Comparison of MD and DO in the United States
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|Andrew Taylor Still (founder)|
In the United States, physicians may hold either the Doctor of Medicine degree (MD) or the Doctor of Osteopathic Medicine degree (DO). MD and DO physicians complete similar residency programs in hospitals, can be licensed in all 50 states, and have rights and responsibilities common to physicians.
Historically, MDs and DOs significantly differed in their approach to medical treatment. Allopathic medicine was primarily based on scientific practices. In contrast, osteopathic medicine was founded in the mid-nineteenth century on the premise of healing the body through osteopathic musculoskeletal manipulation. MD and DO schools can also be distinguished by a relative lack of scientific and clinical research at DO schools. The coursework at MD and DO schools is similar, with the most notable exception being that DO students are taught osteopathic manipulative medicine.
- 1 Background
- 2 Demographics
- 3 Research and scholarly work
- 4 Cultural differences
- 5 Medical education and training
- 6 Professional opportunities
- 7 See also
- 8 References
- 9 External links
While allopathic medicine has followed the development of society, osteopathic medicine is a more recent development. The first MD school in the United States opened in 1807 in New York. In 1845, the American Medical Association was formed, and standards were put into place, with a three-year program including lectures, dissection, and hospital experience. In 1892, frontier physician Andrew Taylor Still founded the American School of Osteopathy in Kirksville, MO as a protest against the present medical system. A. T. Still believed that the conventional medical system lacked credible efficacy, was morally corrupt, and treated effects rather than causes of disease. Throughout the 1900s, DOs fought to gain practice rights and government recognition. The first state to pass such regulations allowing DOs medical practice rights was California in 1901, the last was Nebraska in 1989. Up through the 1960s, osteopathic medicine was labeled a cult by the American Medical Association, and collaboration by physicians with osteopathic practitioners was considered to be unethical.
The American Medical Association'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."
In a 2005 editorial about mitigating the impending shortage of physicians in the United States, Jordan Cohen, MD, then-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.
In the United States, MDs and DOs are fully licensed medical doctors and have full medical practice rights throughout the United States. An MD is accepted worldwide, while the DO degree is accepted in 44 countries abroad. Currently, less than 10% of US physicians have a DO degree. A Doctor of Osteopathic Medicine (DO) is different than an osteopath: a DO is a physician, while an osteopath is not.
Of the 860,917 physicians actively practicing in the United States in 2015, 67.1% hold an MD degree granted in the U.S., 24.3% are international medical graduates, and 7.6% hold a DO degree. The percentage of physicians that hold a DO degree varies by specialty, with the greatest representation in Family Medicine/General Practice (16.5% of general practitioners), Physical Medicine & Rehabilitation (13.8%), and Emergency Medicine (11.2%).
As of 2015, 9.0% of residents and fellows in medical training programs accredited by the Accreditation Council for Graduate Medical Education (ACGME), which accredits all MD residency programs, hold a DO degree. 65.1% of the 19,302 DO graduates enrolled in post-doctoral training are in ACGME-accredited programs, with the remainder in AOA programs. In 2020, the ACGME will take over the accreditation of all residency programs in the United States for both MDs and DOs.
There are significantly more MDs than DOs, though the number of DOs is increasing, due to the relative ease of obtaining admission to a DO school relative to an MD school, and a number of new DO schools opening at a rate faster than MD schools, and an increase in applicants for medical schools as a whole.[not in citation given] A 2012 survey of students applying to both U.S. MD and DO schools found that 9% of applicants were admitted only to an MD school, 46% were admitted only to a DO school, 26% were admitted to both, and 19% were not admitted to any medical schools.[dead link] Geographic location was the top reason given by both DO and MD students for choosing the school in which they enrolled. Of first-year medical students matriculating in 2016, 25.9% (7,369 students) entered DO medical programs and 74.1% (21,030 students) entered MD programs. The Association of American Medical Colleges projects that from 2016 to 2021, first-year DO student enrollment will increase by 19.4% versus a 5.7% increase in MD students. 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). 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 geographic distribution of MD and DO physicians is not uniform. As of 2012, the states with the greatest ratio of active physicians holding a DO degree versus active physicians holding an MD degree were Oklahoma (20.7% of physicians), Iowa, Michigan, Maine, and West Virginia. During that same year, the states with the greatest ratio of active physicians holding an MD degree versus a DO degree were Louisiana, Washington, D.C., Massachusetts, Maryland, and Connecticut. The states with the greatest per capita number of DO physicians are Maine, Michigan, Pennsylvania, Oklahoma, and Iowa. The states with the greatest per capita number of MD physicians are Washington, D.C., Massachusetts, Maryland, New York, and Connecticut. Doctors holding a DO degree are more likely to practice in rural areas.
