Comparison of MD and DO in the United States
In the United States, there are two types of physicians that practice medicine. Most physicians hold the Doctor of Medicine degree (M.D.), while osteopathic physicians hold the Doctor of Osteopathic Medicine degree (D.O.). Other than teaching osteopathic manipulative medicine, the medical training for an M.D. and D.O. is virtually indistinguishable. D.O. physicians complete conventional residencies in hospitals and training programs, are licensed in all states, and have rights and responsibilities, such as military service, that are identical to M.D. physicians and surgeons.
- 1 Background
- 2 Demographics
- 3 Cultural differences
- 4 Medical education and training
- 5 Professional opportunities
- 6 References
- 7 External links
In 2005, Jordan Cohen, the president of the Association of American Medical Colleges (AAMC) stated:
After more than a century of often bitterly contentious relationships between the osteopathic and allopathic medical professions, we now find ourselves living at a time when osteopathic and allopathic graduates are both sought after by many of the same residency programs; are in most instances both licensed by the same licensing boards; are both privileged by many of the same hospitals; and are found in appreciable numbers on the faculties of each other's medical schools.
The AMA's current definition of a physician is "an individual who has received a 'Doctor of Medicine' or a 'Doctor of Osteopathic Medicine' degree or an equivalent degree following successful completion of a prescribed course of study from a school of medicine or osteopathic medicine."
The sex and racial distribution of DOs and MDs are similar. Currently, there are significantly more MDs than DOs. In 2013, 6,449 students (24.3%) matriculated as first-year students into D.O. medical programs and 20,055 students (75.7%) matriculated as first-year students into M.D. programs.
A 2012 survey of students applying to both U.S. M.D. and D.O. schools found that 46% were admitted only to a D.O. school, 9% were admitted only to an M.D. school, 26% were admitted to both, and 19% were not admitted to any medical schools. Geographic location was the top reason given by both D.O. and M.D. students for choosing the school in which they enrolled. The college's approach to learning and teaching and the college's reputation were highly ranked by respondents attending D.O. medical schools.
Of physicians practicing in the United States, 7% are osteopathic physicians (2010), 26% are international medical graduates (2012), and 67% are allopathic physicians. Between 1980 and 2005, the annual number of new MDs remained stable at around 16,000. During the same period, the number of new DOs increased by more than 200% (from about 1,150 to about 2,800). Graduates from DO medical programs are expected to increase to as many as 4,000 by 2015. The number of new MDs per 100,000 people fell from 7.5 to 5.6, while the number of new DOs per 100,000 rose from 0.4 to 0.8.
The distribution of both M.D. and D.O. physicians in the United States is not uniform, as the number of physicians per capita varies. As of 2009, the states with the most M.D. physicians per capita were the District of Columbia, Massachusetts, Maryland, and New York. The states with the lowest number of M.D. physicians per capita were Idaho, Oklahoma, Mississippi, Wyoming and Nevada. Osteopathic physicians are more concentrated in the midwestern states than in other regions of the U.S. As of 2011, the states with the most osteopathic physicians per capita were Michigan, Maine, Oklahoma, Pennsylvania. The states with the lowest number of D.O. physicians per capita were Louisiana, Alabama, Nebraska, and North Carolina.
Some authors describe less quantifiable distinctions between the two medical professions. Avery Hurt writes, "In actual practice, the variations between the two types of physicians are often so slight as to be unnoticeable to patients, and a day in the life of each can appear indistinguishable. But the differences are there, subtle but deep." Several studies have investigated these differences. One study compared the patient interactions of DOs and MDs. The study found that "osteopathic physicians were more likely to use patient's first names and to discuss the social, family and emotional impact of illnesses." For example, "66% of DOs discussed a patient's emotional state compared with about one-third of MDs." The same study found that MD qualified "physicians scored higher in discussing literature or scientific basis of treatment." Another study analyzed 341.4 million patient visits to general and family medicine specialists in the United States, including 64.9 million visits to DOs and 276.5 million visits to MDs. It found that there was no significant difference between DOs and MDs "with regard to time spent with patients and preventive medicine services."
