MD vs DO: Choosing Between Two Paths Into Medicine
By Muntasir Minhaz • Published Aug 04, 2026 • Graduate & Professional School
MD and DO degrees both make you a fully licensed physician who can practice in any specialty. The main differences are training philosophy, licensing exams, and the size of each applicant pool.
🎓 MD schools teach allopathic medicine and use USMLE Step exams for licensing.
🎓 DO schools add osteopathic manipulative treatment training and use COMLEX-USA, though DO students can also take the USMLE.
📩 In the 2026 Match, US MD seniors had a 93.5% PGY-1 match rate and US DO seniors hit 93.2%, the highest ever for DO seniors.
🏠 DO schools now train close to 30% of all US medical students, across 47 colleges of osteopathic medicine.
What MD and DO Degrees Have in Common
An MD (Doctor of Medicine) and a DO (Doctor of Osteopathic Medicine) are both full medical degrees. Graduates of either path complete four years of medical school, apply through a residency match, and become licensed physicians who can prescribe medication, perform surgery, and practice in any specialty from family medicine to neurosurgery.
Admissions committees for both degree types look at your GPA, MCAT score, clinical experience, and letters of recommendation. Course sequences in the first two years overlap heavily, covering anatomy, physiology, pharmacology, and pathology before students move into clinical rotations.
Where the Two Paths Diverge
The clearest difference is osteopathic manipulative treatment (OMT), a hands-on set of techniques DO students learn for diagnosing and treating musculoskeletal issues. MD curricula do not include OMT. Osteopathic medicine also places more explicit emphasis on primary care and a whole-body approach to treatment, though many DO graduates go on to competitive specialties.
Licensing exams differ too. MD students take the USMLE Step 1, Step 2 CK, and Step 3. DO students take the COMLEX-USA series through the National Board of Osteopathic Medical Examiners, and many also sit for the USMLE to keep residency options fully open, since some MD-heavy residency programs are more familiar with USMLE scores.
| Factor | MD | DO |
|---|---|---|
| Accrediting body | LCME | Commission on Osteopathic College Accreditation |
| Licensing exam | USMLE Step 1-3 | COMLEX-USA (USMLE optional) |
| Added coursework | None beyond standard curriculum | Osteopathic manipulative treatment |
| 2026 PGY-1 match rate, US seniors | 93.5% | 93.2% |
How Big Is Each Applicant Pool
DO education has grown fast. Total osteopathic enrollment reached 40,905 students in 2025-26, a 2.9% jump from the year before, according to the American Association of Colleges of Osteopathic Medicine . There are 47 colleges of osteopathic medicine (COMs) running 74 teaching locations across 36 states, and DO students now make up close to 30% of all medical students in the country.
MD programs remain the larger and more established track overall, with a longer history and a wider spread of research-intensive academic medical centers attached to them. Neither path is easier to get into across the board. Average MCAT and GPA numbers at individual MD schools tend to run higher than at individual DO schools, but competitive DO programs draw strong applicants too, and the gap has narrowed as osteopathic medicine has grown.
Residency Outcomes for Both Degrees
Both MD and DO graduates enter the same National Resident Matching Program. In the 2026 Main Residency Match, the largest in NRMP history, US MD seniors posted a 93.5% PGY-1 match rate with an overall placement rate of 97.8% once you count Supplemental Offer and Acceptance Program placements. US DO seniors matched at 93.2% for PGY-1, their highest rate ever recorded and up 0.6 points from 2025, according to the National Resident Matching Program .
DO seniors have historically matched at slightly lower rates than MD seniors in the most competitive surgical subspecialties, though the gap has closed year over year as more residency programs run a single, degree-blind selection process. If you have a specific specialty in mind, check that specialty's own match data by degree type rather than relying on the overall numbers.
How to Choose
Pick based on fit, not prestige. If hands-on musculoskeletal treatment and a primary-care-forward training model appeal to you, DO school gives you that built in. If you want the broadest possible name recognition among residency directors in every specialty including the most competitive surgical subspecialties, MD programs still carry a slight edge there, though it keeps narrowing.
Apply broadly and honestly assess your MCAT and GPA against both MD and DO average admitted-student ranges. Many students apply to both tracks in the same cycle. Whichever degree you earn, your board scores, clinical performance, and letters during rotations will matter more to your eventual specialty and location than the two letters after your name.