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Doctor of Osteopathic Medicine (DO or D.O., or in Australia DO USA) is a
medical degree A medical degree is a professional degree admitted to those who have passed coursework in the fields of medicine and/or surgery from an accredited medical school. Obtaining a degree in medicine allows for the recipient to continue on into special ...
conferred by the 38 osteopathic
medical schools A medical school is a tertiary educational institution, or part of such an institution, that teaches medicine, and awards a professional degree for physicians. Such medical degrees include the Bachelor of Medicine, Bachelor of Surgery (MBBS, M ...
in the
United States The United States of America (U.S.A. or USA), commonly known as the United States (U.S. or US) or America, is a country primarily located in North America. It consists of 50 states, a federal district, five major unincorporated territorie ...
. DO and Doctor of Medicine (MD) degrees are
equivalent Equivalence or Equivalent may refer to: Arts and entertainment *Album-equivalent unit, a measurement unit in the music industry * Equivalence class (music) *'' Equivalent VIII'', or ''The Bricks'', a minimalist sculpture by Carl Andre *''Equiva ...
: a DO graduate may become licensed as a
physician A physician (American English), medical practitioner (Commonwealth English), medical doctor, or simply doctor, is a health professional who practices medicine, which is concerned with promoting, maintaining or restoring health through th ...
or
surgeon In modern medicine, a surgeon is a medical professional who performs surgery. Although there are different traditions in different times and places, a modern surgeon usually is also a licensed physician or received the same medical training as ...
and thus have full
medical Medicine is the science and practice of caring for a patient, managing the diagnosis, prognosis, prevention, treatment, palliation of their injury or disease, and promoting their health. Medicine encompasses a variety of health care practic ...
and
surgical Surgery ''cheirourgikē'' (composed of χείρ, "hand", and ἔργον, "work"), via la, chirurgiae, meaning "hand work". is a medical specialty that uses operative manual and instrumental techniques on a person to investigate or treat a pat ...
practicing rights in all 50 US states. , there were 168,701 osteopathic physicians and medical students in DO programs across the United States. Osteopathic medicine emerged historically from
osteopathy Osteopathy () is a type of alternative medicine that emphasizes physical manipulation of the body's muscle tissue and bones. Practitioners of osteopathy are referred to as osteopaths. Osteopathic manipulation is the core set of techniques in ...
, but has become a distinct profession. , more than 28% of all US medical students were DO students. The curricula at DO-granting medical schools are equivalent to those at MD-granting medical schools, which focus the first two years on the biomedical and clinical sciences, then two years on core clinical training in the clinical specialties. One notable difference between DO and MD training is that DOs spend an additional 300–500 hours to study a set of hands-on manipulation (OMT) of the
human musculoskeletal system The human musculoskeletal system (also known as the human locomotor system, and previously the activity system) is an organ system that gives humans the ability to move using their muscular and skeletal systems. The musculoskeletal system provid ...
along with learning conventional Western medicine and surgery like their MD peers. Upon completing osteopathic medical school, a DO graduate may enter an
internship An internship is a period of work experience offered by an organization for a limited period of time. Once confined to medical graduates, internship is used practice for a wide range of placements in businesses, non-profit organizations and gover ...
or
residency Residency may refer to: * Domicile (law), the act of establishing or maintaining a residence in a given place ** Permanent residency, indefinite residence within a country despite not having citizenship * Residency (medicine), a stage of postgrad ...
training program, which may be followed by fellowship training. DO graduates attend the same
graduate medical education Graduate Medical Education (GME) refers to any type of formal medical education, usually hospital-sponsored or hospital-based training, pursued after receipt of the M.D. or D.O. degree in the United States This education includes internship, resi ...
programs as their MD counterparts.