The sex and racial distribution of DOs and MDs are similar.
Research and scholarly work
In comparison to allopathic medicine, osteopathic medicine has been criticized for the relative lack of research and lesser emphasis on scientific inquiry at D.O. schools in comparison with M.D. schools. According to the Journal of the American Osteopathic Association, the "inability to institutionalize research, particularly clinical research, at osteopathic institutions has, over the years, weakened the acculturation, socialization, and distinctive beliefs and practices of osteopathic students and graduates."
Allopathic medical schools have applied for and received 800 times more funding for scientific and clinical research from the National Institutes of Health than osteopathic schools have. Osteopathic schools ranked last out of 17 types of educational institutions, including veterinary medicine, optometry, social work, and dentistry. In 2014, the Journal of the American Osteopathic Association stated that research from osteopathic schools amounted to "fewer than 15 publications per year per school, and more than a quarter of these publications had never been cited. Clearly, scholarly contributions from osteopathic medical schools are unacceptably low in both quantity and quality."
Several studies have investigated whether there is a difference in the approach to patients by MDs and DOs. A study of patient visits to general and family medicine physicians in the U.S., including 277 million visits to MDs and 65 million visits to DOs, found that there was no significant difference between DOs and MDs with regard to time spent with patients and preventive medicine services.
The study of approximately 341 million healthcare visits founds that there was no difference on the rate that doctors provided to patients diet or nutrition counseling, weight reduction counseling, exercise counseling, tobacco use or exposure counseling, and mental health or stress reduction counseling. Some authors[who?] describe subjective distinctions in patient interactions, but 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."
Self-characterization and identification
A study conducted during 1993-94 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.
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 medical physicians, while less than half felt their patients identified them as such.
As the training of DOs and MDs becomes less distinct, some have expressed concern that the unique characteristics of osteopathic medicine 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 schools and organizations 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 in the 19th century 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 comparisons with osteopathic medicine or alternative medicine. Some authors argue that the terms "osteopathic" and "allopathic" should be dropped altogether, since their original meanings bear little relevance to the current practice of modern medicine.
Medical education and training
The Liaison Committee on Medical Education (LCME) accredits the 144 U.S. medical schools that award the MD degree, while the American Osteopathic Association (AOA)'s Commission on Osteopathic College Accreditation (COCA) accredits the 34 osteopathic medical schools that award the DO degree. Osteopathic schools tend to be affiliated with smaller universities.
Michigan State University, Rowan University, and Nova Southeastern University offer both MD and DO 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 an MD 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 the creation of more local residency programs and improve the university’s ability to acquire research funding and state funding, while opponents wanted to protect the discipline of osteopathy.
61% of graduating seniors at osteopathic medical schools evaluated that over half of their required in-hospital training was delivered by MD physicians. Overall, osteopathic medical schools have more modest research programs compared to MD schools, and fewer DO schools are part of universities that own a hospital. Osteopathic medical schools tend to have a stronger focus on primary care medicine than MD schools. DO 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 DO and MD 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 DO schools. As of 2006, the average osteopathic medical 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 Integrative Health 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 MD 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 DO 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
There is a statistical difference in average GPA and MCAT scores of those who matriculate at DO schools versus those who matriculate at MD schools. In 2016, the average MCAT and GPA for students entering U.S.-based MD programs were 508.7 and 3.70, respectively, and 502.2 and 3.54 for DO matriculants. DO medical schools are more likely to accept non-traditional students, who are older, coming to medicine as a second career, etc.
