Intro

Before we start talking about the differences a DO and a MD. I want to address the giant elephant in the room:

There’s a stigma that DO’s are “less than” doctors somehow. In fact I commonly get these questions when asking about becoming a DO vs. a MD:

“Is a DO even a real doctor?”  (Hint: Yes they are).

“Don’t DO’s get paid way less than doctors?”(Hint: No, the same).

“Can DO’s even be surgeons?”(Hint: YES! Neurosurgeons, Orthopedic surgeons, ENT surgeons. In fact it’s better in some cases, ahem sports medicine

“Are YOU Dr.Khan, critical care doctor extraordinaire, a DO?”I sure am!

So let’s further discuss the differences between DO’s and MD’s, and see which one you should become:

What is a DO? A quick overview:

In the United States, there are two types of licensed physicians: A D.O. and M.D.

A doctor of osteopathic medicine attends an osteopathic medical school for 4 years, similar to a M.D.s training. However, from the beginning curriculum, a whole-person approach is emphasized, focusing in on prevention and a mind-body-spirit connection. Essentially, a different philosophy of utilizing the body’s natural ability to heal itself is woven into standard western medicine. It goes beyond classroom learning though, because we also learn OMT (osteopathic manipulative treatments). Think of it as physical therapy on steroids, to put it simply, but it’s much more than that. We get deep training in the musculoskeletal system, allowing us to diagnose and treat ailments using hands on OMT.

Here’s that whole description in chart form:

So a DO does way more training in the musculoskeletal system. Doesn’t that sounds awesome! Shouldn’t all doctors do that?

Short answer: YES!

Long answer: Yeeeeeeessssss… but it’s hard to do. There’s a giant amount of information that doctors must learn quickly in 4 years. There’s also a long history of politics and prestige of the two professions in the United States that I won’t bore you with here.

There are only 145,000 DOs in the U.S., so we’re a pretty special bunch!

Internationally, osteopathic medicine is practiced VERY differently, even in Canada. Many Osteopaths are not physicians, and they do not take the standard allopathic medical school classes. These international Osteopaths, not to be confused with Osteopathic Physicians, practice similarly to physical therapists. In the United States, if you wanted to learn osteopathic medicine, you would be required to attend medical school.

What is a MD? A quick overview

A M.D. is a doctor who practices allopathic medicine, the system of diagnosing and treating diseases with tests and pharmaceuticals. Basically, modern western medicine as you classically know it. There are approximately 1.1 million MDs in the U.S.

Most people think every doctor is an MD, but I bet you know several DO’s and don’t even know it.

DO vs. MD Salary: There’s no difference!

Because training and licensing of doctors is the same in the U.S., doctors get paid the same. For example, an ICU DO doctor will get paid the same as an ICU MD doctor. (unless of course, one is male and one is female. *zing! 😉 #wewantequalpay)

Here’s the 2018 averages for salaries across the United States:

	DO SALARY	MD SALARY
Orthopedist	$497,000	$497,000
Pediatrician	$212,000	$212,000
Psychiatrist	$273,000	$273,000

Oh what a coincidence, they are literally the same!

So if you’re trying to become an MD over a DO because of salary reasons, just know there’s literally no salary difference in United States.

Don’t DOs Still Have a Stigma? Is that a real thing?

YES! There is definitely still a stigma.

Let’s hear some of the common (but un-true) things people think about DO’s. I’ll go through each one for you:

“Are DO’s real doctors?”

YES! Like I’ve mentioned before, Osteopathic Physicians are licensed medical doctors in the United States and can practice in ANY specialty. Residency programs are available to all Osteopathic medical students, thus all board certifications are available. There are DOs practicing in every area of medicine across the country.

“Do DO’s get paid less?”

NO! This is NOT a thing! Approximately 50% of Osteopathic medical students go into primary care, and many proudly serve rural areas. Typically, primary care doctors get paid the least, but it’s not because of being a DO. As a critical care doctor practicing in COVID ICUs, I can guarantee I’m getting paid the same as my MD colleagues.

“Can DO’s even be surgeons?”

YES! What pre-med and medical students fail to realize is that surgery IS a competitive field. If you don’t have the grades or hustle to be competitive, you’re not going to be competitive as an MD or a DO student. Some residency programs may still have a stigma, like I mentioned before, that’s deep rooted in politics and cultures of that particular hospital, but overall DO surgeons exist. In fact, my favorite DO surgeon is Dr. Sadia Khan, a kick ass oncoplastic breast surgeon practicing in Orange County. She’s my hero.

Has that stigma of a DO limited my career as a doctor?

Nope!

I’m a kickass critical care and neurocritical care doctor and former assistant professor of medicine at one of the top medical schools in the country! Learn more about my daily doctor routine here.

So no, it hasn’t limited my options!

