Convert D.O. To M.D. Degree

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Should We Even Have a DO Degree?

I just did a web search for “Why go to a DO school?”

The top two results that I received:

• “Reapply or go to DO school?”
• “Why are Osteopathic medical schools treated like the plague?”

I’m sure you could search “MD vs DO” and get similar results. I’ve talked about some of the cut-and-dry basics of the DO vs MD discussion already here.

In the interview that I had with ATSU KCOM, I asked what they thought about this general sentiment of “My grades aren’t good enough for an MD school, so I should go to a DO school instead.” Their response:

A little disappointment actually, because the curriculum is the same, so it’s not any easier than any med schools out there. But I do feel a little disappointment, and I even interviewed a kid the other day who iterated that. He said, “Well my dad, who is a physician, said, ‘Your grades aren’t good enough, try a DO school.’”

The osteopathic philosophy

I often see the following statements from premed students about why they are leaning towards going to an osteopathic school:

“I like the osteopathic philosophy of prevention.”

“I like the holistic approach of osteopathy.”

Yet, 4 years from now, those same graduating DOs are going into surgery, dermatology, emergency medicine, or internal medicine with a cardiology fellowship, where for the most part prevention goes out the window and they are treating acute disease just like the MDs.

I recently saw a push that was made a few years ago to change the DO degree to something like “MD, DO (Doctor of Medicine, Diploma in Osteopathy)” to stop the confusion and show the public that DOs are in fact the “same” as MDs, just with additional training on top. It failed. I’m glad it did.

Don’t get me wrong: I do believe DOs are on the same level as MDs. But I think if you’re going to make an argument for the “holistic” and “preventative” philosophy as reasons to go to a DO school, then they should truly be different.

The origins of osteopathic medicine

This was the basis on which Andrew Taylor Still created the osteopathic field in the first place:

“that science which consists of such exact, exhaustive, and verifiable knowledge of the structure and function of the human mechanism, anatomical, physiological and psychological, including the chemistry and physics of its known elements, as has made discoverable certain organic laws and remedial resources, within the body itself, by which nature under the scientific treatment peculiar to osteopathic practice, apart from all ordinary methods of extraneous, artificial, or medicinal stimulation, and in harmonious accord with its own mechanical principles, molecular activities, and metabolic processes, may recover from displacements, disorganizations, derangements, and consequent disease, and regained its normal equilibrium of form and function in health and strength. – Still, Andrew Taylor (1908). Autobiography of A.T. Still. Kirksville, Missouri. pp. 91–93, 97–98, 403.

When I was still a premed, I was very interested in the DO field; having an exercise physiology background, it seemed to fit very well. But I also knew that, at the time, I wanted to be an orthopod—which would not have been easy as a DO—and which honestly doesn’t fit with the above statements of “preventative” and “holistic,” because it’s surgery.

A surgeon cuts, sutures, removes and heals what is broken. There is nothing preventative about it. A torn meniscus is not healed with hip surgery because that is where the meniscus injury came from.

Should DOs differentiate themselves further from MDs?

If there is an argument to be made, it would be to differentiate the fields even more. If a DO truly wants to be dignified as a physician who treats holistically and prevents disease, they should go into a specialty (or lack thereof) where you can actually do that.

Osteopathic Manipulative Therapy (OMT) is the great differentiator between DOs and MDs. I’ve worked side-by-side with DOs and have had patients request the DO because of OMT. But how does a dermatologist or emergency room physician use OMT in their practice?

DOs and primary care

The primary care specialties of family practice, pediatrics, internal medicine (without the cardiology fellowship) and a specialty like physiatry (PM&R) are the perfect fields for osteopathic physicians and the use of OMT. Pathology most definitely is not (I’m not quite sure how OMT would work on a corpse).

Obviously, the ACGME and AOA do not share this opinion with me, as they are looking to merge the post-graduate training for DOs and MDs.

Again, I truly believe osteopathic physicians are on a level playing field with their allopathic physician colleagues. There is no doubt about it. I’ve been surrounded by and have worked with great DO trauma surgeons, radiologists, and others, but I think to stand out, DOs should truly stand apart.

Here are just some of my thoughts:

• If you are going to merge post-graduate training for DOs and MDs, then don’t have two degrees. Get rid of the DO degree name. Make every school an MD school.
• Make Osteopathy a fellowship, like cardiology or pulmonology. This would allow the students who want the “holistic” and more “preventative” education and background to pursue that directly.
• If you truly want to be different and keep the DO degree, then stand for the core values that A.T. Still stood for. DOs should not go into surgery. They should not go into anesthesia. They should not go into dermatology, radiology, emergency medicine or any other specialty that doesn’t allow them to use OMT to it’s fullest potential.
• We (as a collective community, and especially the premed crowd) need to stop viewing DO schools as being on a second tier. Just because the average GPA and MCAT scores are lower does not mean they are second-tier schools. It just means they don’t put as much weight into those scores as most MD schools do.
• The public needs to be better educated on the values and benefits of an osteopathic physician. The AOA needs to start educating the public with marketing campaigns (anything has to be better than Pfizer pushing more erection pill commercials).

