The MD vs DO question is one of the most misunderstood topics in pre-med advising. Both degrees produce fully licensed physicians. Both graduates can prescribe medication, perform surgery, specialize in any field, and practice in any state. The differences are real but smaller than most applicants believe.
Core Differences
Osteopathic Manipulative Medicine (OMM): DO programs include an additional 200+ hours of training in osteopathic manipulative treatment — a hands-on approach to diagnosis and treatment using manual techniques. Some DOs use OMM extensively in practice (particularly primary care and musculoskeletal medicine); many use it rarely or never. If OMM does not align with your practice vision, that is worth considering.
Educational Philosophy: Osteopathic medicine historically emphasized a whole-person, preventive care philosophy. In practice, the clinical curriculum at most DO schools is very similar to MD programs. The philosophical distinction matters most in how schools present themselves, less so in day-to-day training.
USMLE vs COMLEX: MD students take the USMLE licensing exam series. DO students take COMLEX but may also take USMLE (which most DO students applying to MD residency programs do). Since the 2020 merger of the ACGME and AOA residency accreditation systems, DO graduates match into the same residency programs using the same NRMP system as MD graduates.
Admissions Differences
MD programs are on average more selective. AAMC data shows average GPA for MD matriculants around 3.73 (cumulative) and average MCAT around 511.9. AACOMAS data for DO matriculants shows averages around 3.57 GPA and 504 MCAT. This is not a quality difference — it reflects historical perception and applicant self-selection. Both groups produce competent physicians.
Should You Apply to Both?
For most applicants with a cumulative GPA under 3.6 or MCAT under 508, applying to both MD and DO programs is a sound strategic decision that significantly increases your total number of viable schools. For applicants above those thresholds, the decision is more philosophical — do you want the OMM curriculum? Do any specific DO schools have programs or locations that appeal to you?
Specialty Considerations
Some highly competitive specialties (neurosurgery, dermatology, plastic surgery) historically matched fewer DO graduates. Since 2020, match outcomes have improved significantly, but the most competitive specialties still show MD advantages. If you are set on a hyper-competitive specialty, this is worth researching by looking at NRMP match data by degree type for specific programs.