I graduated from a DO school and I can honestly tell you that given the opportunity you should strongly consider going the MD route.
First, there is usually a big cost difference. DO schools are incredibly expensive compared to state MD schools. In the face of declining reimbursements for healthcare why put yourself in any more debt than necessary? If you debt load is too high then you may feel pressured to forego primary care specialties and pursue specialties that are more financially rewarding. Don't forget that once all of your training is done you actually have to practice your trade and why condemn yourself to a career you don't love.
Second, the philosophical difference between MDs and DOs is WAY over-emphasized by the AOA. Your ability to treat someone compassionately and holistically is about WHO YOU ARE and not about your medical school. You will not change someone sitting in a classroom for 2 years or in an OMM lab a few hours a week.
Next, the DO degree carries with it many extra hurdles that seem to never end. First there is the question of board exams. Do you pay the extra money and take USMLE in order to leave the option of applying for competitive ACGME residencies, or do you just take the COMLEX.
Then you have to set up your elective rotations for 4th year of med school...does the hospital you like accept DO students? If they do accept DO rotators, are they treated the same as the MDs? At one hospital I rotated at the MD students got free meal cards and were allowed to perform procedures whereas DOs were given "Observer" only status.
Next comes residency match. Do you match MD or DO? Is there good DO GME available in your specialty of choice? Keep in mind that the specialty you choose before you go to medical school may very well be different than the one you choose when Match time comes around. There are some areas in the DO GME that are very lacking for good programs. You must then decide whether or not to complete the DO internship that is required in 5 states. If you truly want to live in those states you may be forced to limit your residency choices (some of the ACGME specialties have categorial residencies where internship/residency are combined so as a DO who needs to complete the DO internship, you would not be eligible for those spots). Also, if you do complete a DO residency, are there quality DO fellowships available? Will the allopathic fellowships accept your DO residency training? Does the allopathic subspecialty board recognize the COMLEX for purposes of board certification exam eligibility.
Next comes employment. Does the group or academic institution you want to join hire DOs? Do the hospitals give DOs a hard time with getting credentials? There may be hospitals that will resist credentialling AOA-certified specialists.
Lastly, there are issues with CME to keep your medical license current. If you practice in a state where there are separate DO and MD medical boards, you may be forced to obtain a certain amount of "DO credit hours-category 1-A" to maintain your "License to Practice Osteopathic Medicine and Surgery" in that state. That means attending DO conferences and paying AOA dues. There is a big difference in quality between the American Society of Anesthesiologist's conference and the American Osteopathic Anesthesiology conference.
I am not hating on DOs or saying that MDs are better. I firmly believe that even if costs are the same, going MD is "easier".
One thing I would not worry about however is what PATIENTS think about MD vs. DO. I get more positive comments about being a DO than I would have ever imagined. I have even met a few patients who didn't even know what an MD is. Can you believe that! I do not feel insecure about being a DO in any way but I know that I have jumped through many extra obstacles than necessary to get to where I am.
Anyway, patients will come to you because there is a demand for your the services you provide. Whether they will keep you as their doctor will depend much more on WHO YOU ARE than the initials after your name.
Excellent post.
I choose MD over DO because of cost (got into my instate school and I get to live at home) but also because I had read up on some of the extra hurdles that DO may have to undergo for medical licensing.
The thing is, being a medical minority have some drawbacks, mostly institutional and related to residency/fellowship training, so I figured, unless the DO school gave me some 'extra' perks that outweighed the issues related to DO training, I would pick the MD over DO. I'm not adament about getting the DO, I just wanted to be a doctor, so I picked the degree that would get me to my goal in the least painful way. For some people, that may mean location, costs, philosophy, 'right feel'. For me, it was licensing and training (not taking two board exams, finding DO friendly hospital rotations etc). But I guess I was fortunate to have financially supportive parents, no family/dependents to worry about, and a large amount of mobility so I only had to consider the actual education offered and not these extraneous factors.
Also, rotations at many DO schools are not as nicely structured as MD schools. I did some research and only accepted DO schools which had a structured clinical years. While the above poster mentioned licensing as an issue, I also found that some DO schools don't have a teaching hospital close by for students. They farm out their kids to other places to do rotations. This may mean moving to other cities or states to do 3rd and 3th year rotations. I didn't like the idea of moving two years after med school, and I especially didn't like that some schools made you do rotations at different locations throughout your two clinical years (all that moving!). Most allo schools will have a medical hospital(s) on campus for students to rotate and some osteo schools do as well. But I found out that having a hospital close by for rotations is more of a given in the MD world than a DO world
I also felt that the preceptor based rotations that some DO schools I interviewed at was not for me. I decided that I preferred doing rotations at a traditional teaching hospital where I could follow multiple doctors, and have a hospital hiearchy setup similar to what many residencies are like.
There are some perks to the rotation system of osteo schools, some people get to move back to their families to do rotations, others like to experience multiple hospitals. And some tell me they like the intimate feel of a preceptor based rotation.
However, I suggest students look carefully over the differences between most MD and DO schools and make sure the benefits outweigh the drawbacks. I knew a student at a DO school that had to drive several hours every month during his clinical years back to the main campus to do his exams. That's just too much of a pain for me. There are DO schools that don't make you do that, and had a pretty traditional, structured approach to their rotation years, but you have to do your research.
So, while I know that it's not a popular thing to say on the forum, but I would try to pick an allo school simply for the benefits that goes with being a 'medical majority', even if the location/costs/nonacademic reasons were fairly equal (or even a little bit less than equal). It's just easier than fighting program directors come match time that the quality of your education is comparable to the MDs. Also, allo schools can do the 'holistic' medicine. I'd say that my school is pretty gung ho about it. The only thing missing is the OMM, but it's not a big deal to me. If OMM is a huge thing, DO is definitely a better place to learn it!
I have gone thruogh the process of applying to both allo and osteo and I did some fairly extensive research into the curriculum of the two schools. While I think both can produce good doctors, I just find that, given a MD majority world, it was easier to get the MD than the DO, but I have met students who had other considerations for doing DO and they are perfectly content with their choice.
*Sunny on psycho alert*