A Harvard study found significant differences in the attitudes of DOs and MDs. The study found that 40.1% of MD students and physicians described themselves as "socioemotionally" oriented over "technoscientific" orientation. 63.8% of their DO counterparts self-identified as socioemotional. (p < .0001)
One study of DOs attempted to investigate their perceptions of differences in philosophy and practice between themselves and their MD counterparts. 88% of the respondents had a self-identification as osteopathic physicians, but less than half felt their patients identified them as such. The study asked respondents to identify points of philosophical and practical difference between DOs and MDs; no more than 1/3 of respondents could agree on any single such point of difference.
As the training of DOs and MDs becomes less distinct, some have expressed concern that their unique characteristics will be lost. Others welcome the rapprochement and already consider modern medicine to be the type of medicine practiced by both "MD and DO type doctors." One persistent difference is the respective acceptance of the terms "allopathic" and "osteopathic." DO medical organizations and medical schools all include the word osteopathic in their names, and such groups actively promote an "osteopathic approach" to medicine. While "osteopathy" was a term used by its founder AT Still to describe his new philosophy of medicine, "allopathic medicine" was originally a derogatory term coined by Samuel Hahnemann to contrast the conventional medicine of his day with his alternative system of homeopathic medicine. Today, the term "allopathic physician" is used infrequently, usually in discussions relating to osteopathic medicine or alternative medicine. Some authors argue that the term should be dropped altogether, since its original meaning bears little relevance to the current practice of modern medicine and conventional medicine has never endorsed any principle of allopathy. Similarly, the use of the terms "osteopath" and "osteopathy" are now discouraged when describing osteopathic physicians that have earned the degree of Doctor of Osteopathic Medicine and the field of osteopathic medicine, respectively.
Medical education and training
The Liaison Committee on Medical Education (LCME) accredits the 141 U.S.-medical schools that award the M.D. degree, while the American Osteopathic Association (AOA) Commission on Osteopathic College Accreditation (COCA) accredits the 30 colleges of osteopathic medicine in 42 locations in the United States that award the D.O. degree.
Michigan State University and Rowan University are the only universities that have both M.D. and D.O. accredited programs. In 2009, Kansas City University proposed starting a dual MD/DO program in addition to the existing DO program, and the University of North Texas, explored the possibility of starting independent M.D. program that would be offered alongside the DO program. Both proposals were met with controversy. Proponents argued that adding an MD program would lead to more local residencies created, and improve the university’s ability to acquire research funding and state funding. Opponents argue that adding the MD programs could cause the osteopathic program to lose its focus on "holistic care," would result in more competition for the already limited number of existing residencies (if more were not opened), and would drain resources from the established osteopathic programs.
Overall, osteopathic medical schools have more modest research programs compared to M.D. schools, and fewer D.O. schools own a hospital. Historically, osteopathic medical schools had associations with osteopathic hospitals, which were usually small, rural, community based hospitals. However, in 1990s and 2000s, economic and regulatory pressures caused many small hospitals, including most osteopathic hospitals, to either close or join larger hospital networks.
Osteopathic medical schools tend to have a stronger focus on primary care medicine than M.D. schools. D.O. schools have developed various strategies to encourage their graduates to pursue primary care, such as offering accelerated 3-year programs for primary care, focusing clinical education in community health centers, and selecting rural or under-served urban areas for the location of new campuses.