History

Osteopathy Osteopathy () is a type of alternative medicine that emphasizes physical manipulation of the body's muscle tissue and bones. Practitioners of osteopathy are referred to as osteopaths. Osteopathic manipulation is the core set of techniques in ...
, the older form of
osteopathic medicine Osteopathy () is a type of alternative medicine that emphasizes physical manipulation of the body's muscle tissue and bones. Practitioners of osteopathy are referred to as osteopaths. Osteopathic manipulation is the core set of techniques in ...
, began in the United States in 1874. The term "
osteopathy Osteopathy () is a type of alternative medicine that emphasizes physical manipulation of the body's muscle tissue and bones. Practitioners of osteopathy are referred to as osteopaths. Osteopathic manipulation is the core set of techniques in ...
" was coined by the physician and surgeon
Andrew Taylor Still Andrew Taylor Still, DO (August 6, 1828 – December 12, 1917) was the founder of osteopathic medicine. He was also a physician and surgeon, author, inventor and Kansas territorial and state legislator. He was one of the founders of Baker Univers ...
, who named his new discipline of medicine "osteopathy", reasoning that "the bone, ''osteon'', was the starting point from which ewas to ascertain the cause of pathological conditions". He founded the American School of Osteopathy (now
A.T. Still University A.T. Still University (ATSU) is a private medical school based in Kirksville, Missouri, with a second campus in Arizona and third campus in Santa Maria, California. It was founded in 1892 by Andrew Taylor Still and was the world's first osteopa ...
of the Health Sciences) in
Kirksville Kirksville is the county seat and most populous city in Adair County, Missouri. Located in Benton Township, Adair County, Missouri, Benton Township, its population was 17,530 at the 2020 United States census, 2020 census. Kirksville is home to ...
, Missouri, for the teaching of osteopathy on May 10, 1892. While the state of Missouri granted the right to award the MD degree, he remained dissatisfied with the limitations of conventional medicine and instead chose to retain the distinction of the DO degree. In 1898 the American Institute of Osteopathy started the ''
Journal of Osteopathy The ''Journal of Osteopathy'' was a monthly medical journal that was first published in May 1894 in Kirksville, Missouri by the American School of Osteopathy. It was the first regular publication about the field of osteopathy. Andrew Taylor Still ...
'' (presently known as the ''Journal of Osteopathic Medicine'') and by that time four states recognized the profession. The osteopathic medical profession has evolved into two branches: non-physician
manual medicine Chiropractic is a form of alternative medicine concerned with the diagnosis, treatment and prevention of mechanical disorders of the musculoskeletal system, especially of the spine. It has esoteric origins and is based on several pseudosc ...
osteopaths, who were educated and trained outside the United States; and US-trained osteopathic physicians, who conduct a full scope of medical and surgical practice. The regulation of non-physician manual medicine osteopaths varies greatly between jurisdictions. In the United States, osteopathic physicians holding the DO degree have the same rights, privileges, and responsibilities as
physicians A physician (American English), medical practitioner (Commonwealth English), medical doctor, or simply doctor, is a health professional who practices medicine, which is concerned with promoting, maintaining or restoring health through th ...
with a
Doctor of Medicine Doctor of Medicine (abbreviated M.D., from the Latin language, Latin ''Medicinae Doctor'') is a medical degree, the meaning of which varies between different jurisdictions. In the United States, and some other countries, the M.D. denotes a profes ...
(MD) degree. Osteopathic physicians and non-physician osteopaths are so distinct that in practice they function as separate professions. As originally conceived by Andrew Still, the letters "DO" stood for "Diplomate in Osteopathy" and the title conferred by the degree was "Doctor of Osteopathy". Subsequently, the degree also came to be entitled "Doctor of Osteopathic Medicine". Since the late 20th century, the AOA has preferred that this title be used exclusively. Its members resolved at a 1960 conference: A minority of DOs continue to use the old terms, and the American Academy of Osteopathy retains the old usage in its name.


