My 1984 Boston University medical
school diploma, written in Latin, proudly proclaims me, in bold gothic letters,
to be a newly minted “Doctoris Medicinae,” or “Doctor of
Medicine.” Long have I stared at those fancy words, identical to the
terminology used on my late father’s medical school diploma from the same
institution in 1950.
But what if those letters stood
not for Doctor of Medicine but Doctor of Osteopathic Medicine? Would it matter?
Is the training that different? Is my medical skill and knowledge base better
or more advanced than that of an Osteopathic Physician?
The short answer is “no.” Osteopathic medical degrees, offered in 35 schools in the US compared with 141 schools that offer the MD degree, have become widely accepted as equivalent in scope and training when compared to their MD counterparts. Osteopathic medicine grew out of a late-19th-century American tradition in medical practice founded by Andrew Taylor Still. He began a movement of medical education and practice that encompassed training physicians in musculoskeletal manipulation as well as other more traditional disciplines of established medical knowledge.
Today, the physicians who graduate from these schools, in addition to having received virtually identical training and coursework that is offered at MD-granting schools, also gain additional training (hundreds of hours, depending on the particular DO school) of musculoskeletal manipulation as a basis for treating disease. While there is controversy as to the effectiveness of that type of treatment, what is not in question is the DO’s acceptance as an equivalent degree to the MD in terms of rights, advanced medical training opportunities (internships, residencies and fellowships) and licensing, professional associations and medical leadership roles.
Having said all this, there may
be subtle differences in the overall approach to the patient and her/his care.
Reflected in that is the tendency for DO physicians to concentrate in primary
care and internal medicine. This may be, in part, that the osteopathic approach
to medicine might be viewed by some as to be more slanted towards treating the
whole person than the MD-allopathic model of diagnosis and treatment. One need
look no further than that the DO’s training encompasses hands-on manipulation
of the human body to understand why this might be the case. While this approach
may reflect the tendencies to step outside the allopathic role and move into
physical manipulation as an additional approach to heal, there is still
controversy, as I have mentioned, as to the overall efficacy of this attitude
One minor difference to report
between DO and MD applicants to medical school: the MCAT (Medical College
Admission Test) scores and GPA’s of DO applicants were slightly lower than MD
applicants. Whether this is of significance in the overall quality of care
delivered by DOs is, in my opinion, dubious on this point. Still, it is a
statistic that has been evaluated. Indeed, I have worked side by side with DOs
in a variety of clinical settings, both at the general, specialty and
sub-specialty level, and have noted no differences in diagnostic skill, quality
of care or any other parameter one might choose to select. But that is
anecdotal. I believe the studies on this bear me out, but you are free to
search on your own.
So, since 20% of all medical school enrollment is now at schools that offer the DO degree, you can expect to see a lot more of these professionals treating you in all aspects of medical care in the future. You should also rest assured that these doctors have equivalent training and have passed comparable or identical exams that MD’s have completed to practice their arts.
The bottom line here: MD or DO?
Nowadays, it does not really matter.
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