Osteopathic manipulative medicine
Many authors note the most obvious difference between the curricula of D.O. and M.D. schools is osteopathic manipulative medicine (OMM), a form of hands-on care used to diagnose, treat and prevent illness or injury and is taught only at D.O. schools. As of 2006, the average osteopathic student spent almost 8 weeks on clerkships for OMM during their third and fourth years. The National Institute of Health's National Center for Complementary and Alternative Medicine states that overall, studies have shown that spinal manipulation can provide mild-to-moderate relief from low-back pain and appears to be as effective as conventional medical treatments. In 2007 guidelines, the American College of Physicians and the American Pain Society include spinal manipulation as one of several treatment options for practitioners to consider using when pain does not improve with self-care. Spinal manipulation is generally a safe treatment for low-back pain. Serious complications are very rare. A 2001 survey of DOs found that more than 50% of the respondents used OMT (osteopathic manipulative treatment) on less than 5% of their patients. The survey was the latest indication that DOs have become more like M.D. qualified physicians in all respects: fewer perform OMT, more prescribe drugs, and many perform surgery as a first option. One area which has been implicated, but not been formally studied regarding the decline in OMT usage among DOs in practice, is the role of reimbursement changes. Only in the last several years could a D.O. charge for both an office visit (Evaluation & Management services) and use a procedure (CPT) code when performing OMT; previously, it was bundled.
Student aptitude indicators
Some authors note the differences in average GPA and MCAT scores of those who matriculate at D.O. schools versus those who matriculate at M.D. schools within the United States. In 2012, the average MCAT and GPA for students entering U.S.-based M.D. programs were 31.2 and 3.68, respectively, and 26.85 and 3.51 for D.O. matriculants, although the gap has been getting smaller every year. Up to one third of students matriculating at a D.O. medical school were not accepted by M.D. programs; however, DO medical schools are more likely to accept non-traditional students, who are older, coming to medicine as a second career, etc. D.O. medical students are required to take the Comprehensive Osteopathic Medical Licensure Examination (COMLEX-USA) that is sponsored by the National Board of Osteopathic Medical Examiners (NBOME). This exam is a prerequisite for D.O.-associated residency programs, which are available in almost every specialty of medicine and surgery. D.O. medical students may also choose to sit for the USMLE if they wish to take an M.D. residency; however, if they have taken COMLEX, it may or may not be needed, depending on the individual institution’s program requirements. USMLE pass rates for D.O. and M.D. students in 2012 are as follows: Step 1: 91% and 94%, Step 2 CK: 96% and 97%, and Step 2 CS: 87% and 97% respectively (this number may be misleading as only 46 D.O. students compared to 17,118 M.D. students were evaluated for Step 2 CS) Step 3: 100% and 95% (this number may be misleading, as only 16 D.O. students compared to 19,056 M.D. students, were evaluated for Step 3).
Graduates of both D.O. and M.D. medical schools are eligible to apply to residency programs through the National Resident Matching Program (NRMP), which represents ACGME-accredited programs. In 2003, 99% of new U.S. MDs and 43% of new U.S. DOs went on to train in ACGME-accredited residency programs.
Currently, the American Osteopathic Association accredits all D.O. residency programs. However, there have been calls to end the remaining barriers between the two types of programs. Since 1985, a single residency training program can be dual-accredited by both the ACGME and the AOA. By 2015, all post-graduate training for both DOs and MDs will be accredited by the ACGME.
In 2001, the AOA adopted a provision making it possible for a D.O. resident in any M.D. program to apply for osteopathic approval of their training. The topic of dual-accreditation is controversial. Opponents claim that by merging D.O. students into the "M.D. world", the unique quality of osteopathic philosophy will be lost. Supporters claim the programs are popular because of the higher prestige and higher resident reimbursement salaries associated with M.D. programs.
In 2010-2011, approximately 41% of U.S. osteopathic medical students indicated that they intend to pursue an AOA or AOA/ACGME dually-accredited residency programs while 39% indicated that they intend to pursue an ACGME accredited residency program. In 2010-2011, approximately 12% of U.S. osteopathic medical students indicated that they intend to pursue an AOA/ACGME dually-accredited residency program, while 29% planned to pursue an AOA residency and 39% planned to pursue an ACGME-accredited residency program. The number of dually accredited programs increased from 11% of all AOA approved residencies in 2006 to 14% in 2008, and then to 22% in 2010. The most common reason (74%) given by D.O. medical students choosing an ACGME residency or AOA/ACGME dually-accredited program was a more suitable geographic location. M.D. physicians are generally not permitted to train in DO (AOA-accredited) residencies, though this has become a subject of debate within the D.O. profession. The American Osteopathic Association has agreed to study the issue of permitting M.D. physicians to train in D.O. (AOA-accredited) residencies.
