MD vs DO Guide

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JDoctor

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Before you read the below article wonderfully uploaded by BYU, please note that I'll summarize the main difference here.
  • Osteopathic schools require up to 200 hours of manipulation training on top of the medical coursework, demonstrating the emphasis placed on the musculoskeletal system.
  • The osteopathic philosophy focuses on a holistic approach to practicing medicine, meaning treating the patient as a whole—not just the symptoms or injuries.
  • Schooling besides the difference posted above, is the same.
The important thing, I think to take note of is the fact that the approach to this type of medicine is different. I would say, from my understanding, the best way to explain this is that if Walter walks into the doctor with a cough, DO's are trained in the way of thinking about the patient well being, and overall happiness rather than just clearing the cough (which a DO will still do).

Note to Administrators: I have searched on this site for a good hour or so before attempting to look at college websites for a guide. Every single thread has a "don't feed the troll" or "You need to search." This made it very frustrating for me, and as such I wanted to find the difference and post it. If you'd like to slap your name on it, and sticky it I think it'd benefit the whole community.


Thanks for reading the summary, and i'll get on with the whole article posted by http://byu.edu



MD vs. DO


There are two types of degrees to become a physician in the U.S.—an MD (allopathic) degree and a DO (osteopathic) degree. Most people are more familiar with MD physicians, especially in the west. This is most likely because they represent only 6 percent of more than 61,000 DO physicians in the U.S. There are 131 allopathic medical schools and 29 osteopathic medical schools, with most osteopathic schools in the east.

Similarities

DO and MD physicians are alike in that they both utilize scientifically-accepted methods of diagnosis and treatment, including the use of prescription drugs and surgery. Educational requirements are similar in that both degrees require four years of medical school and a residency program of three to seven years. In most instances, DO and MD physicians are examined by the same state licensing board, therefore licensure for both are based on the same requirements and the same or comparable examinations. Both types of physicians are licensed to practice all phases of medicine in every state in America, and both are found in every specialty of medicine. The premedical pathway is identical for both allopathic and osteopathic schools, requiring premedical coursework (which varies slightly from school to school), the MCAT, and a bachelor’s degree.

Differences

While there are many similarities between osteopathic and allopathic physicians, there are also some important differences. First of all, the osteopathic philosophy differs from the allopathic philosophy. The osteopathic philosophy focuses on a holistic approach to practicing medicine, meaning treating the patient as a whole—not just the symptoms or injuries. This holistic approach acknowledges that all the body systems are interconnected and that the musculoskeletal system is especially important in reflecting and affecting the condition of all the other systems. Osteopathic schools require up to 200 hours of manipulation training on top of the medical coursework, demonstrating the emphasis placed on the musculoskeletal system. This training teaches students manual therapy and manipulation techniques, adding another tool to traditional forms of diagnosis and treatment to effectively care for patients.

Around 65 percent of DO physicians practice in primary care whereas the majority of MD physicians specialize. Many DO physicians practice in rural settings as primary care physicians, while MD physicians tend to stay close to metropolitan areas where there are more specialty positions available. However, there are MD and DO physicians in different environments all over the country. Currently, more medical applicants apply to allopathic schools than osteopathic schools, resulting in higher admission criteria for allopathic medical schools (refer to the MD and DO statistics handouts for more information) and DO schools use a different application service. Additional information regarding AMCAS, AACOMAS, and TMDSAS can be found in our office handouts.

MD and DO students and residents take different licensure exams, but both are important in determining factors for acceptance to residency programs. MD students take the United States Medical Licensing Exam (USMLE), while DO students take the Comprehensive Osteopathic Medical Licensing Examination (COMLEX). DO medical students can apply to MD residency programs and are most competitive for those in primary care. While there are DO physicians in all sorts of MD residencies, it may be more difficult to get into a top MD residency program in a very competitive residency specialty as a DO. Some MD residencies will accept COMLEX board scores, while others require DO students to take the USMLE on top of taking the COMLEX. Many MD residencies don’t’ regard the manipulation training as relevant to their specialty.