Demographics

In 2018, there were 114,425 osteopathic
medical doctors Doctor of Medicine (abbreviated M.D., from the Latin ''Medicinae Doctor'') is a medical degree, the meaning of which varies between different jurisdictions. In the United States, and some other countries, the M.D. denotes a professional degree. T ...
in the United States and 145,343 total DOs and osteopathic medical students. The proportion of females in the profession has steadily increased since the 1980s. In 1985, about 10 percent of DO physicians were female, compared with 41 percent in 2018. Between 2008 and 2012, 49 percent of new DO graduates were females. During the 2011–12 academic year, the osteopathic medical student body consisted of: 69 percent white/non-Hispanic, 19 percent Asian or Pacific Islander, 3.5 percent Hispanic, 3 percent African-American, and 0.5 percent Native American or Alaskan. The remainder were listed as "other or not entered". The five-year change in osteopathic medical student enrollment by ethnicity has increased by 19 percent for white/non-Hispanic students, 36 percent for Asian-American students, 24 percent for Black/African American students, and 60 percent for Hispanic/Latino students.


Education, training and distinctiveness

Osteopathic medical school curricula are equivalent to those at schools granting the MD degree (
Doctor of Medicine Doctor of Medicine (abbreviated M.D., from the Latin language, Latin ''Medicinae Doctor'') is a medical degree, the meaning of which varies between different jurisdictions. In the United States, and some other countries, the M.D. denotes a profes ...
). Both US-granted MD and US-granted DO programs are listed in the
World Directory of Medical Schools The World Directory of Medical Schools is a public database of institutions that provide medical education. There are over 3,600 medical schools listed in the directory. The directory is published as a collaboration of the World Federation for Medic ...
as medical schools. Once admitted to an osteopathic medical school, students study for four years to graduate. The schooling is divided into the pre-clinical and clinical years. The pre-clinical years, the first and second years, focus on the biomedical and clinical sciences. The clinical years, the third and fourth years, consist of core clinical training and
sub-internship A sub-internship (abbreviated ''sub-I'') or acting internship (AI) is a clinical rotation of a fourth-year medical student in the United States medical education system, which may take place at a different hospital than the student's medical scho ...
s in the clinical specialties. Osteopathic medical school accreditation standards require training in internal medicine, obstetrics/gynecology,
pediatrics Pediatrics ( also spelled ''paediatrics'' or ''pædiatrics'') is the branch of medicine that involves the medical care of infants, children, adolescents, and young adults. In the United Kingdom, paediatrics covers many of their youth until th ...
, family medicine,
surgery Surgery ''cheirourgikē'' (composed of χείρ, "hand", and ἔργον, "work"), via la, chirurgiae, meaning "hand work". is a medical specialty that uses operative manual and instrumental techniques on a person to investigate or treat a pat ...
,
psychiatry Psychiatry is the medical specialty devoted to the diagnosis, prevention, and treatment of mental disorders. These include various maladaptations related to mood, behaviour, cognition, and perceptions. See glossary of psychiatry. Initial psych ...
,
emergency medicine Emergency medicine is the medical speciality concerned with the care of illnesses or injuries requiring immediate medical attention. Emergency physicians (often called “ER doctors” in the United States) continuously learn to care for unsche ...
,
radiology Radiology ( ) is the medical discipline that uses medical imaging to diagnose diseases and guide their treatment, within the bodies of humans and other animals. It began with radiography (which is why its name has a root referring to radiat ...
,
preventive medicine Preventive healthcare, or prophylaxis, consists of measures taken for the purposes of disease prevention.Hugh R. Leavell and E. Gurney Clark as "the science and art of preventing disease, prolonging life, and promoting physical and mental hea ...
, and
public health Public health is "the science and art of preventing disease, prolonging life and promoting health through the organized efforts and informed choices of society, organizations, public and private, communities and individuals". Analyzing the det ...
. According to
Harrison's Principles of Internal Medicine ''Harrison's Principles of Internal Medicine'' is an American textbook of internal medicine. First published in 1950, it is in its 21st edition (published in 2022 by McGraw-Hill Professional ) and comes in two volumes. Although it is aimed at a ...
, "the training, practice, credentialing, licensure, and reimbursement of osteopathic physicians is virtually indistinguishable from those of physicians with MD qualifications, with 4 years of osteopathic medical school followed by specialty and subspecialty training and