As of July 2015, the AOA, AACOM, and the ACGME will create a single, unified accreditation system for graduate medical education programs in the United States. This will ensure that all physicians trained in the U.S. will have the same graduate medical education accreditation - ACGME.
Resident specialty choice
There are notable differences in the specialty choices of DOs and MDs. One study attributes this to a difference in the 'cultures' of their medical schools, concluding that the "practices and educational structures in osteopathic medical schools [D.O.] better support the production of primary care physician." According to one survey, 54.6% of deans of M.D. medical schools reported that training future primary care physicians was more important to their institutions than training future specialist physicians, compared with 100% of D.O. medical school deans. (F = 893.11,95, p < .0001).
|Medical School Application service||AMCAS/TMDSAS||AACOMAS/TMDSAS|
|Years of medical school||4||4|
|Medical Licensing Exam (MLE) Step 1||USMLE required||
|MLE, Step 2||USMLE required||COMLEX required|
|residency||M.D. (ACGME)||one must be selected:
|Board Certification||Medical specialty boards||Either M.D. or D.O. medical specialty boards|
Continuing medical education
To maintain a license to practice medicine, U.S. physicians are required to complete additional training every few years, so called continuing medical education (CME). There are subtle differences in the CME requirements for M.D. and D.O. qualified physicians, and in how these CME credits are approved. The requirements for maintaining a physician license for M.D. or D.O. qualified physicians are almost identical in most states, though there are small differences. For example, in the case of Pennsylvania, M.D. licenses begin on December 31, whereas D.O. ones begin on October 31.
There are currently more M.D. schools than D.O. schools offering medical training in the United States. However, the D.O. medical profession is expanding rapidly, with approximately 1 in 4 medical students now entering a D.O. medical school. Both DOs and MDs have the option to train and practice in any of the medical specialties and sub-specialties. One exception is the Neuromusculoskeletal Medicine specialty which is only available to D.O.s who have completed a one-year traditional internship.
Both degrees are recognized internationally as a medical degree. Accredited D.O. and M.D. medical schools are both included in the World Health Organization’s World Directory of Medical Schools. DOs are recognized and accepted by international medical organizations such as Doctors Without Borders.
- "What is a DO?". Osteopathic.org. Retrieved 20 Dec 2014.
- Dennis L. Kasper, Eugene Braunwald, Anthony S. Fauci, Stephen L. Hauser, Dan L. Longo, J. Larry Jameson, and Kurt J. Isselbacher, Eds (2012). "Complementary and Alternative Medicine". Harrison's principles of internal medicine. (18th ed. ed.). New York: McGraw-Hill. ISBN 978-0071748896.
- Chapter 34: Complementary and Alternative Medicine. Goldman: Cecil Textbook of Medicine, 22nd ed. Saunders. 2004.
- Cohen, Jordan. "Following in Flexner's Footsteps". American Medical Association. Retrieved 14 July 2012.
- "Resolution 302 referred". AMA House of Delegates. Retrieved 14 July 2012.
- Peters AS, Clark-Chiarelli N, Block SD (1999). "Comparison of Osteopathic and Allopathic Medical Schools' Support for Primary Care". J Gen Intern Med 14 (12): 730–9. doi:10.1046/j.1525-1497.1999.03179.x. PMC 1496864. PMID 10632817.
- Medical School Expansion Plans: Results of the 2006 AAMC Survey Center for Workforce Studies. American Association of Medical Colleges. February 2007.
- "Results of the 2013 Medical School Enrollment Survey". Association of American Medical Colleges. Retrieved 2 Nov 2014.
- "2012 Applicants to U.S. and Offshore Medical Schools". AACOM. Retrieved 2 Nov 2014.
- "Osteopathic Medical Profession Report 2010". American Osteopathic Association.
- "International Medical Graduates in American Medicine: Contemporary challenges and opportunities". American Medical Association. p. 7. Retrieved 10 July 2012.
