The DO Pathway: Osteopathic Medicine in the United States
The United States has two routes to a full physician licence: the MD, awarded by LCME-accredited medical schools, and the DO, awarded by colleges of osteopathic medicine accredited by the Commission on Osteopathic College Accreditation (COCA). Both lead to unrestricted licensure in all US states, yet international applicants frequently overlook the DO route entirely.
Published 2026-02-10 · Updated 2026-09-12 · Last verified 2026-09-12 · Medically reviewed 2026-09-12
Answer in brief
A DO is a fully licensed US physician. Osteopathic colleges are accredited by COCA rather than LCME, applications are submitted through AACOMAS, students take COMLEX-USA (and often USMLE as well), and graduates enter the same ACGME residency system as MD graduates. The curriculum adds osteopathic principles and manipulative treatment to the standard medical curriculum.
What the DO degree is
The Doctor of Osteopathic Medicine is one of two degrees that lead to full medical licensure in the United States. DOs prescribe medication, perform surgery and practise in every specialty. The curriculum covers the same biomedical and clinical content as an MD program, with additional training in osteopathic principles and osteopathic manipulative treatment.
| Point | MD | DO |
|---|---|---|
| Accreditor | LCME | COCA |
| Application service | AMCAS | AACOMAS |
| Licensing examination | USMLE | COMLEX-USA, with USMLE optional and common |
| Residency system | ACGME accredited programs | The same ACGME accredited programs |
| Licensure | Full licensure in all states | Full licensure in all states |
| Distinct curriculum content | — | Osteopathic principles and manipulative treatment |
Residency under the single accreditation system
US graduate medical education operates under a single accreditation system, so MD and DO graduates apply to the same ACGME-accredited residency programs through ERAS and the NRMP Match. Individual programs set their own screening practices, and some state a preference for particular examinations or score reporting; read each program's published requirements rather than assuming parity in screening.
Examination strategy is a real decision
International applicants and DO programs
Osteopathic colleges vary in whether they accept non-US applicants, and several require permanent residency or citizenship. Where international applicants are accepted, the requirements resemble MD admissions: a bachelor's degree, prerequisite sciences, the MCAT, letters of recommendation and evidence of funding. Osteopathic schools commonly ask for a letter from a DO physician; confirm each college's current expectation.
Applying through AACOMAS
- Bachelor's degree with prerequisite coursework as each college specifies
- MCAT score within the accepted validity window
- AACOMAS application, followed by college-specific secondary applications
- Letters of recommendation, often including one from a physician
- Documented clinical exposure, including shadowing where required
Frequently asked questions
Is a DO the same as an MD?
Both are fully licensed US physicians with the same practice rights. The degrees differ in accreditor, application service, licensing examination series and the osteopathic component of the curriculum.
Can DOs enter competitive specialties?
DO graduates train across all specialties, but competitive specialties are competitive for every applicant. No degree route guarantees entry to a given specialty.
Do DO students have to take the USMLE?
COMLEX-USA is the required series for DO students. USMLE is optional, and many students take it because some residency programmes screen on USMLE results.
Is the DO recognised outside the United States?
Recognition varies by country and is decided by each national regulator. Check the regulator in the country where you intend to practise.
Official sources
Requirements, fees and outcome data change. Check each source for its own publication date.
- 1.Osteopathic medical colleges and the DO degree — American Association of Colleges of Osteopathic Medicine
- 2.Commission on Osteopathic College Accreditation — American Osteopathic Association
- 3.COMLEX-USA examination series — National Board of Osteopathic Medical Examiners
- 4.Accredited residency and fellowship programs — Accreditation Council for Graduate Medical Education (ACGME)
- 5.Main Residency Match results and data — National Resident Matching Program (NRMP)
- 6.State medical board licensure requirements — Federation of State Medical Boards
Authorship and review
Reviewed for factual accuracy against publicly available primary sources. Requirements change; verify directly with the relevant school, accreditor, examination authority or licensing body.
Written by
MBBSinAmerica Editorial Team
Research and editorial desk
The editorial desk compiles US medical education information from accreditor publications, medical school websites, examination authorities and federal data releases, and records a source and verification date for every figure published.
Areas of expertise: LCME accreditation records, AMCAS and MD admissions processes, USMLE and ECFMG requirements, NRMP Match reporting.
Reviewed by
Medical Review Board
MD / MBBS reviewers with US graduate medical education experience · United States
Review panel members check that descriptions of degrees, examinations, accreditation and residency processes reflect the current published requirements of the responsible bodies, and that no page implies a guaranteed admission, examination or Match outcome.
Review date: 2026-09-12
Reviewers receive no payment from medical schools, test preparation providers or recruitment agencies, and review assignments are unrelated to advertising relationships.