board certification Board certification is the process by which a physician or other professional demonstrates a mastery of advanced knowledge and skills through written, practical, or simulator-based testing. Certification bodies There are more than 25 boards that ...
". DO schools provide an additional 300–500 hours in the study of hands-on manual medicine and the body's musculoskeletal system, which is referred to as
osteopathic manipulative medicine Osteopathy () is a type of alternative medicine that emphasizes physical manipulation of the body's muscle tissue and bones. Practitioners of osteopathy are referred to as osteopaths. Osteopathic manipulation is the core set of techniques i ...
(OMM). Osteopathic physicians use OMM predominantly to treat musculoskeletal conditions. Before entering osteopathic medical school, an applicant must complete a four-year undergraduate degree and take a national standardized exam called the
Medical College Admissions Test The Medical College Admission Test (MCAT; ) is a Computer-based testing, computer-based standardized examination for prospective medical students (both Allopathic M.D. and Ostepathic D.O.) in the United States, Australia, Canada, and Offshore m ...
(MCAT). Some combined undergraduate/medical programs exist. Some authors note the differences in the average MCAT scores and
grade point average Grading in education is the process of applying standardized measurements for varying levels of achievements in a course. Grades can be assigned as letters (usually A through F), as a range (for example, 1 to 6), as a percentage, or as a numbe ...
of students who
matriculate Matriculation is the formal process of entering a university, or of becoming eligible to enter by fulfilling certain academic requirements such as a matriculation examination. Australia In Australia, the term "matriculation" is seldom used now. ...
at DO schools compared to those who matriculate at MD schools within the United States. In 2021, the average MCAT and GPA for students entering US-based MD programs were 511.5 and 3.73, respectively, and 504.0 and 3.55 for DO matriculants. DO medical schools are more likely to accept non-traditional students, who are older and entering medicine as a second career, or coming from non-science majors. DO medical students are required to take the Comprehensive Osteopathic Medical Licensure Examination (
COMLEX-USA The Comprehensive Osteopathic Medical Licensing Examination of the United States (COMLEX-USA) is a series of three osteopathic medical licensing examinations administered by the National Board of Osteopathic Medical Examiners (NBOME) similar to t ...
), which is sponsored by the
National Board of Osteopathic Medical Examiners The National Board of Osteopathic Medical Examiners (NBOME), founded in 1934 as the National Osteopathic Board of Examiners for Osteopathic Physicians and Surgeons, Inc., is a United States examination board which sets state recognized examinatio ...
(NBOME). The COMLEX-USA is series of four osteopathic medical licensing examinations. The first three exams of the COMLEX-USA are taken during medical school and are prerequisites for residency programs. Level 2 consists of a multiple-choice portion and a patient evaluation exam (PE). COMLEX-Level 2 PE is available in
Chicago (''City in a Garden''); I Will , image_map = , map_caption = Interactive Map of Chicago , coordinates = , coordinates_footnotes = , subdivision_type = Country , subdivision_name ...
, Illinois, and
Philadelphia Philadelphia, often called Philly, is the largest city in the Commonwealth of Pennsylvania, the sixth-largest city in the U.S., the second-largest city in both the Northeast megalopolis and Mid-Atlantic regions after New York City. Sinc ...
, Pennsylvania. It is graded as a Pass/Fail exam. Finally, COMLEX Level 3 is taken during the first year of residency. In addition to the COMLEX-USA, DO medical students may choose to sit for the MD licensure examinations, which are called the
United States Medical Licensing Examination The United States Medical Licensing Examination (USMLE) is a three-step examination program for medical licensure in the United States sponsored by the Federation of State Medical Boards (FSMB) and the National Board of Medical Examiners (NBME). P ...
(USMLE). This is typically done under specific circumstances, such as when the student desires to enter a residency that may have a historic preference for the USMLE, or if a higher USMLE score would help elevate the student's application to be more competitive. USMLE pass rates for DO and MD students in 2012 are as follows: Step 1: 91% and 94%, Step 2 CK: 96% and 97%, and Step 2 CS: 87% and 97%, respectively (this number may be misleading as only 46 DO students compared to 17,118 MD students were evaluated for Step 2 CS) Step 3: 100% and 95% (this number may be misleading, as only 16 DO students compared to 19,056 MD students, were evaluated for Step 3).