- Salsberg, Edward and Grover, Atul. Physician Workforce Shortages: Implications and Issues for Academic Health Centers and Policymakers. Academic Medicine, Vol. 81, No. 9 / September 2006.
- Cohen, Jordan. A Word from the President: "Filling the Workforce Gap." AAMC Reporter: April 2005.
- "Active Physicians and Nurses by State: 2009". U.S. Census Bureau. Retrieved 24 August 2012.
- "2011 State Physician Workforce Data Book". Association of American Medical Colleges. p. 23. Retrieved November 2011.
- Hurt, Avery (February 2007). "Inside osteopathic medicine's parallel world". The New Physician. American Medical Student Association. Retrieved 13 July 2012.
- Adams, Damon Adams D (Aug 23, 2003). "Small study compares styles: Osteopathic physicians talk more about feelings". Amednews.com.
- Licciardone JC (2007). "A comparison of patient visits to osteopathic and allopathic general and family medicine physicians: results from the National Ambulatory Medical Care Survey, 2003–2004". Osteopath Med Prim Care 1: 2. doi:10.1186/1750-4732-1-2. PMC 1805772. PMID 17371578.
- Peters AS, Clark-Chiarelli N, Block SD (1999). "Comparison of osteopathic and allopathic medical Schools' support for primary care". J Gen Intern Med 14 (12): 730–9. doi:10.1046/j.1525-1497.1999.03179.x. PMC 1496864. PMID 10632817.
- Johnson SM, Kurtz ME (December 2002). "Perceptions of philosophic and practice differences between US osteopathic physicians and their allopathic counterparts". Soc Sci Med 55 (12): 2141–8. doi:10.1016/S0277-9536(01)00357-4. PMID 12409127.
- Ziegler, Jennifer. Osteopathic residencies struggle to keep up with the growing number of DO grads. The New Physician. April 2004.
- Allopathic Medical/Neurosurgical Glossary. Northern California Neurosurgery. accessed Nov 5, 2007.
- Berkenwald, Alan D. (1 February 1998). "In the Name of Medicine". Annals of Internal Medicine 128 (3): 246–250. doi:10.7326/0003-4819-128-3-199802010-00023. Retrieved 12 July 2012.
- Whorton JC (2004), Nature Cures: The History of Alternative Medicine in America, New York: Oxford University Press, pp. 18, 52, ISBN 0-19-517162-4
- Gundling, M.D., Katherine E. (November 1998). "When Did I Become an "Allopath"?". Archives of Internal Medicine 158 (20): 2185–2186. doi:10.1001/archinte.158.20.2185. PMID 9818797. Retrieved 12 July 2012.
- Jarvis WT Misuse of the Term "Allopathy"
- "Style Guide for Reporting on Osteopathic Medicine". American Osteopathic Association. Retrieved 13 July 2012.
- Patrick Wu, Jonathan Siu (2012). "A Brief Guide to Osteopathic Medicine For Students, By Students". American Association of Colleges of Osteopathic Medicine. Retrieved 20 August 2013.
- Miller T, Hooker RS, Mains DA (May 1, 2006). "Characteristics of osteopathic physicians choosing to practice rural primary care". J Am Osteopath Assoc 106 (5): 274–9. PMID 16717369.
- "Medical Schools". American Association of Medical Colleges. Retrieved 24 August 2012.
- "Directory of Accredited Programs". LCME. 2011-05-31. Retrieved 2012-02-22.
- "Colleges of Osteopathic Medicine". Osteopathic.org. Retrieved 2012-02-22.
- Hedger, Brian (April 27, 2009). "Texas university explores offering an MD degree in addition to its DO program". American Medical News. Retrieved 5 July 2012.
- "Fired medical school president had been pushing big changes". Joplin Metro. December 25, 2009. Retrieved 30 June 2012.
- Chen, Candace; Mullan, Fitzhugh (June 2009). "The separate osteopathic medical education pathway: uniquely addressing national needs. Point.". Academic medicine : journal of the Association of American Medical Colleges 84 (6): 695. doi:10.1097/ACM.0b013e3181a3dd28. PMID 19474535. Retrieved 3 November 2012.
