DOCTOR OF OSTEOPATHIC MEDICINE (D.O.) is a professional doctoral
degree for physicians and surgeons offered by medical schools in the
One hundred forty-one medical schools offer the M.D. degree in the United States. Thirty-three medical schools offer the D.O. degree at forty-eight locations in thirty-one states. Since 2007, total D.O. student enrollment has been increasing yearly. In 2015, more than twenty percent of all medical school enrollment in the United States comprised D.O. students. The curricula at osteopathic medical schools are similar to those at M.D.-granting medical schools , which focus the first two years on the biomedical and clinical sciences, then two years on core clinical training in the clinical specialties.
Upon completing medical school, a D.O. graduate may enter an internship or residency training program, which may be followed by fellowship training . Some D.O. graduates attend the same graduate medical education programs as their M.D. counterparts, and then take M.D. specialty board exams, while other D.O. graduates enter osteopathic programs, and take D.O. specialty board examinations.
One notable difference between D.O. and M.D. training is that D.O. training adds 300 – 500 hours studying techniques for hands-on manipulation of the human musculoskeletal system .
* 1 History * 2 Demographics
* 3 Education, training and distinctiveness
* 3.1 Examinations
* 4 Licensing and board certification
* 5 International variations
* 5.1 International practice rights
* 6 See also * 7 Notes and references * 8 External links
Further information: Osteopathic medicine in the United States § History
The practice of osteopathy began in the
The osteopathic medical profession has evolved into two branches:
non-physician manual medicine osteopaths who were educated and trained
As originally conceived by Andrew Still, the letters "DO" stood for "Diplomate in Osteopathy" and the title conferred by the degree was "Doctor of Osteopathy". Subsequently the degree also came to be entitled "Doctor of Osteopathic Medicine", and in more recent times the AOA has preferred that this title be used exclusively, resolving in a 1960 conference:
Be it resolved, that the
American Osteopathic Association
Nevertheless, some DOs continue to use the old terms and the American Academy of Osteopathy retains the old usage in its name.
In 2015, there were 96,954 osteopathic medical doctors in the United States and 123,075 total DOs and osteopathic medical students. The proportion of females in the profession has steadily increased since the 1980s. In 1985, about 10 percent of D.O. physicians were female, compared with 40 percent in 2015. Between 2008 and 2012, 49 percent of new D.O. graduates were females.
During the 2011-12 academic year, the osteopathic medical student body consisted of: 69 percent white/non-Hispanic, 19 percent Asian or Pacific Islander, 3.5 percent Hispanic, 3 percent African-American, and 0.5 percent Native American or Alaskan. The remainder were listed as "other or not entered." The five-year change in osteopathic medical student enrollment by ethnicity has increased by 19 percent for white/non-Hispanic students, 36 percent for Asian-American students, 24 percent for Black/African American students and 60 percent for Hispanic/Latino students.
EDUCATION, TRAINING AND DISTINCTIVENESS
Osteopathic medical school curricula are virtually identical to those
at schools granting the M.D. degree (Doctor of
D.O. schools provide an additional 300–500 hours in the study of hands-on manual medicine and the body's musculoskeletal system, which is referred to as osteopathic manipulative medicine (OMM). Historically, osteopaths subscribed to the view that such body manipulation can bring about systemic healing – a belief which is a form of pseudomedicine – but today American osteopathic physicians have largely evolved away from such pre-scientific ideas. Osteopathic physicians who use OMM predominantly use it to treat musculoskeletal conditions, for which there is conflicting evidence . Particular criticism has been targeted at craniosacral therapy , a component of OMM taught at many D.O. schools that has limited scientific support.
To be considered for entry into a D.O. program, an applicant must complete a national standardized exam called the Medical College Admissions Test (MCAT). Some authors note the differences in the average MCAT scores and grade point average of students who matriculate at D.O. schools versus those who matriculate at M.D. schools within the United States. In 2015, the average MCAT and GPA for students entering U.S.-based M.D. programs were 31.4 and 3.70, respectively, and 27.33 and 3.55 for D.O. matriculants, although the gap has been getting smaller every year. D.O. medical schools are more likely to accept non-traditional students who are older and entering medicine as a second career or coming from non-science majors.
D.O. medical students are required to take the Comprehensive Osteopathic Medical Licensure Examination ( COMLEX-USA ), which is sponsored by the National Board of Osteopathic Medical Examiners (NBOME). The COMLEX-USA is series of four osteopathic medical licensing examinations. The first two steps of the COMLEX-USA are taken during medical school and are prerequisites for osteopathic residency programs, which are available in almost every specialty of medicine and surgery. The third step exam consists of a written portion and a physical exam evaluation. The physical exam evaluation (COMLEX- PE), is only available in select regions in the country and graded as a PASS/FAIL exam. Finally, the step 4 portion of the COMLEX is taken during residency.