Do you agree? Disagree? Let me know. Come join the Premed Hangout (our Facebook group) and leave a post with your thoughts!

Links and Other Resources

Can You Convert a DO to an MD Degree? (Explained!)

The idea that students studying towards a DO degree should be given the opportunity to convert to an MD degree (and vice versa), has been long discussed. Arguments over the small differences in earning both degrees, coupled with 2020 residency mergers, certainly do a lot to support the argument.

So Can You Convert A DO to an MD Degree?

You can’t convert between osteopathic (DO) medical degrees and allopathic (MD) degrees. The governing and accreditation boards for both remain separate. As do the specific colleges designed to deliver on teaching.

Although you could in the past, and may be able to again in the future (possibly via a merger), it’s impossible right now.

Still, despite these facts being true, that doesn’t stop the debate.

In this article, we’ll explore the idea of DO to MD conversion, look at the history of the idea and look into the reasons why you can’t.

We’ll also explore:

• The future possibility of MD/DO conversion
• The statements issued by specific boards
• The similarities and differences between the degrees (that could help lead to their separation)

Ready to learn more? Let’s get started.

Why You Should Be Able to Convert a DO to MD

While you can’t currently convert a DO to an MD degree, the idea that you should is pretty persuasive.

Back in 1982 a legal case took place arguing that DOs should be able to use MD letters in communications with patients. Relying on the argument that “(t)here is no substantial difference between accredited medical schools irrespective of the terminology of the degree conferred, except that students attending medical schools conferring the degree ‘Doctor of Osteopath’ are required to take, and be examined in, several courses in manipulative therapy,” the case was eventually thrown out. The Texas court failed to agree.

Fast forward to the 2020s however, and the debate is still ongoing.

The idea that a DO to MD conversion should occur, according to research, seems to exist on the following four principles:

1. Separation only really exists because of retiring accrediting board members motivated by financial incentive
2. It was already once possible to convert a DO to an MD degree for a small fee (specific to California, ending in 1962)
3. Residency positions are open to applicants holding either degree
4. There’s minimal difference between the content studied and examined

Whether there’s any real weight between these arguments, is not enough.

For now, earning a DO is still a separate process from earning an MD.

Is There A Possibility of an MD/DO Degree Merger?

Despite persuasive arguments, for many, the possibility of a merger is still very little.

This is because, as it stands, there is no real benefit. For doctors working in the US (excepting those who wish to work abroad – see the section below on “International Limitations” for more), job prospects and salaries are much the same. Degree holders from either path go on to specialize via residency (and often end up in the same careers) through the same match process.

Also, the impact on patient care delivery is small – few doctors or patients care about the initials attached to a medical degree.

What about merging COMLEX with STEP?

One place a merger could be possible is when it comes to exams. Dropping the COMLEX (the DO board exam) and replacing it with STEP (the MD equivalent), makes more sense. This is mainly because there is a large amount of overlap between topics on either exam and the materials used to study for both.

Many students theorize this could happen within the next few years.

Why Can’t You Convert a DO degree to an MD?

According to more skeptical students, the decision could have a lot to do with money.

Both degrees are governed and accredited individually. Both are earned at specifically designed colleges and teaching hospitals. Both degrees operate as individual “competing businesses.”

What About AOA Leadership? Doesn’t That Mean DO and MD could Merge?

Some students argue that because AOA leadership is slowly dying (evidenced by a 2019 statement that seemed to open up to the idea of a potential merger), rules on separation could eventually relax.

But this doesn’t take into consideration the other side of the argument; the governing committee behind the MD, the Liaison Committee on Medical Education (LCME). Without a public statement, we have no almost no idea where they stand on a potential MD-DO combined degree or conversion.

Because some feel the MD is the more prestigious (and competitive) degree, we can’t just assume the LCME would be open to any conversion or merger. The greater possibility is that the LCME just takes over everything.

Finally, sooner rather than later, osteopathic medical schools will likely be forced into joining with and being accredited by the Liaison Commission for Medical Education (LCME). The logic is inescapable. By agreeing to the proposition that one accreditation system with one common standard on the graduate medical education level through ACGME is in “the public interest,” the osteopathic profession will likely be unable to offer a rational and compelling reason why one accreditation system with one common standard accrediting all US medical schools (allopathic and osteopathic) is not in “the public interest” on the undergraduate level. This is particularly the case when the LCME is composed of the same partners—AMA and AAMC—on the graduate medical education level. And given that tuition-dependent medical schools with comparatively few full time faculty members cannot meet current LCME standards, DO schools will close or lose their osteopathic identity.

– Dr Gevitz, 2016

When Can You Convert a DO to an MD Degree?

As of right now, there are only predictions. Even then it’s more likely that the two will combine under one degree, making conversion pointless.