- Hilsenrath, Peter E. (Sep 2006). "Osteopathic medicine in transition: postmortem of the Osteopathic Medical Center of Texas.". The Journal of the American Osteopathic Association 106 (9): 558–61. PMID 17079525. Retrieved 3 November 2012.
- Shannon, Stephen C.; Teitelbaum, Howard S. (June 2009). "The status and future of osteopathic medical education in the United States". Academic medicine : journal of the Association of American Medical Colleges 84 (6): 707–11. doi:10.1097/ACM.0b013e3181a43be8. PMID 19474542.
- Krueger, PM; Dane, P; Slocum, P; Kimmelman, M (June 2009). "Osteopathic clinical training in three universities". Academic medicine : journal of the Association of American Medical Colleges 84 (6): 712–7. doi:10.1097/ACM.0b013e3181a409b1. PMID 19474543.
- "National Center for Complementary and Alternative Medicine". Nccam.nih.gov. March 27, 2008. Retrieved December 17, 2011.
- Chou, Roger; Amir Qaseem; Vincenza Snow; Donald Casey; Thomas Cross; Paul Shekelle; Douglas K. Owens (2 October 2007). "Diagnosis and Treatment of Low Back Pain: A Joint Clinical Practice Guideline from the American College of Physicians and the American Pain Society". Annals of Internal Medicine 147 (7): 478–491. doi:10.7326/0003-4819-147-7-200710020-00006. PMID 17909209. Retrieved 6 July 2012.
- Chou, R; Huffman, LH (2 October 2007). "Nonpharmacologic therapies for acute and chronic low back pain: a review of the evidence for an American Pain Society/American College of Physicians clinical practice guideline.". Annals of internal medicine 147 (7): 492–504. doi:10.7326/0003-4819-147-7-200710020-00007. PMID 17909210. Retrieved 24 August 2012.
- "Spinal Manipulation for Low-Back Pain | NCCAM". Nccam.nih.gov. 2012-01-18. Retrieved 2012-02-22.
- Johnson SM, Kurtz ME (2001). "Diminished use of osteopathic manipulative treatment and its impact on the uniqueness of the osteopathic profession". Acad Med 76 (8): 821–8. doi:10.1097/00001888-200108000-00016. PMID 11500286.
- Karen T. Snider, DO; Douglas J. Jorgensen, DO, CPC (2009-08-01). "Billing and Coding for Osteopathic Manipulative Treatment". Jaoa.org. Retrieved 2012-02-22.
- "Billing and Coding for OMT". Jaoa.org. 2009-11-01. Retrieved 2012-02-22.
- "Table 17: MCAT Scores and GPAs for Applicants and Matriculants to U.S. Medical Schools". Association of American Medical Colleges. 2000–2011.
- "AACOMAS Matriculant Profile 2012 Entering Class". American Association of Colleges of Osteopathic Medicine. Retrieved 14 July 2012.
- "Mean MCAT Scores & GPAs of Matriculating Osteopathic Students" (PDF). Retrieved April 10, 2012.
- Cooper RA (2003). "Medical schools and their applicants: an analysis". Health Aff (Millwood) 22 (4): 71–84. doi:10.1377/hlthaff.22.4.71. PMID 12889752.
- "Osteopathic Medical College Information Book". American Association of Colleges of Osteopathic Medicine. 2012.
- Madison Park (June 13, 2011). "Never too late to be a doctor". CNN News. Retrieved December 17, 2011.
- "United States Medical Licensing Examination | USMLE Bulletin | Eligibility". Usmle.org. Retrieved 2012-02-22.
- "COMLEX-1 and USMLE-1 Are Not Interchangeable Examinations - Sarko - 2010 - Academic Emergency Medicine - Wiley Online Library". Onlinelibrary.wiley.com. Retrieved 2012-02-22.