MD students take United States Medical Licensing Examination (USMLE)'s series of three licensing exams during and after medical school.
DO students are required to take the Comprehensive Osteopathic Medical Licensure Examination (COMLEX-USA) that is administered by the National Board of Osteopathic Medical Examiners (NBOME). This exam is a prerequisite for DO-associated residency programs, which are available in almost every specialty of medicine and surgery. DO medical students may also choose to sit for the USMLE if they wish to take an MD residency and about 48% take USMLE Step 1. However, if they have taken COMLEX, it may or may not be needed, depending on the individual institution’s program requirements.
Currently, the ACGME accredits all MD residency programs, while the American Osteopathic Association (AOA) accredits all DO residency programs. DO students may choose to apply to ACGME-accredited residency programs through the National Resident Matching Program (NRMP) rather than completing a DO residency. As of 2014, 54% of DOs in post-doctoral training are enrolled in an ACGME-accredited residency program and 46% are enrolled in an AOA-accredited residency program.
Since 1985, a single residency training program can be dual-accredited by both the ACGME and the AOA. 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. In 2001, the AOA adopted a provision making it possible for a DO resident in any MD program to apply for osteopathic approval of their training. The topic of dual-accreditation is controversial. Opponents claim that by merging DO students into the "MD 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 MD programs.
Over 5 years starting in 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, and as of June 30, 2020, the AOA will cease its accreditation functions.
Steps to licensure
|Standardized admissions examination||Medical College Admission Test (MCAT)|
|Medical school application service||AMCAS/TMDSAS||AACOMAS/TMDSAS|
|Years of medical school||4|
|Medical Licensing Exams (MLE)||USMLE required||
|MD (ACGME)||One must be selected:
(After June 30, 2020)
|Board certification||MD medical specialty boards||Either DO or MD medical specialty boards|
Continuing medical education
To maintain a professional license to practice medicine, U.S. physicians are required to complete ongoing additional training, known as continuing medical education (CME). CME requirements differ from state to state and between the American Osteopathic Medical Association (DO) and the American Medical Association (MD) governing bodies.
An MD is accepted worldwide, while the DO degree is accepted in 44 countries abroad. Accredited DO and MD medical schools are both included in the World Health Organization’s World Directory of Medical Schools. MDs and DOs are both accepted by international medical organizations such as Doctors Without Borders.
- "What is a DO?". American Osteopathic Association. Retrieved 20 Dec 2014.
- Clark, Brian C.; Blazyk, Jack (1 August 2014). "Research in the Osteopathic Medical Profession: Roadmap to Recovery". The Journal of the American Osteopathic Association. 114 (8): 608–614. doi:10.7556/jaoa.2014.124. Retrieved 16 April 2018 – via jaoa.org.
- Dennis L. Kasper, Eugene Braunwald, Anthony S. Fauci, Stephen L. Hauser, Dan L. Longo, J. Larry Jameson, and Kurt J. Isselbacher, Eds (2012). "10: Complementary and Alternative Medicine". Harrison's Principles of Internal Medicine (18th ed.). New York: McGraw-Hill. p. 63. ISBN 978-0071748896.
- Still AT.The Philosophy and Mechanical Principles of Osteopathy. Kansas City, Mo: Hudson-Kimberly Pub Co; 1902:9–20,185,210,270. Version 2.0. Inter Linea Web site. Accessed January 23, 2006.
- Gevitz, Norman (2004). The DO's: osteopathic medicine in America. Baltimore, Maryland: Johns Hopkins University Press. ISBN 0-8018-7833-0.
- Briggs, Josephine P. (16 April 2018). Kasper, Dennis; Fauci, Anthony; Hauser, Stephen; Longo, Dan; Jameson, J. Larry; Loscalzo, Joseph, eds. Harrison's Principles of Internal Medicine. McGraw-Hill Education. Retrieved 16 April 2018 – via Access Medicine.