Refer to the MSAR and www.aamc.org/students/start.htm for more information regarding allopathic medicine or the Osteopathic Medical College Information Book and www.aacom.org for more information regarding osteopathic medicine.
 
I just don't buy that DOs are more holistic. I have met engaged MDs and left my DO because of his bedside manner. I have looked at the curriculum of multiple schools and I don't see anything that would make one more holistic or more likely to only treat the symptoms. Could it be that the holistic model comes from the fact that so many DOs are in primary care?
 
I just don't buy that DOs are more holistic. I have met engaged MDs and left my DO because of his bedside manner. I have looked at the curriculum of multiple schools and I don't see anything that would make one more holistic or more likely to only treat the symptoms. Could it be that the holistic model comes from the fact that so many DOs are in primary care?
It's actually beaten to death in our curriculum. MDs also get similarly focused training though, so I wouldn't say its unique.
 
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philosophy and practicality are probably two very different things.
 
One thing to point out: it doesn't actually follow that MD criteria for admissions are > DO based on applicant volume. Some of the schools with the highest app volume are far from the most prestigious/selective. They should just say criteria are higher and there's more applicants. Applicant quality rather than quantity would be the more likely explanation, since no amount of 20-something MCAT applicants will let them raise their medians to 33.
 
6-day-old member seeks to solve MD vs. DO with his thread. I admire your optimism, but come on. Aside from posting the beating the dead horse, I'll actually contribute.

The term "holistic approach" needs to be dumped. It's ill-defined and not representative of whatever the "definition" of MD and DO differences are. A prospective medical student should consider:

1.) OMT training (which is not necessarily used in residency training OR practice as an attending)
2.) Taking the COMLEX (sometimes also the USMLE if desired or sometimes both)
3.) AOA residencies vs dual AOA/ACGME accredited vs. ACGME.

And now,

:beat:
 
The osteopathic philosophy focuses on a holistic approach to practicing medicine, meaning treating the patient as a whole—not just the symptoms or injuries.

This is what people who don't know what the hell they're doing say to justify the fact that they don't know what the hell they're doing. Real doctors can care about treating the patient as a whole, it's not like being smart enough to go to medical school excludes the possibility of being a decent human being that knows how to think. In fact, learning a ton of facts and developing the ability to think about them for patients somehow manages to be more useful than sitting at the bedside holding the patient's hand telling them that you're treating them holistically.
 
I wonder if Podiatry schools talk about "treating the whole patient" too?

They'll have to if they want to treat foot-in-the-mouth syndrome.
 
I got no answers here besides those telling me not to troll. I searched and this is a valuable answer. If you disagree tell me why, I don't care which is "better" i searched for the philosophy difference.

Also my infancy doesnt immediately make my input invaluable.

Also this is what I found. Not my opinion
 
I got no answers here besides those telling me not to troll. I searched and this is a valuable answer. If you disagree tell me why, I don't care which is "better" i searched for the philosophy difference.

Also my infancy doesnt immediately make my input invaluable.

Also this is what I found. Not my opinion
Use the search function. You are assumed to be a troll because you're asking about a topic that has been asked about way too many times.
 
Use the search function. You are assumed to be a troll because you're asking about a topic that has been asked about way too many times.


As I said, almost every thread has no valuable contribution. Its always "stop beating dead horse" or "trolling"

Also, no one can really tell me the difference other than this article. Is it wrong?
 
As I said, almost every thread has no valuable contribution. Its always "stop beating dead horse" or "trolling"

Also, no one can really tell me the difference other than this article. Is it wrong?
No it's because you're asking about MD vs DO... And no one will tell you anything new or something that you can't look up. I'll be surprised if anyone else contributes to this thread in a meaningful way.
 
You got no answers because we're tired of fighting about this. No one agrees.

How is there an argument here? I want the facts which i seemingly found but people dont agree with I guess. I do appreciate the input on this thread but I stand by that if that is the difference (philosophy) then thats what it is even if i dont agree.
 
the real difference between md and do is about 0.4 points in gpa and 4 points on the old mcat

the whole holistic bullcrap is nonsense and omm is just another waste of 4 hours per week


Just a sales technique?
 