- Chick, Davoren A.; Harley P. Friedman; Vincent B. Young; David Solomon (22 January 2010). "Relationship Between COMLEX and USMLE Scores Among Osteopathic Medical Students who Take Both Examinations". Teaching and Learning in Medicine 22 (1): 3–7. doi:10.1080/10401330903445422. PMID 20391276.
- "Physical Medicine & Rehabilitation Residency Program Director’s Manual". Association of Academic Physiatrists. Retrieved May 2011.
- "Program Directors FAQ". NBOME. Retrieved 2012-02-22.
- "2012 Annual Report". National Board of Medical Examiners. 2012. Retrieved 20 August 2013.
- Charting Outcomes in the Match Characteristics of Applicants Who Matched to Their Preferred Specialty in the 2007 NRMP Main Residency Match, 2nd Ed. National Resident Matching Program and Association of American Medical Colleges August 2007.
- Mychaskiw G (May 1, 2006). "Will the last DO turn off the lights?". J Am Osteopath Assoc 106 (5): 252–3, 302; discussion 302–3. PMID 16717365.
- Steier KJ (May 1, 2006). "Time to accept allopathic physicians into AOA-approved residencies?". J Am Osteopath Assoc 106 (5): 250–2. PMID 16717364.
- Forte TE (May 1, 2007). "Repatriating DOs with MD-affiliated residencies". J Am Osteopath Assoc 107 (5): 174, 197. PMID 17596585.
- "M.D./D.O. Dual Accreditation | UW Family Medicine". Fammed.wisc.edu. 2011-11-15. Retrieved 2012-02-22.
- Hayes OW (November 1, 1998). "Dual approval of a residency program: ten years' experience and implications for postdoctoral training". J Am Osteopath Assoc 98 (11): 647–52. PMID 9846049.
- Rao, Ankita (March 11, 2013). "Osteopathic physicians make headway in conventional medicine". The Washington Post. Retrieved 14 March 2013.
- Resolution 42: Approval of ACGME Training as an AOA-Approved Internship. American Osteopathic Association. accessed October 2007.
- Terry RR (August 1, 2003). "Dually accredited family practice residencies: wave of the future". Journal of the American Osteopathic Association 103 (8): 367–70. PMID 12956249.
- "AACOM 2010-11 Academic Year Survey of Graduating Seniors Summary Report". AACOM. 2011. Retrieved 2012-06-22.
- Burkhart, DN; Lischka, TA (April 2011). "Dual and parallel postdoctoral training programs: implications for the osteopathic medical profession.". The Journal of the American Osteopathic Association 111 (4): 247–56. PMID 21562295. Retrieved 24 August 2012.
- Schierhorn, Carolyn (June 2008). "Educators at summit frame future of OGME". The DO. Retrieved 1 July 2012.
- Schierhorn, Carolyn (Feb 2008). "Slumping OGME piques educators at summit". The DO. pp. 22–28. Retrieved 1 July 2012.
- "M.D.s and D.O.s Moving toward a Single, Unified Accreditation System for Graduate Medical Education". ACGME. Retrieved 3 November 2012.
- "AOA, ACGME Move Toward Unified Accreditation for Graduate Medical Education Programs". AOA. Retrieved 3 November 2012.
- Peters AS, Clark-Chiarelli N, Block SD (1999). "Comparison of osteopathic and allopathic medical Schools' support for primary care". J Gen Intern Med 14 (12): 730–9. doi:10.1046/j.1525-1497.1999.03179.x. PMC 1496864. PMID 10632817.
- Requirements for license renewal. Pennsylvania Medical Society.
- "Public Hearing on Notice of Proposed Rulemaking on Program Integrity: Gainful Employment". American Association of Colleges of Osteopathic Medicine. Retrieved November 4, 2010.
- "Neuromuscular Medicine and OMM". Northeast Regional Medical Center.
- "World Directory of Medical Schools". University of Copenhagen. Retrieved 5 July 2012.
- "Work in the Field: FAQ". Doctors Without Borders. Retrieved 2 Nov 2014.
- What's the difference between osteopathic and conventional MD medicine?
- American Medical Student Association forum on MD and DO medicine