Peter White, USMLE and COMLEX tutor for MedSchoolCoach, is here to tell us about the osteopathic pathway. Depending on where you grew up and where you live now, you may or may not be familiar with osteopathic medicine. Osteopathic medicine is a sect of medicine and one of the degree pathways by which you can currently complete in the United States to become a practicing physician.
Peter talks about the history is osteopathic medicine, the differences between MD and DO degrees, the application process, trends in the osteopathic profession, and current job opportunities.
[1:20] A history of osteopathic medicine.
The first allopathic medicine school was formed in 1807. Several years later, in 1845, the American Medical Association was formed. In the 1860s, there was a man named Andrew Taylor Still who is widely considered the founder of osteopathic medicine. He entered the Union Army and served as the hospital steward, getting highly involved in medicine at that time. In 1864, his three kids died of meningitis, which caused him to begin questioning the practices of medicine. He came up with some radical ideas such as avoiding drug use, putting a greater emphasis on community and preventative medicine, and that the body systems are interrelated.
In 1892, Andrew Taylor Still formed the American School of Osteopathy in Kirksville, Missouri, which is where the A.T. Still University is today. Since that time, osteopathy has grown immensely. The American Osteopathic Association was formed in 1897, and in the early 1900s, several schools were formed. Since the 1960s, practice rates for osteopathic physicians have been growing immensely.
One of the more unique aspects of osteopathic physicians is that they serve a big role in the military compared to other fields. They make up over 40% of the US military positions.
[3:09] The differences between MD and DO degrees.
The requirements for the two degrees are very similar. Both pathways require you to complete two years of basic science clinical training and two years of clinical clerkships. The major difference is that osteopathic positions must complete an additional 200 hours of osteopathic training in osteopathic medicine. This is basically the treatment of muscle and skeletal conditions, such as some of the treatments used when you go see a chiropractor.
Another difference is the osteopathic principles. They are four key tenets of osteopathic medicine: the body is a unit; the body is capable of self-regulation, self-healing, and health maintenance; structure and function are reciprocally interrelated; and rational treatment is based on the understanding of these principles. These are believed to create a more holistic approach that promotes patient centeredness.
Regarding the application process, it’s nearly the same for osteopathic physicians; they just use a different website service.
The number of DOs is rapidly increasing in the country. Currently over a quarter of medical students are now DOs, and this number is expected to rise. From 2016 to 2021, the amount of DOs is expected to increase by 20%, whereas MDs are expected to increase by about 5%.
[6:37] Board exams and the ACMG merger.
In the osteopathic world, the board exams are fairly similar. You take three levels of boards: level 1, level 2 CE, level 2 PE, and level 3 which is taken in residency. These exams are taken at the same point in time as the similar USMLE exams. Most osteopathic physicians have been taking both the COMLEX and USMLE exams, largely due to the ACMG merger. Historically, DOs have had their own residency and their own matching process, but this is currently the final year where there will be two separate matches. For osteopathic medical students, this can make it tougher to get into non-primary care specialities. This calls for medical students, especially osteopathic students, to have better board scores and put themselves in better positions.