MSUCOM doesn't recquire a letter from a D.O. or M.D., they want letters from people who know you well. Naturally it is better to use a letter from a D.O., since it shows that you have experience in the field, and most likely a stong understanding of the philosophies of osteopathic medicine. If you can't get one from a D.O., try to get one from some one who has worked with you in a health care setting. SIDE NOTE**.........the first question for your evaluator on MSUCOM's evaluation form is: "Please comment on the applicant's level of understanding of the osteopathic philosophy and commitment to becoming an osteopathic physician." So, you should definitely review the questions on the evaluation forms before selecting your evaluators. Other schools may have similar questions on their forms. For any forms that have a similar question, make sure you take the time to discuss your knowledge of osteopathic medicine with your evaluator if you haven't already.