Licensing and board certification

To obtain a license to practice medicine in the United States, osteopathic medical students must pass the
Comprehensive Osteopathic Medical Licensing Examination The Comprehensive Osteopathic Medical Licensing Examination of the United States (COMLEX-USA) is a series of three osteopathic medical licensing examinations administered by the National Board of Osteopathic Medical Examiners (NBOME) similar to t ...
(COMLEX), the licensure exam administered by the
National Board of Osteopathic Medical Examiners The National Board of Osteopathic Medical Examiners (NBOME), founded in 1934 as the National Osteopathic Board of Examiners for Osteopathic Physicians and Surgeons, Inc., is a United States examination board which sets state recognized examinatio ...
throughout their medical training. Students are given the option of also taking the
United States Medical Licensing Examination The United States Medical Licensing Examination (USMLE) is a three-step examination program for medical licensure in the United States sponsored by the Federation of State Medical Boards (FSMB) and the National Board of Medical Examiners (NBME). P ...
(USMLE) to apply for certain residency programs that may want USMLE scores in addition to COMLEX scores. Those that have received or are in the process of earning an MD or DO degree are both eligible to sit for the USMLE. Because of their additional training, only DO candidates are eligible to sit for the COMLEX. Upon completion of internship and residency requirements for their chosen medical specialty, holders of the DO may elect to be board certified by either a specialty board (through the
American Medical Association The American Medical Association (AMA) is a professional association and lobbying group of physicians and medical students. Founded in 1847, it is headquartered in Chicago, Illinois. Membership was approximately 240,000 in 2016. The AMA's state ...
's
American Board of Medical Specialties Established in 1933, the American Board of Medical Specialties (ABMS) is a non-profit organization which represent 24 broad areas of specialty medicine. ABMS is the largest physician-led specialty certification organization in the United States ...
) or an osteopathic specialty board (through the
American Osteopathic Association Bureau of Osteopathic Specialists Established in 1939, the American Osteopathic Association Bureau of Osteopathic Specialists (AOABOS) is a non-profit umbrella organization for 18 medical specialty boards in the United States. Along with the American Board of Medical Specialties (A ...
certifying boards) or both. In February 2014, the
American Osteopathic Association The American Osteopathic Association (AOA) is the representative member organization for the more than 176,000 osteopathic medical doctors (D.O.s) and osteopathic medical students in the United States. The AOA is headquartered in Chicago, Illinoi ...
and the Accreditation Council for Graduate Medical Education agreed to unify standard and osteopathic
graduate medical education Graduate Medical Education (GME) refers to any type of formal medical education, usually hospital-sponsored or hospital-based training, pursued after receipt of the M.D. or D.O. degree in the United States This education includes internship, resi ...
starting in 2020. Depending on the state, medical licensure may be issued from a combined board (DO and MD) or a separate board of medical examiners. All of the 70 state medical boards are members of the
Federation of State Medical Boards The Federation of State Medical Boards (FSMB) of the United States is a national non-profit organization that represents the 71 state medical and osteopathic boards of the United States and its territories and co-sponsors the United States Medica ...
. Retired MD and
U.S. Air Force The United States Air Force (USAF) is the air service branch of the United States Armed Forces, and is one of the eight uniformed services of the United States. Originally created on 1 August 1907, as a part of the United States Army Sign ...
flight surgeon A flight surgeon is a military medical officer practicing in the clinical field of aviation medicine. Although the term "flight surgery" is considered improper by purists, it may occasionally be encountered. Flight surgeons are physicians ( MD ...
Harriet Hall Harriet A. Hall (born July 2, 1945) is a U.S. retired family physician, former U.S. Air Force flight surgeon and skeptic who writes about alternative medicine and quackery for ''Skeptic'' and ''Skeptical Inquirer''. She writes under the name T ...
stated that DOs trained in the U.S. are Doctors of Osteopathic Medicine and are legally equivalent to MDs. "They must be distinguished from 'osteopaths', members of a less regulated or unregulated profession that is practiced in many countries. Osteopaths get inferior training that can't be compared to that of DOs."


