DO vs. MD: What You Need to Know! (Part Two)

For more information about Osteopathic physicians, check out Part One of this blog series where we discuss an overview of Osteopathic Medicine and tackle Residency Match Rates.

In this article we will be covering the following topics listed below.

1. Medical School Boards

2. MD vs. DO Salary

3. How to choose between MD vs. DO

Medical School Boards:

In short, Osteopathic medical students have additional requirements for national board examinations. In order to graduate from an osteopathic medical school, students must pass all their COMLEX (Comprehensive Osteopathic Medical Licensing Examination) exams. Unfortunately, until recently, these students would also have to take allopathic medical student exams termed the USMLE (United States Medical Licensing Examination) to match into a non-osteopathic residency. Essentially, they have to deal with the headache of passing double-licensing examinations whereas allopathic (M.D.) students only take one.

A major step forward for D.O. programs was in 2020 when a merger of allopathic and osteopathic accreditation programs occurred. This resulted in ACGME-accredited residencies to recognize the COMLEX exam as an equal to the USMLE exam. As mentioned, these board scores are an essential component to the residency match. This is great news for osteopathic physician recognition, but it is still too early to see if the new practices will take hold at individual residency programs. While programs may formally recognize the equivalency of a COMLEX score, they have far more expertise in interpreting USMLE scores. So, at this given point and time, it is still in a D.O. student’s best interest to prepare for both board exams – yet another limitation these future physicians face.

Osteopathic Medicine Salary:

Do osteopathic physicians make less than their Allopathic counterparts? During your research, you may have come across some articles discussing lower salaries for osteopathic physicians. While the headline may scream “avoid osteopathic education,” closer analysis will show that the findings are secondary to statistical manipulation.

It is true that on average, M.D. physicians earn more than D.O. physicians based on flat salary data. Meaning, if you compare all practicing M.D. physicians and their average salary to all D.O. physicians salary average salary, M.D.'s appear to make more. What these findings neglect to highlight is that there are far more M.D. physicians in higher paying specialties. This feature is likely due to lower match rates in these competetive fields, or alternatively osteopathic physician choice. Another variable is that there is a higher percentage of M.D. physicians in urban environments which can lead to artificially higher wages due to a higher cost of living.

When these factors are accounted for, M.D. and D.O. physicians actually make comparable salaries when examined side by side. The rate of specialization is the true indicator of potential income, although location and years’ experience are other contributing factors.

How to Choose between M.D. and D.O.:

While there are obvious pro's can con's to applying to Osteopathic Programs you will need to make the decision for yourself. Choosing to apply to these programs will be primarily based on your medical school statistics and the likelihood that you will be able to obtain a medical school acceptance.

1. Your medical school statistics.

In general, if you are an extremely qualified applicant, it would be in your best interest to avoid applying to D.O. programs. They will likely utilize a yield-protection strategy and consider your application a healthy donation to the cause. For example, if you are rocking a 520 MCAT, and a 3.90 sGPA, with unique extracurriculars, you have a relatively high probability of getting accepted to most M.D. programs. Save your time and money and focus your efforts on rounding out your application, or preparing for interviews.

However, if you are a "borderline" applicant, have an institutional action, weak extracurriculars or other application weaknesses, it would be in your best interest to apply to D.O. medical schools (perhaps even exclusively). Applicants with weaker medical school statistics (low MCAT/GPA) but strong extracurriculars will also benefit from applying. Most osteopathic programs value holistic applicants over pure academics. For perspective, the average MCAT and GPA for allopathic medical students is 511.5 and 3.73, respectively. On the other hand, the average MCAT and GPA for osteopathic medical school students is 503.8 and 3.54. These figures alone suggest that M.D. applicants must achieve a higher academic level to secure a program admission.

2. Your Medical School List:

Depending on how many medical schools you plan to apply to and the current distribution of safety, target, and reach schools, you may be inclined to add a few osteopathic programs to the list. Secondary to your lower statistics, you may find that your distribution is very top heavy with plenty of Reach programs and only 1-2 safety schools. To protect yourself from the possibility of repeating the cycle, you should consider applying to D.O. schools. It will be far better to become a D.O. than it will be to face the application cycle again, which also offers no guarantees of success.

3. Overestimation of Qualifications:

While you may not want to hear this, almost every applicant overestimates how successful their application cycle will be. This can be particularly true for non-traditional pharmacy applicants like yourself. While you may have a unique educational background, I don’t want to give you any false confidence into thinking your application is bulletproof. Right now, you are operating in a vacuum and likely don’t realize how many other qualified and prepared students are entering the same application cycle as you. Even if starting a new D.O. application can be a monstrous task, it will be worth it in the end if you can avoid re-applying. Don’t overestimate your qualifications and add a safety net of osteopathic medical schools.

4. Holding Two Acceptances:

If you find yourself holding an acceptance to both a D.O. and M.D. school, I advise you to consider the M.D. pathway. Unless there are extenuating circumstances such as exorbitant financial downsides, or considerable distance from family, it would be wise to use the M.D. advantage to your benefit. While I do not personally agree with the residency bias or stigma surrounding the D.O. degree, your goal should be to match into the residency of your dreams. By choosing to go M.D. you may have a slight edge against D.O. applicants when it comes time to match.

This stigma is particularly true for prestigious residency programs and highly specialized fields such as neurosurgery. This medical field is dramatically changing and by the time you are in the position to match this entire bias may be completely absolved.

Check out Part One.

Disclaimer: The limitations I have discussed are not reflective of any viewpoint that I hold and are a shared collection of information based on residency match numbers and professional sentiment.

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If you haven't even started your journey into medical school, check out our other Blog Articles here.

For more questions, review our article "6 Most Common Questions About Transitioning From Pharmacy to Medicine."

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