In fact, there’s tons of successful DO’s out there doing great things in their career and outside of their career:

Some DO Success Stories:

Dr. Kristina Angelo: A successful DO specializing in infectious disease and works at the CDC. She saved lives working to help contain the massive ebola outbreak in Africa in 2016. How freaking cool is that?

Dr. Sadia Khan: A successful DO surgeon specializing in oncoplastic breast surgery.

Dr. Mike: We all know this guy. A super successful primary care DO who has one of the top YouTube channels. Bet you didn’t know he was a DO, huh?

…..all of these people have highly lucrative and successful careers as doctors, and they share one thing in common: They are DO’s!

“What if I apply to a Caribbean school to become an MD?”

That’s great! These schools teach the same good stuff! You do you boo! But remember, if you want to practice medicine in the United States, you will be considered a foreign medical graduate (FMG), regardless of U.S. citizenship or where you do your medical student rotations. This means that when you apply for residency, you’re competing with the rest of the world’s doctors trying to practice in the U.S. The residency match rates are scary. Imagine all that student loan debt, with no job.

NRMP 2020 data:

• Allopathic students: 93.7%
• Osteopathic students: 90.7%
• US citizen FMGs: 61%
• Non-US citizen FMGs 61.1%

The real question and debate really comes down to this: Go to a DO school or a Caribbean school? My opinion: if you’re applying to Caribbean schools as your “backup” before ever applying to or considering DO schools, you’ve made a huge mistake.

Caribbean schools have several disadvantages:

Caribbean School Disadvantage #1.) You’re leaving the country. Let that sink in. You need your friends and family the MOST during medical school for support. Obviously if this is your only choice, sacrifices need to made for your goals, but it’s really hard flying in and out of the country (cost, flight time). I was SO lucky and I used to go home every time we had a 3-4 day weekend. I’m thankful for that.

Caribbean School Disadvantage #2.) The school class sizes are HUGE. My class was only 135. These classes range from 500-800, meaning the professors are spread super thin if you need help:

Compare this to my DO class of only 135 students. This means I had much easier access to professors and help, and knew every single classmate.

Caribbean School Disadvantage #3.) These schools are FOR profit. Huge loans. And overall as a business, I have serious concerns that they will care about your well being as a medical student, although I’ve heard this has been improving in the last several years. Just be careful.

Caribbean School Disadvantage #4.) Foreign medical graduate status. You’re not a United States trained doctor. If you thought being a DO was hard to get into residency, imagine being an FMG. Way harder! It’s only the status that’s a hurdle. The caliber of doctor and training are the same.

Caribbean School Disadvantage #5.) Island living isn’t all it’s cracked up to be. Hurricane season is REAL. Entire schools have been destroyed (Most recently Ross University by Hurricane Maria in 2017.)

Caribbean School Disadvantage #6.) The attrition rate (aka drop out rate) for US medical schools are 1-2%, and some Caribbean Medical Schools have rates ranging from 30-60% (from various sources). This is why there’s such a large class size to begin with. The reason for this drop out rate is unclear in the data. Again, be aware and be cautious. ASK!

Read more about these schools here.

My theory on if you should go to a Caribbean school:

If you get into a MD school or DO school in the United States. Go there, not a Caribbean school.

If you’re a reapplicant that didn’t get into a MD school in the United States, make sure to apply to DO schools this time. Don’t just choose or rush to the Caribbean if you haven’t applied to both MD and DO schools for at least 2 cycles. Don’t miss out on an opportunity that might be a good choice for you. Get all the info.

If you don’t get into an MD school or DO school in the United States after 2-3 cycles. Go to a Caribbean school if you get in.

You can excel anywhere if it’s your true dream and passion! I know many successful and incredible doctors that have trained everywhere across the globe.

DO or MD, doesn’t matter.

All specialties are available to you at any stage. Some people just have a tougher road, and that’s just life. Take what you can get and make the most of it! YOU can do it!

Make sure you have all the information before you make your choice.

That’s it. It’s not very complicated!

DO vs. MD Cheat Sheet:

Let’s just do a quick re-cap of DO’s vs MD’s.

How many DO’s in the United States: 145,000
How many MD’s in the United States: 1.1 Million

Average salary of DO: $189,000
Average salary of MD: $189,000 (It’s the same)!

Differences in training and specialties:

USA MD residency match rates: 93.7%
USA DO residency match rates: 90.7%
US citizen FMGs residency match rates: 61%
Non-US citizen FMGs residency match rates 61.1%

At the end of the day it doesn’t matter where you get your education from, as long as you picked the school that’s right for you, and you get that doctor degree to save lives! Chase those dreams!

If you’re still feeling stuck, check out my FREE masterclass on How to Get Into Medical School, Despite Low Scores. Sign up HERE.