How is there an argument here? I want the facts which i seemingly found but people dont agree with I guess. I do appreciate the input on this thread but I stand by that if that is the difference (philosophy) then thats what it is even if i dont agree.
Just a sales technique?
The argument is whether there's anything other than considerably lower admissions criteria to separate DO. Many believe there isnt. OMM is packed with pseudoscience and there is no such thing as a holistic philosophical difference. That's bull **** nonsense speak like "synergy". Nowhere will you find any real concrete examples of DO's behaving more "holistically" whatever the hell that would even look like
 
The argument is whether there's anything other than considerably lower admissions criteria to separate DO. Many believe there isnt. OMM is packed with pseudoscience and there is no such thing as a holistic philosophical difference. That's bull **** nonsense speak like "synergy". Nowhere will you find any real concrete examples of DO's behaving more "holistically" whatever the hell that would even look like


So the article that I found is just trying to be a selling point for DO.

If it's the case it's lower criteria is that looked less upon?
 
So the article that I found is just trying to be a selling point for DO.

If it's the case it's lower criteria is that looked less upon?
We already hip to DO brah. We are not buying what they're selling. It's as good as MD for some people and not so much for others. Many people bone for MD over DO. That's all there is to it.
 
So the article that I found is just trying to be a selling point for DO.

If it's the case it's lower criteria is that looked less upon?

No one really cares. It's easier to some degree to get into a DO school, but you learn the same stuff and if you get the grades and the step 1 scores and know your stuff then really no one cares.
 
We already hip to DO brah. We are not buying what they're selling. It's as good as MD for some people and not so much for others. Many people bone for MD over DO. That's all there is to it.

Soo... update?

MD vs. DO - What's different?

DO - Do a little bit more work on-top of med school during class.
 
If there really is no difference, that's great! I'm just not sure the distinction.. although a kind admin explained to me why it's a touchy subject.

If you actually researched topic, you'll find what the residents and attendings are saying about this topic. Historically, DO started off as a split from MD by a guy who wanted to focus on outdated practices of osteopathy and "treating patient as a whole". Then later with the advent of something called evidence-based medicine, MD grew stronger while osteopathy started becoming obsolete. Many good DO schools do follow EBM while keeping OMM as an elective, so from a practical purpose, what MD and DO physicians do are identical.

Then came the merger, which is really just ACGME acquiring AOA residencies. The top DO schools are capable of sending graduates to ACGME residencies, except for some ultracompetitive specialties. The poorer DO schools that easily pop up and expand are likely wiped out by the acquisition.

So, really from an outsider perspective, there is no difference. For residency perspective, there is some to significant difference and why US MD > US DO.

I hope i explained this well and experts like @Law2Doc @mimelim @Tired and others can clarify and expand.
 
If you actually researched topic, you'll find what the residents and attendings are saying about this topic. Historically, DO started off as a split from MD by a guy who wanted to focus on outdated practices of osteopathy and "treating patient as a whole". Then later with the advent of something called evidence-based medicine, MD grew stronger while osteopathy started becoming obsolete. Many good DO schools do follow EBM while keeping OMM as an elective, so from a practical purpose, what MD and DO physicians do are identical.

Then came the merger, which is really just ACGME acquiring AOA residencies. The top DO schools are capable of sending graduates to ACGME residencies, except for some ultracompetitive specialties. The poorer DO schools that easily pop up and expand are likely wiped out by the acquisition.

So, really from an outsider perspective, there is no difference. For residency perspective, there is some to significant difference and why US MD > US DO.

I hope i explained this well and experts like @Law2Doc @mimelim @Tired and others can clarify and expand.

Perfect explanation. I also learned why this is such a touchy subject, and MD is where I'd like to go personally.
 
Could the "holistic treatment" statement prominent in the philosophy be a product of an underlying family physician focused training?

DO schools emphasize primary care, and the family physicians I know (MDs) suggest there's a difference in how they were taught (relative to PCP internal med). Residency instilled a different lens through which they viewed patients -- some knowledge difference, some perception/focus difference.

