Pre-Med Debate Classic: D.O. vs. M.D.

In case you haven’t already figured it out, I happen to be a student at an osteopathic school, which means I am working towards my DO degree rather than my MD. There are a lot of misconceptions about the degree among pre-meds, so I thought I would dedicate a post to discussing the issue before moving forward. I’ll address the major arguments point-by-point.

Being a DO student means you failed at being a pre-med. This shows up all the time on SDN and in casual conversations with pre-meds. The facts are that the average MCAT/GPA combination for allopathic (MD) schools is around 30-32/3.6, and the averages for most osteopathic schools are around 25-29/3.3-3.6. It’s hard to find overall statistics for these things, but I think most people would agree that these numbers are roughly correct. MCAT averages have risen in recent years, such that many DO schools are now on par with the averages of allopathic medical students from a few years ago (and I don’t see anyone calling them failures).  Osteopathic medical students beat out hundreds of other applicants to get their seat at school just like allopathic students did, with EC’s, research, good grades and good interviewing skills. Osteopathic schools allow good students to become good doctors, which is not something to be ashamed of. All of us become physicians and all of us will see patients – with a possible 150,000 physicianshortage in the near future, none of us will be hard up for work. 

DO’s only do primary care. It’s true that many DO’s choose to fill the growing primary care shortage in the US after graduation. To start with, there is nothing wrong with primary care! Primary care is a challenging specialty which many physicians enjoy practicing, with reimbursement rates rising through the new healthcare laws. Though many DO’s go into primary care, plenty of them choose to specialize (if you need proof, just check out the match lists from 2011) DO’s can do the same residencies as MD’s with the additional option of taking a DO-only "AOA" residency, which offers training in specialties like dermatology, neurosurgery, radiology and anesthesiology, along with the other typical specialties. DO’s go into literally every specialty available – it’s all about your abilities and what you want to do. It is incrementally more difficult to get into the highly competitive specialties comparatively speaking, but it was already hard to begin with.

My patients won’t respect me if I have the wrong letters after my name. This misconception is less valid now than it has ever been! With PA’s, NP’s, CNA’s and a myriad of other degree titles for medical professionals, patients are getting used to seeing degrees other than MD at their bedside. Many people have been treated by a DO and they never even knew it – imagine my surprise when I found out during my first year of med school that the doctors running the hospital in my hometown were all graduates of osteopathic institutions. More than anything, patients will be looking for you because you’re a physician. Maybe they googled 'pediatrician,' maybe a friend told them that they saw this great doctor down on XYZ street, or maybe they passed by your office and remembered that it was on their way home from work. They’re going to be looking for a doctor who treats their patients well, and anyone – MD or DO – has the potential to do exactly that.

You don’t get a good education at DO schools. I will not try to claim that all DO schools have great curricula and board scores, because not all of them do. There are excellent DO schools and there are some who are still struggling to do well, so it is important to thoroughly research your school of interest before you apply and certainly before you commit to matriculating (this goes for allopathic schools too!). With only 27 osteopathic schools, even a few poorly-run schools can make it look like the whole operation is flawed. That being said, there are also DO schools with good reputations and match rates. Some examples are Nova-Southeastern, Western, LECOMs, TCOM, the PCOMs, ATSU, AZCOM and several that I’m sure are not on my list. These are not the only good DO schools, but my main point is that there are many good options when applying to osteopathic institutions. We learn almost exactly the same material with the addition of osteopathic manipulation. It’s not like they censor pertinent medical information from our curriculum just because we get a different degree.

I’ll have a better chance if I go to a Caribbean school. This argument has been beaten to death in various places. If having an MD is of the utmost importance to you, then I welcome you to attend a Caribbean school. There are good clinicians who come out of foreign medical schools, and I would never try to demean their efforts. However, when speaking statistically, you are much more likely to match into a solid US residency as a DO. If your goal is to attend an ACGME (MD) residency, you have a 71% chance of doing so with a DO degree and a 50% chance of doing so with a Caribbean degree. The biggest difference here is that as a DO you also have the option of also applying AOA, where you are very likely to match even if you did not match (or chose not to match) into an ACGME residency. You can view the statistics and numbers on this SDN post, where a kind soul has taken the time to detail all the numbers.

If your goal is to be a physician you have many choices in schools, and 27 of those schools are osteopathic institutions. DO or MD, we will all be judged by our patients and our peers on our competency, compassion and willingness to do hard work. To end this post, I would like to leave you with a few DO’s who might surprise you…

Dr. Robert Hendron, Professor and Vice Chair of Psychiatry, Director of Child and Adolescent Psychiatry at UC San Francisco 

Dr. Ronald Blanck, 39^th Surgeon General of the Army 

Dr. Tyler Cymet, Professor of Medicine at Johns Hopkins University 

Dr. Kimberly Parks, Cardiologist at Massachusettes General Hospital featured on ABC’s “Boston Med”

Dr. Robert McCarron, Director of the Internal Medicine/Psychiatry Residency at UC Davis 

Dr. Andrea Amalfitano, Geneticist and Gene Therapy Researcher at Michigan State University 

Dr. James Leiber, Assistant Professor in Family Medicine at LECOM-Bradenton, formerly an Air Force physician who treated both President Bush and Vice President Dick Cheney

Dr. Janice Knebl, Geriatrician, Professor at the Texas College of Osteopathic Medicine, Vice Chairman of the National Board of Osteopathic Medical Examiners

Dr. Suzanne Frasca, Dr. Mariya Rosenfeld and Dr. Lana Selitsky, OB-GYNs at Beth Israel Medical Center

Dr. Robert Dickerman, Neurosurgeon cited as one of the best neurosurgeons in the Dallas-Fort Worth area