- "H-405.969 Definition of a Physician". American Medical Association. Retrieved 27 Sep 2015.
- Cohen, Jordan. "Following in Flexner's Footsteps". American Medical Association. Retrieved 14 July 2012.
- "The Difference Between U.S.-Trained Osteopathic Physicians and Osteopaths Trained Abroad". www.aacom.org. American Association of Colleges of Osteopathic Medicine.
- "Active Physicians with a U.S. Doctor of Osteopathic Medicine (DO) by Specialty, 2015". www.aamc.org. American Association of Medical Colleges. Retrieved 7 September 2017.
- Wu, Siu (April 2012). "A Brief Guide to Osteopathic Medicine" (PDF). AACOM. Archived from the original (PDF) on May 1, 2016. Retrieved June 5, 2016.
- "2016 Physician Specialty Data Book". Association of American Medical Colleges.
- "2016 Osteopathic Medical Profession Report" (PDF). American Osteopathic Association.
- "2012 Applicants to U.S. and Offshore Medical Schools" (PDF). American Association of Colleges of Osteopathic Medicine. Retrieved 2 Nov 2014.
- "Results of the 2016 Medical School Enrollment Survey" (PDF). Association of American Medical Colleges. Retrieved 24 Aug 2017.
- Salsberg E; Grover A (2006). "Physician workforce shortages: implications and issues for academic health centers and policymakers". Acad Med. 81 (9): 782–7. doi:10.1097/00001888-200609000-00003. PMID 16936479.
- "2013 State Physician Workforce Data Book" (PDF). Association of American Medical Colleges. p. 19. Retrieved 1 September 2015.
- 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 . PMID 10632817.
- Gevitz N (Mar 2001). "Researched and demonstrated: inquiry and infrastructure at osteopathic institutions" (Free full text). The Journal of the American Osteopathic Association. 101 (3): 174–179. PMID 11329813.
- Kelso A, Townsend A. The status and future of osteopathic research. In: Northup G, ed. Osteopathic Research: Growth and Development. Chicago, Ill: American Osteopathic Association; 1987.
- Licciardone JC (2007). "Osteopathic research: elephants, enigmas, and evidence". Osteopathic Medicine and Primary Care. 1: 7. doi:10.1186/1750-4732-1-7. PMC . PMID 17371583.
- 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 . PMID 17371578.
- Hurt, Avery (Feb 2007). "Inside osteopathic medicine's parallel world". The New Physician. American Medical Student Association.
- 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.
- Zeigler, Jennifer (April 2004). "Osteopathic residencies struggle to keep up with the growing number of DO grads". The New Physician. 53 (3).
- "Medical/Neurosurgical Glossary". Northern California Neurosurgery Medical Group. Retrieved 27 Sep 2015.
- Berkenwald A (1 February 1998). "In the Name of Medicine". Ann Intern Med. 128 (3): 246–250. doi:10.7326/0003-4819-128-3-199802010-00023. Retrieved 27 Sep 2015.
- 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 K (9 November 1998). "When Did I Become an "Allopath"?". Arch Intern Med. 158 (20): 2185–2186. doi:10.1001/archinte.158.20.2185. PMID 9818797. Retrieved 27 Sep 2015.
- Jarvis WT (1 Dec 2000). "Misuse of the Term "Allopathy"". National Council Against Health Fraud. Retrieved 27 Sep 2015.
- "Medical Schools". Association of American Medical Colleges. Retrieved 27 Sep 2015.
- "Medical School Directory". Liaison Committee on Medical Education. Archived from the original on 14 November 2013. Retrieved 27 Sep 2015.
- "Osteopathic Medical Schools". American Osteopathic Association. Retrieved 31 March 2016.
- Salzberg, Steven. "Osteopathic Physicians Versus Doctors". forbes.com. Retrieved 16 April 2018.
- 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.
- "AACOM 2014-15 Academic Year Survey of Graduating Seniors Summary" (PDF). AACOM. 2015. Retrieved June 5, 2016.