Could that be what DO schools are suggesting? I guess the FM doc could be idealistic about the specialty, but... Just came to mind.
 
Mods, can we like, get a forum function that if a person tries to type any variant of "MD vs DO" in a thread title, a hand comes out of the screen and slaps them upside the head?

That technology exists, right?

That's not contributing to this anymore than me asking about it.

I have some valuable input on this thread, and I believe anyone searching will receive good information on this topic. Probably not on my speicifc post, but on @Lawper posts.
 
That's bull **** nonsense speak like "synergy".

First of all, http://cdn.meme.am/instances/500x/15315086.jpg

If you actually researched topic, you'll find what the residents and attendings are saying about this topic. Historically, DO started off as a split from MD by a guy who wanted to focus on outdated practices of osteopathy and "treating patient as a whole". Then later with the advent of something called evidence-based medicine, MD grew stronger while osteopathy started becoming obsolete. Many good DO schools do follow EBM while keeping OMM as an elective, so from a practical purpose, what MD and DO physicians do are identical.

Then came the merger, which is really just ACGME acquiring AOA residencies. The top DO schools are capable of sending graduates to ACGME residencies, except for some ultracompetitive specialties. The poorer DO schools that easily pop up and expand are likely wiped out by the acquisition.

So, really from an outsider perspective, there is no difference. For residency perspective, there is some to significant difference and why US MD > US DO.

I hope i explained this well and experts like @Law2Doc @mimelim @Tired and others can clarify and expand.

Sort of. Osteopathic medicine originated from an MD who felt traditional "allopathic" medicine was ineffective and actually harmful. He focused on osteopathic manipulation, which even if it was only a placebo would still be superior to the actively harmful medical treatments available at the time. The two fields have since grown back together, and you'd be hard-pressed to find much difference between a practicing MD and DO. All DO schools require OMM, it's never an elective, unless you choose to do an elective month of it during your clinical years. They all also teach evidence-based medicine, not just the "good DO schools." There have also been some reputable studies supporting OMM in common-sense applications like low back pain, before you dismiss it completely as witchcraft. If you've ever seen a physical therapist work, they use many of the same techniques as DOs learn in OMM, and they have value when applied appropriately. Unfortunately, there are those who also talk about cranial manipulation who give us all a bad name, but the vast majority do no OMM at all.

The merger isn't "ACGME acquiring AOA residencies." It's all residencies falling under the same accrediting body. Some AOA residencies will likely be eliminated, as they will not meet the requirements of this new governing body, but that only reflects on DO schools in that AOA residencies require some sort of affiliation with an osteopathic school. The residency merger will not close any osteopathic medical schools, as the ACGME is entirely separate from the accrediting bodies of medical schools (LCME and COCA for MD and DO, respectively). All osteopathic schools send students to ACGME residencies, not just the "top ones." That falls upon the student, rather than their school. I'd be surprised if many ACGME residency program directors, if any at all, regarded any DO schools as really being in different tiers. They're all pretty much looked at as one group: DO's.
 
I would say, from my understanding, the best way to explain this is that if Walter walks into the doctor with a cough, DO's are trained in the way of thinking about the patient well being, and overall happiness rather than just clearing the cough (which a DO will still do).

I''m sorry. Are you saying MDs don't consider the overall well being and happiness of the patient? No no. In practice, every kind doctor, whether MD or DO, does this.
 
I always hear this, but have never seen the citations. Can you throw a few up here? Would like to read these.
I mean technically OMM in the right places in the right ways can claim every success than chiropracty and a lot of PT can, no?
 
6-day-old member seeks to solve MD vs. DO with his thread. I admire your optimism, but come on. Aside from posting the beating the dead horse, I'll actually contribute.

The term "holistic approach" needs to be dumped. It's ill-defined and not representative of whatever the "definition" of MD and DO differences are. A prospective medical student should consider:

1.) OMT training (which is not necessarily used in residency training OR practice as an attending)
2.) Taking the COMLEX (sometimes also the USMLE if desired or sometimes both)
3.) AOA residencies vs dual AOA/ACGME accredited vs. ACGME.