For some, this could be in the next 10 years…

I believe the MD DO merger will take place within 10 years. Everyone’s saying that “old guards” will not allow that to happen. But the “old guards” are already gone. Any DO who is younger than 55 are the same crowd who advocate for the MDO 20 years ago. This age group probably makes up up to 75% of DOs. AOA with its shrinking membership will not be able to stop the merger if LCME proposes it..

– Solodyn, SDN

For others, possibly never…

The AOA is part of the ACGME voting board now. They still have some power. I don’t think MD and DO will merge. LCME doesn’t care and doesn’t want anything to do with DO schools.

– DrStephenStrange, SDN

What is a DO degree?

DO stands for Doctorate of Osteopathic Medicine. The degree is undertaken at an osteopathic medical school and upon completion, graduates will be able to use the letters DO after their name. DO’s make up approximately 11% of all practicing physicians in the US.

Osteopathic medical schools take a holistic approach to medicine. Students mostly go on to work in a generalized role in rural areas. There are around 37 DO medical schools in America, and around 121,000 DO physicians currently practicing. While not as popular as MD degrees, the number of people choosing a DO degree is increasing.

What is an MD degree?

MD stands for Doctor of Medicine, and it is the most popular type of medical degree undertaken in the US. Students train in allopathic medicine, focusing on the diagnosis and treatment of disease. Upon completion, graduates can use the letters MD after their name.

Students attend a medical school accredited by the Liaison Committee on Medical Education (LCME). They also specialize in specific areas of medicine such as neurology, ophthalmology, and cardiology. There are currently 155 accredited MD programs available in the US.

What are the differences between a DO and MD degree?

Some of the differences between a DO and MD degree include the teaching approach, salary, international opportunities, and education. However, both DO and MD graduates will be licensed to practice medicine equally in all 50 states.

With DO degrees, students follow a holistic, whole-body approach. They need to undergo an additional 200 hours of training in the Osteopathic Manipulative Treatment field. MD students, on the other hand, do not undergo this extra training.

DO Vs MD Salary

Technically, DOs and MDs can earn the same kind of salary. However, as most DO graduates enter into a primary care field, statistically they do earn a lower salary than MD graduates who go into a specialized field.

International Limitations

Perhaps one of the biggest differences that you will need to take into account, is the international opportunities available. MD degrees are more widely accepted throughout the world than DO degrees. This means if you want to practice medicine abroad, an MD degree would be the better option. That being said, DO degrees are becoming more accepted thanks to their rise in popularity. DO graduates have full practice rights in approximately 50 different countries.

Routes to Qualification

When it comes to getting qualified, DO students need to pass a Comprehensive Medical Licensing Examination (COMLEX). MD students, on the other hand, need to pass the United States Medical Licensing Exam (USMLE).

Both DO and MD programs teach science-based classes, such as biochemistry, physiology, and anatomy. The coursework for DO programs is slightly different in the fact that a tenth of it focuses on hands-on therapies.

These are the main differences you will need to consider when deciding which degree to undertake.

Is a DO or an MD degree better?

Both DO and MD degrees allow you to practice medicine. While they may take different approaches and the requirements differ slightly, they are equally as good as one another. DO degrees are not as well known as MD degrees, but that is starting to change now more students are opting to go down the DO route.

For patients, having DO or MD after your name doesn’t make a difference. You will still be viewed as a medical professional regardless of what letters you have after your name. However, when it comes to employment opportunities, you may find it easier to get into your chosen career with an MD degree.

To determine which type of degree is the best option for you, consider where you want to practice medicine, and whether you would like to learn Osteopathic Manipulative Treatment. One could argue that a DO degree is more impressive due to the additional training and skills acquired. However, there really is very little difference between the two.

Is residency different for a DO and MD?

In 2020, the Graduate Medical Education (GME) and American Osteopathic Association (AOA) changed the residency match requirements for DO and MD doctors. Both DO and MD students can now apply for the same positions after completing school. Prior to this, DO and MD doctors went through separate residency matches.

The only remaining difference between DO and MD residency is that DO students can become board certified in Osteopathic Manipulative Medicine. This is typically paired with Neuromuscular Medicine and is referred to as an OMM/NMM residency.

DO graduates can find it a little more difficult to obtain a residency, but this is mostly down to how few medical schools there are. Statistically, there are far more MD students looking for a residency program, which ultimately leads to a higher acceptance rate compared to DO students.

What are DO and MD admission requirements?

Admission requirements are almost the same for DO and MD medical schools. There are pre-requisite courses that need to be taken at the undergraduate level, and students need to shadow a DO or MD physician. Additionally, both DO and MD applicants need to take an MCAT (Medical College Admission Test) test.

A personal statement will be required when applying for admission into a DO or MD program. Do students will need to write a personal statement for AACOMAS, while MD students will write one for AMCAS.

Applications for both DO and MD schools begin in May, though AMCAS applications can be submitted in June.

Understanding the key differences between a DO and MD degree will help you to decide which path is right for you. You cannot convert a DO degree into an MD degree, but in reality, they both provide the same opportunities so it shouldn’t matter too much.