In addition to the COMLEX-USA, D.O. medical students may choose to
sit for the M.D. licensure examinations, which are called the United
States Medical Licensing Examination (USMLE). This is typically done
if the student desires to enter an M.D. residency. However, this is
not always required, as some M.D. residency programs do not require
the USMLE from D.O. applicants. 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). Further information: Comparison of MD and
DO in the
LICENSING AND BOARD CERTIFICATION
To obtain a license to practice medicine in the United States,
osteopathic medical students must pass the Comprehensive Osteopathic
Medical Licensing Examination (COMLEX), the licensure exam
administered by the National Board of Osteopathic Medical Examiners
throughout their medical training. Students are given the option of
also taking the
Upon completion of internship and residency requirements for their
chosen medical specialty, and depending on whether the program
ACGME or AOA accredited, holders of the D.O. may elect to
be board certified by either a specialty board (through the American
Medical Association 's
American Board of Medical Specialties
Depending on the state, medical licensure may be issued from a combined board (D.O. and M.D.) or a separate board of medical examiners. All of the 70 state medical boards are members of the Federation of State Medical Boards .
Currently, there are no osteopathic programs located outside of the
INTERNATIONAL PRACTICE RIGHTS
The following is an "International Licensure Summary" for
U.S.-trained Doctors of Osteopathic Medicine, as listed by the
American Osteopathic Association
AOA International Licensure Summary. COUNTRY YEAR OF LATEST POLICY MEDICAL PRACTICE RIGHTS REQUIREMENTS FOR LICENSURE
Argentina 2006 Unlimited Foreign physicians must submit credentials to various agencies and then appear before any of the National Universities in order to have their diploma recognized.
Australia 2013 Unlimited According to documents published online, the Medical Board of Australia has “agreed to accept the DO USA as a primary medical qualification for the purposes of medical registration provided that the DO USA was awarded by a medical school which has been accredited by the Commission on Osteopathic College Accreditation .”"
Austria 2009 Unlimited Hospital must have position unable to be filled by Austrian physician.
Bahamas 2004 Unlimited U.S. license recognized.
Bahrain 2010 Unlimited U.S. license recognized.
Barbados 1995 Limited OMM only.
Belize 2009 Unlimited Must complete a Belizean residency for permanent license eligibility.
Bermuda 1997 Unlimited Required at least 2 years of GME and examination or interview by the Council’s Examination Committee. Non-Bermudans must have approval from the Ministry of Labour & Home Affairs to work on the island.
Brazil 2007 Unlimited Completion of Brazilian board exam, establishing residency & some training in Brazilian hospital is required.
Unlimited Requires at least 2 years of GME accredited by the ACGME or AOA and must have passed the Universities Coordinating Council Exam, a basic sciences exam, and have passed all three parts of the LMCC .
Unlimited Requires at least 1 year of GME approved by the AOA or the ACGME, completed at least 1 year of GME in Canada, passed all three parts of the LMCC.
Unlimited U.S. license recognized.
Unlimited Requires at least 2 years of GME approved by the AOA or the ACGME and have passed all 3 parts of the LMCC. Reciprocity pathway for D.O. physicians with a Maine license.
Unlimited The Medical Act 2011 allows full licensure of osteopathic physicians, both for the country’s full registry & its educational registry.
Unlimited U.S. license recognized.
Unlimited Requires a Canadian or ACGME residency.
Unlimited Requires a Canadian or ACGME residency.
Prince Edward Island
Requires 1 year of GME approved by the AOA or ACGME, 1 year of GME
in Quebec passed the written, oral and clinical board examination of
the College of Family
Unlimited U.S. license recognized.
Cayman Islands (UK) 1983 Unlimited U.S. license recognized.
Central African Republic 1990 Unlimited U.S. licensure and annual attendance at the National Congress for Physicians.
Chile 2008 Unlimited A written exam in Spanish is required, besides a series of practical tests involving common procedures (CPR, intubation, lumbar puncture, etc.).
China 2009 Unlimited U.S.-D.O. physicians are permitted to apply for "Short Term Medical Practice."
Colombia 1996 Unlimited Same requirements as other foreign physicians.
Costa Rica 2009 Unlimited Same requirements as other foreign physicians.
Dominican Republic 2000 Unlimited U.S. license & board certification recognized.