And now,

:beat:


OK, but doesn't holistic mean treating the whole person and not just the disease?
 
I''m sorry. Are you saying MDs don't consider the overall well being and happiness of the patient? No no. In practice, every kind doctor, whether MD or DO, does this.


It was my understanding that use of holistic is based on emphasis in approach; that is to say, is it truly woven in and throughout the approach/philosophy in terms of education, OR is it merely tagged on or thrown into the curriculum/education here and there like black pepper? It's kind of like how one approaches things by way of worldview--perhaps not the best example.
 
OP, if you really want to know what the difference is, go read the forums on ENT and Ophtho residency applications. Sure, DOs can match at good ACGME programs if they're competitive and have the board scores. But when given identical MD and DO applicants most top programs will go with the MD every time. And for more competitive specialties like ENT, Ophtho, Derm, etc. you'd be hard pressed to find more than a couple DOs. Say what you will about holistic vs not, or OMM vs not, but when it comes to residency applications and competitive specialties you're just going to have a harder time as a DO.

And by the way, the majority of people I know at DO schools are very aware of this.
 
It took 111 minutes for someone to post :beat:. Not a bad response time. Now this thread can rest in peace with the others. Or it will devolve into arguments about what the merger means. Whatever anyone says about the merger, take it with a grain of salt because nobody knows for sure. Moral of the story OP is that
MD+OMM=DO
MD+ Decreased chance as competitive specialty - a few gpa and mcat points = DO
 
...
MD+OMM=DO...

Um no. Both schools are the same length and most people are maxing out the learning hours over this journey.
So the equation is really "MD + OMM = DO MINUS about 200 hours of other medicine". people trying to promote osteopathy sometimes try to say it's an "MD plus" degree, but that's completely bogus. For everything you spend more time on in med school you necessarilly spend less on something else.
 
Neither, it is the piece of parsley on the entree that makes it look prettier and is technically edible, but really doesn't actually make it taste any better.

See, now to me that is sad. OTOH, guess it's better to not pretend about it. I mean if it's not really there for you, ick, it's like a forced relationship. Better for it to be real--totally authentic.

As an amateur chef, I find both health and taste benefits in adding the right herbs and spices. Meat and potatoes alone is just plain bland and boring and has limited health benefits.
I am not even really sure you can teach this kind of thing--I mean in principle, yes, but in authentic application, eh.
 
NSAIDs are equivalent to PT which is equivalent to chiro/iontophoresis/trigger point injections/steroids/acupuncture/sham acupuncture/a poultice of berries and herbs/rubbing dirt on it/cow urine/stem cell therapy.
You forgot prayer


See, now to me that is sad. OTOH, guess it's better to not pretend about it. I mean if it's not really there for you, ick, it's like a forced relationship. Better for it to be real--totally authentic.

As an amateur chef, I find both health and taste benefits in adding the right herbs and spices. Meat and potatoes alone is just plain bland and boring and has limited health benefits.
I am not even really sure you can teach this kind of thing--I mean in principle, yes, but in authentic application, eh.
If you REALLY want to treat the person holistically in ways MDs don't, check out ND schools. I think they'd be perfect for you.

I especially love that the home page has the caduceus instead of the staff of asclepius

" Naturopathic physicians are trained as primary care providers who diagnose, treat and manage patients with acute and chronic conditions, while addressing disease and dysfunction at the level of body, mind and spirit. They concentrate on whole patient wellness through health promotion and disease prevention, attempting to find the underlying cause of the patient’s condition. "

Damn, that sounds so sexy
 
I was guessing it would be like this. All these chronic MSK conditions seem to shake out the same in the literature: NSAIDs are equivalent to PT which is equivalent to chiro/iontophoresis/trigger point injections/steroids/acupuncture/sham acupuncture/a poultice of berries and herbs/rubbing dirt on it/cow urine/stem cell therapy.

And of course, opiates are consistently shown to be worse than all those, but 50% of patients need them to get through the day.
Is the literature really that nebulous for chronic MSK conditions?
 
You forgot prayer



If you REALLY want to treat the person holistically in ways MDs don't, check out ND schools. I think they'd be perfect for you.