- Chen C; Mullan F (June 2009). "The separate osteopathic medical education pathway: uniquely addressing national needs. Point". Acad Med. 84 (6): 695. doi:10.1097/ACM.0b013e3181a3dd28. PMID 19474535.
- Krueger PM; Dane P; Slocum P; Kimmelman M (June 2009). "Osteopathic clinical training in three universities". Acad Med. 84 (6): 712–7. doi:10.1097/ACM.0b013e3181a409b1. PMID 19474543.
- "Spinal Manipulation for Low-Back Pain | NCCIH". National Institutes of Health National Center for Complementary and Integrative Health. 26 Jan 2015. Retrieved 27 Sep 2015.
- Chou R; Qaseem A; Snow V; Casey D; Cross T; Shekelle P; Owens DK (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". Ann Intern Med. 147 (7): 478–491. doi:10.7326/0003-4819-147-7-200710020-00006. PMID 17909209.
- 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". Ann Intern Med. 147 (7): 492–504. doi:10.7326/0003-4819-147-7-200710020-00007. PMID 17909210. Retrieved 24 August 2012.
- 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.
- Snider KT; Jorgensen DJ (Aug 2009). "Billing and coding for osteopathic manipulative treatment". J Am Osteopath Assoc. 109 (8): 409–13. PMID 19706830.
- "Table A-16: MCAT Scores and GPAs for Applicants and Matriculants to U.S. Medical Schools, 2016-2017" (PDF). American Association of Medical Colleges. Retrieved 24 Aug 2017.
- "2016 AACOMAS Profile: Applicant and Matriculant Report" (PDF). American Association of Colleges of Osteopathic Medicine. Retrieved 24 Aug 2017.
- "Osteopathic Medical College Information Book" (PDF). American Association of Colleges of Osteopathic Medicine. 2016. p. 19. Retrieved 27 Sep 2015.
- Madison Park (June 13, 2011). "Never too late to be a doctor". CNN News. Retrieved December 17, 2011.
- "Eligibility for the USMLE Examinations". United States Medical Licensing Examination. Retrieved 27 Sep 2015.
- Sarko J; Svoren E; Katz E (Feb 2010). "COMLEX-1 and USMLE-1 are not interchangeable examinations". Acad Emerg Med. 17 (2): 218–20. doi:10.1111/j.1553-2712.2009.00632.x. PMID 20070273. Retrieved 27 Sep 2015.
- Chick DA; Friedman HP; Young VB; Solomon D (Jan 2010). "Relationship between COMLEX and USMLE scores among osteopathic medical students who take both examinations". Teach Learn Med. 22 (1): 3–7. doi:10.1080/10401330903445422. PMID 20391276.
- "Information for Program Directors". National Board of Osteopathic Medical Examiners. Retrieved 27 Sep 2015.
- Hayes OW (November 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.
- Burkhart, DN; Lischka, TA (April 2011). "Dual and parallel postdoctoral training programs: implications for the osteopathic medical profession". J Am Osteopath Assoc. 111 (4): 247–56. PMID 21562295.
- Bulger JB (Dec 2006). "Approval of ACGME Training as an AOA-approved internship: history and review of current data". J Am Osteopath Assoc. 106 (12): 708–13. PMID 17242416.
- Terry RR (August 2003). "Dually accredited family practice residencies: wave of the future". J Am Osteopath Assoc. 103 (8): 367–70. PMID 12956249.
- "Single GME Accreditation System". Accreditation Council for Graduate Medical Education. Retrieved 31 August 2015.
- "The Single GME Accreditation System". American Osteopathic Association. Retrieved 31 August 2015.
- "MD vs DO - What are the Differences (and similarities)?". medicalschoolhq.net. 3 March 2012. Retrieved 16 April 2018.
- "Does osteopathic medicine have a future? - Philly". philly.com. Retrieved 16 April 2018.
- "World Directory of Medical Schools". University of Copenhagen. Retrieved 5 July 2012.
- "Work in the Field: FAQ". Doctors Without Borders. Retrieved 2 Nov 2014.