for the rest of our lives.
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The DO discrimination doesnt really effect matching chances to a large degree unless its a surgical sub or Derm. Sure some specialties are more challenging not as much because youre a DO but just because they are competitive in general (Cards, GI) for both MDs and DOs. typically for a DO trying to match into these 2 subspecialties, it is in their best interest to apply to university IM programs which requires a more competitive academic profile in the applicant thus making them harder to match into in the long run. These university/academic IM programs open more doors and offer better fellowship matches than DO/AOA IM programs and increase your chances. These academic places have mostly MDs which makes being a DO a slightly uphill battle but that is much more surmountable than say applying derm, ENT, NS, plastics, Ophtho as a DO.
 
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MDFUTURE123 said:
Its not like DO's cannot specialize. Most of the DO schools I interviewed at had pretty good match lists, so its not impossible, just a lot harder, and with taxes like OPP and OMT...
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You can say that again. HUGE taxes. Also, in response to the media bashing Trumps doctor being a DO lmao Biden's doctor is also a DO
 
Most DOs match into residencies at a 80 to 90 % rate for most specialties. Gen surg around 60% Google Charting Outcomes. Competetive residencies require a competetive app, even if you are an MD. Yes, some residencies are not open to DOs. A misconception is that you can only get good training at a top 10 program. I have a student at a university affiliate Level 1 trauma center, where they did Gen Surg and are now in their kick a$$ CT surgery fellowship. I can guarantee they will be very well trained and skillful. So seek out these good affiliate programs and play the match game well. I totally agree that as a DO you will deal with discrimimation and pedigree snobbery. You will be answering the question from patients, "DO, what's that" for your entire career. The equalizer is that I got paid the same as my partners from U Penn.
If you cant handle it, better take that gap year
 
I have been involved in medicine as an MD (or med student) since 1973. I am now retired. I have been a department head
for 23 years. I can confidently say that there is nobody (who matters) who cares a whit about MD vs DO. It is a dead issue among the cognizant. Same with the “ivy” stuff.
All these games and nonsense disappear when you are working your butt off trying to make a living in a very difficult field that is only getting more so.
 
mikesheree said:
I have been involved in medicine as an MD (or med student) since 1973. I am now retired. I have been a department head
for 23 years. I can confidently say that there is nobody (who matters) who cares a whit about MD vs DO. It is a dead issue among the cognizant. Same with the “ivy” stuff.
All these games and nonsense disappear when you are working your butt off trying to make a living in a very difficult field that is only getting more so.
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Good grouping on your Avatar! You and I are of similar vintage, I'm just a few years younger. I was the 2nd DO to be on staff at our local university hospital. I received some odd looks initially was often quizzed about why I was doing something a certain way. My experience was mostly from a different time to be sure, as I spent the last 17 years in Med Ed. As far as the Ivy's, about 3 years ago, an associate in my Internists practice was quick to work into our conversation that he trained at Penn. This took all of about 30 sec. Our local University IM program has never taken a DO as a resident and probably won't in my lifetime. This told to my by my Internist who takes care of all the hotshots in the University Health System. I totally agree with " ..nobody, (who matters), gives a whit about DO and MD." DO was a good path for me and while working in the university world, I was recognized for my merits and abilities rather than my degree. When I left for private practice, I didn't apply for the job. I got a phone call and was recruited by former colleagues. Medicine, for the most part is like that.
 
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