I especially love that the home page has the caduceus instead of the staff of asclepius

" Naturopathic physicians are trained as primary care providers who diagnose, treat and manage patients with acute and chronic conditions, while addressing disease and dysfunction at the level of body, mind and spirit. They concentrate on whole patient wellness through health promotion and disease prevention, attempting to find the underlying cause of the patient’s condition. "

Damn, that sounds so sexy


Nah, I'd get a doctoral degree in biochemical and molecular nutrition first through Tuft's or Emory.
 
It's not that I don't feel it, it's that the word lacks meaning. "Treating the whole person" or "Treating the cause of disease not the symptoms," these are platitudes with no substance. Looking at the whole person is basic doctoring, and keeps you from missing important elements of the diagnosis that could change your treatment plan. And diseases have both causes and symptoms, failing to address one or the other is incompetence.

I'm sure DO schools teach their students to treat the whole person. Implying that MD schools do not is nothing more than aggressive DO marketing at the expense of their colleagues. If MDs didn't do those things, why would the AOA agree to a merger? Why would their students apply to our match? They know it's ridiculous, which is why it's basically only the pre-DOs who repeat this trope anymore.


Eh regardless, I want to believe most take a truly holistic approach, but the sad thing is, it takes more time, patience, and good insight. As modern medicine became more and more of the machine, the approach became at best, very limited, at worst, non-existent. Treating causes and curing disease processes is often not possible; but treating symptoms with pharm companies right by medicine, well, . . . I am not against pharms, just saying.... And sure, there is a significant exception often enough in surgical approaches; but like I have said before, CABG does not cure the etiological disease process per se. Many surgical procedures by time, and that is not a bad thing necessarily either. I mean w/o surgery, approaches in modern medicine would be quite limited, and so would lifespans--not to mention the importance of palliative approaches for quality of life and so forth.

I just think the true concept of treating the whole person is something most practitioners give a smug grin to as they plow through loads of patients. It's kind of sad that there aren't as many GPs like I knew as a little kid, for instance; but even if you wanted to practice that way today, the "machine" won't let you.
 
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I don't know that nebulous is the right term. It's just that everything is reported as working okay, with nothing clearly better most of the time. Followup is usually limited, they usually only compare 2-3 treatments at a time, and you always get the feeling that the placebo effect exceeded the treatment effect.

And not to sound like a surgical snob. Most of the surgical studies in chronic pain conditions really aren't much better. The ones that are typically cannot be reproduced (eg - Nirschl).
But hasn't literature recently determined that conservative treatment produces similar results as surgery (for certain disc problems) after a 2 year period? Isn't that at least helpful for some who want to avoid surgery?

I'm sure there must be some useful studies regarding chronic MSK problems.
 
But hasn't literature recently determined that conservative treatment produces similar results as surgery (for certain disc problems) after a 2 year period? Isn't that at least helpful for some who want to avoid surgery?

I'm sure there must be some useful studies regarding chronic MSK problems.


Ah the limitations in studies. Meanwhile, I have a family member that had a neurosurgeon do some serious spinal surgery on them. The person would have either become a drug addict or would have committed suicide w/o the surgery--the pain and loss of fx was that bad. 15 years later and they have been able to do a world more than what they could before the surgery.
 
Ah the limitations in studies. Meanwhile, I have a family member that had a neurosurgeon do some serious spinal surgery on them. The person would have either become a drug addict or would have committed suicide w/o the surgery--the pain and loss of fx was that bad. 15 years later and they have been able to do a world more than what they could before the surgery.
OMG guys this dude's family member proves the surgery works !
 
It clearly helps in a lot of cases. And there has to be literature that supports this. :shrug:
You just dont understand the ND holistic approach Cyber. Surgery treats a symptom while people like myself and jl lin want to treat "at the level of body, mind and spirit". You just dont get m̶y̶s̶t̶i̶c̶i̶s̶m̶ holisticism
 
OMG guys this dude's family member proves the surgery works !


Nice effy. If patients had to wait to be treated until everything was 100% proven by EBP , everyone would be dead or healed.
 
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