International variations

Currently, there are no osteopathic medical programs located outside of the United States that would qualify an individual to practice as an osteopathic physician in the United States. Foreign osteopathic degrees are not recognized by any state in the US as being equivalent to American DO degrees.


International practice rights

The International Labor Organization (ILO), an agency of the United Nations, issued a letter affirming that U.S.-trained osteopathic physicians are fully licensed physicians who prescribe medication and perform surgery. The acknowledgment draws a clear separation between American DOs, who are medical doctors, and non-physician osteopaths trained outside of the United States. Within the international standards that classify jobs to promote international comparability across occupations, U.S.-trained DOs are now categorized with all other physicians as medical doctors. This event took place in June 2018 and started a relay of events and opened doors for DOs as more countries started to understand and give full recognition to US-trained medical doctors with the DO degree, e.g. the Association of Medical Councils of Africa (AMCOA) approved a resolution in 2019 granting the AOA's request that AMCOA recognize U.S.-trained DOs as fully licensed physicians with practice rights equivalent to MDs, opening its 20 member countries, which include Botswana, Eswatini, Gambia, Ghana, Kenya, Lesotho, Liberia, Malawi, Mauritius, Namibia, Nigeria, Rwanda, Seychelles, Sierra Leone, South Africa, South Sudan, Tanzania, Uganda, Zambia, and Zimbabwe to DOs. (Note: Some of the member African countries of AMCOA had independently licensed DOs before; however, this recognition unifies those who did or did not). Furthermore, DOs may work internationally with any humanitarian organization such as the
World Health Organization The World Health Organization (WHO) is a specialized agency of the United Nations responsible for international public health. The WHO Constitution states its main objective as "the attainment by all peoples of the highest possible level of h ...
and
Doctors Without Borders Doctor or The Doctor may refer to: Personal titles * Doctor (title), the holder of an accredited academic degree * A medical practitioner, including: ** Physician ** Surgeon ** Dentist ** Veterinary physician ** Optometrist *Other roles ** ...
. The following is an international licensure summary for US-trained Doctors of Osteopathic Medicine, as listed by the
American Osteopathic Association The American Osteopathic Association (AOA) is the representative member organization for the more than 176,000 osteopathic medical doctors (D.O.s) and osteopathic medical students in the United States. The AOA is headquartered in Chicago, Illinoi ...
, that shows countries where US DOs have previously applied for licensure (countries not listed are regions with no history of US DOs applying for licensure):''Frequently Asked Questions regarding International Licensure'', Council on International Osteopathic Medical Education & Affairs, American Osteopathic Association
Contact information listed.


See also

*
List of medical schools in the United States This list of medical schools in the United States includes current and developing academic institutions which award the Doctor of Medicine (MD), or the Doctor of Osteopathic Medicine (DO) a professional level of education, either of which is requir ...


Notes and references


External links


One DO's description on "What Is A DO?"


{{DEFAULTSORT:Osteopathic Medicine Academic degrees in healthcare Doctoral degrees Academic degrees of the United States Medical degrees Osteopathic medicine