Ecuador 1990 Unlimited Same requirements as other foreign physicians. Reciprocity exists with most Latin American countries.
Ethiopia 2011 Unlimited Must renew the license every 5 years.
Finland 1996 Unlimited Same requirements as other foreign physicians.
France 2009 Limited OMM only. The French government does not recognize the full scope of practice osteopathic medicine.
The Gambia 2011 Unlimited
Germany 2008 Unlimited Same requirements as other foreign physicians. Depends on need. Decisions made on individual basis.
Greece 2009 Unlimited Greek citizenship required, unless, in rare instances, there exists a crucial need for certain types of specialist physicians. Further, a work permit must be obtained, a difficult task, and speaking Greek is an unwritten requirement. These are the same requirements as other foreign physicians.
Grenada 2007 Unlimited U.S. license recognized.
Guyana 1996 Unlimited Case-by case basis.
Honduras 2009 Unlimited National Autonomous University must accredit all foreign titles. After accreditation is completed, the applicant must seek registration with the Medical College of Honduras (MCH).
Hong Kong 1998 Unlimited Written examination. Personal interview. Training approval.
India 2012 Unlimited Unlimited for short-term work.
Indonesia 1992 Unlimited & Restricted Foreign physicians affiliated with a university project or a mission have unlimited practice rights. No private practice allowed.
Iran 2009 Unlimited Iranian citizens who have received both the DO degree from a US osteopathic school and are board certified in a clinical specialty. Osteopathic degrees from other countries are not accepted. The process of evaluation of the medical education and clinical training is under the jurisdiction of the Ministry of Health and Medical Education (MoHME).
Israel 2007 Unlimited Same requirements as other foreign physicians. Hebrew required.
Jamaica 1994 Limited & Restricted D.O. physicians were permitted to supply some services while participating in a specific mission project.
Jordan 2012 Unlimited
Kenya 2007 Unlimited
Lebanon 2004 Unlimited AOA letter required. Examination required.
Lesotho 1990s Unlimited Applicants must appear before the Medical, Dental and Pharmacy Council to answer some medical questions and present their credentials. The Council will also make a recommendation about where the applicant’s skills would be most helpful in the country.
Liberia 1990s Unlimited Same requirements as other foreign physicians.
Luxembourg 1987 Unlimited The practice of medicine in Luxembourg by a doctor who is not an EU national is very rare.
Malta 2010 Unlimited Accepted on a case by case basis if training meets the minimum educational requirements for physicians in the EU (Article 24 of Directive 2005/36/EC). Examination required.
Malawi 1991 Unlimited
Mexico 2011 Unlimited D.O. physicians can now obtain short-term & long-term licensure through the Health Secretary’s office. All other Mexican states require work permits - only available in conjunction with the association of a short-term medical mission project.
Micronesia 1993 Unlimited Statutes specifically include DOs
Nepal 2008 Unlimited Approval by the Nepal Medical Council & a visa from the Immigration Department.
Netherlands 2009 Unlimited Same requirements as other foreign physicians.
New Zealand 2008 Unlimited Hearing required. Case-by-case basis.
Nigeria 2010 Unlimited U.S. Licensure and completion of specialty training required.
Norway 2009 Limited OMM only, but DOs may apply for recognition as medical doctors.
Pakistan 2011 Unlimited U.S. osteopathic medical schools meet the Medical and Dental Council’s statutory regulations for international medical graduates. Scope is unlimited, but practice setting may be restricted
Panama 2009 Unlimited Panamanian citizenship required.
Papua New Guinea 2010 Unlimited Work permit required. Short-term or a long-term volunteer service license also available.
Peru 2011 Unlimited Process for licensure is the same as for other IMGs.
Poland 2009 Unlimited Examination & Polish required.
Qatar 2011 Unlimited Must possess a valid work visa, and pass written and oral examinations.
Russia 2006 Unlimited Foreign physicians make arrangements to practice through Russian sponsors, such as hospitals or businesses.
Saint Lucia 2000 Unlimited U.S. credentials recognized.
Saudi Arabia 2009 Unlimited Foreign physician must be recruited by a government agency, a corporation or a private health care entity, such as a hospital.
Sierra Leone 1993 Unlimited Notarized U.S. credentials.
South Africa 2009 Limited OMM only
Sweden 2005 Unlimited U.S. license recognized.
Taiwan 2008 Unlimited The ROC government recognizes U.S. D.O. degree. Applicants must take Taiwan Examination Yuan to obtain Taiwanese license.
Tanzania 1985 Unlimited U.S. license -webkit-column-width: 30em; column-width: 30em; list-style-type: decimal;">
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* ^ "
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