$229,300/year
Bachelor's degree + 4 years
Certification
AOA or ABMS
Job Growth
3% (2022-2032)
Entry Level
No
Work Setting
Hospitals, private practices, clinics
Last Updated
January 2025
Reviewed by:Sarah Mitchell, PA-C, MPAS – Emergency Medicine Physician Assistant
What is an Osteopathic Physician?
Physician Assistants (PAs) are licensed medical professionals who practice medicine under the supervision of physicians and surgeons. PAs diagnose illnesses, develop and manage treatment plans, prescribe medications, perform procedures, and often serve as patients’ primary healthcare providers. With thousands of hours of medical training, PAs work in virtually every medical specialty and practice setting, from primary care clinics to operating rooms.
The PA profession was created in the 1960s to address physician shortages and improve healthcare access, particularly in underserved areas. According to the American Academy of Physician Associates (AAPA), over 168,000 certified PAs practice in the United States as of 2024. PAs practice autonomously within their scope while maintaining collaborative relationships with physicians. The level of physician supervision required varies by state, with some states granting full practice authority to experienced PAs.
Unlike physicians, PAs can switch specialties without additional residency training, providing career flexibility. The rigorous PA education model emphasizes medical knowledge, clinical reasoning, and practical skills, producing clinicians capable of managing complex patient cases across diverse settings.
Why Become an Osteopathic Physician?
Holistic Patient Care Philosophy:
Osteopathic medicine emphasizes treating the whole person rather than just symptoms or diseases. This patient-centered approach appeals to those valuing comprehensive, integrative care addressing physical, emotional, and social factors affecting health.
Additional Manual Medicine Skills:
DOs learn osteopathic manipulative treatment (OMT), hands-on techniques to diagnose and treat musculoskeletal dysfunction. OMT provides an additional treatment modality for pain, headaches, and musculoskeletal problems without always relying on medications.
Equivalent Practice Rights and Income:
DOs have identical practice authority to MDs, prescribe medications, perform surgery, and earn equivalent salaries. There is no difference in scope of practice, licensing, or professional opportunities.
Primary Care Focus:
Osteopathic medical schools traditionally emphasize primary care and underserved populations. About 57% of DOs practice in primary care specialties (family medicine, internal medicine, pediatrics) versus 35% of MDs, though DOs practice in all specialties.
Potentially Less Competitive Admissions:
While osteopathic medical school remains highly competitive, average admitted student statistics (GPA 3.54, MCAT 503) are slightly lower than allopathic schools (GPA 3.74, MCAT 511). This provides additional pathways for strong candidates.
Growing Profession:
Osteopathic medicine is America's fastest-growing physician segment. New osteopathic medical schools have opened nationwide, increasing opportunities for aspiring physicians.
Same Career Opportunities:
DOs access identical residency programs, fellowships, academic positions, and practice opportunities as MDs. The merged residency system ensures no discrimination in training pathways.
Three Spheres of PHN Influence
What Osteopathic Physicians Do?
In the next section, you’ll learn about the core responsibilities, daily activities, and areas of impact that define a OP—across patient care, nursing practice, and healthcare systems.
Daily Responsibilities and Tasks
Osteopathic physicians perform identical duties to allopathic physicians, with the addition of osteopathic manipulative treatment when appropriate:
Comprehensive Patient Care
DOs conduct thorough patient evaluations including detailed medical histories, physical examinations, and diagnostic testing. They diagnose diseases, develop treatment plans, prescribe medications, perform procedures, and manage chronic conditions. DOs emphasize preventive care and patient education about healthy lifestyle choices.
Primary care DOs manage common conditions including diabetes, hypertension, asthma, infections, and minor injuries. They provide well visits, immunizations, health screenings, and coordinate referrals to specialists when needed. Many DOs serve as patients’ primary care physicians managing long-term health relationships.
Osteopathic Manipulative Treatment (OMT)
The distinguishing feature of osteopathic medicine is OMT, a set of hands-on techniques used to diagnose and treat musculoskeletal dysfunction and enhance the body’s self-healing mechanisms. OMT techniques include:
Muscle Energy: Patient actively moves against physician counterpressure to release muscle tension and improve joint mobility.
Myofascial Release: Sustained pressure applied to fascial restrictions releasing tension and improving tissue mobility.
High-Velocity Low-Amplitude (HVLA): Quick, controlled thrust movements (similar to chiropractic adjustments) restoring joint mobility.
Counterstrain: Positioning body to relieve painful tender points and reduce muscle spasm.
Cranial Osteopathy: Gentle techniques addressing cranial bones and central nervous system.
DOs use OMT to treat back pain, neck pain, headaches, sports injuries, and musculoskeletal problems. OMT complements conventional treatments, often reducing medication needs. However, many DOs in surgical or subspecialty fields use OMT minimally or not at all in their practices.
Specialty-Specific Practice
DOs in surgical specialties perform operations identical to MD surgeons. Orthopedic surgeon DOs perform joint replacements, fracture repairs, and spine surgeries. General surgeon DOs perform appendectomies, cholecystectomies, and hernia repairs. Neurosurgeon DOs operate on brain and spine conditions.
Hospital-based DOs work as hospitalists managing inpatient medical care, emergency physicians handling urgent conditions, anesthesiologists providing anesthesia during surgery, or intensivists managing ICU patients. These roles involve no OMT in most cases.
Subspecialist DOs practice cardiology, gastroenterology, oncology, endocrinology, or other medical subspecialties performing procedures and managing complex medical conditions within their specialty domains.
Patient Education and Preventive Care
DOs emphasize prevention and wellness, educating patients about nutrition, exercise, stress management, and disease prevention. The osteopathic philosophy of treating the whole person encourages discussing lifestyle factors, emotional health, and social determinants affecting patient well-being.
Documentation and Administrative Tasks
Like all physicians, DOs spend significant time documenting patient encounters in electronic health records, reviewing test results, coordinating care with other providers, obtaining insurance authorizations, and participating in quality improvement activities. Documentation burden typically consumes 1-2 hours for every hour of direct patient care.
Teaching and Leadership
DOs teach medical students and residents in academic settings, serve in hospital leadership positions, lead quality improvement initiatives, and participate in medical committees. In areas with high DO concentration, DOs often hold prominent leadership roles in healthcare systems.
What’s Next?
Work Environment and Lifestyle
This section covers hospitals, specialty clinics, academic environments, and leadership roles—helping you visualize your future workplace.
Work Environment and Lifestyle
Where Osteopathic Physicians Work
DOs practice in all settings where MDs practice. Approximately 57% of DOs work in primary care settings (family medicine clinics, internal medicine offices, pediatric practices), higher than the 35% of MDs in primary care. However, DOs increasingly enter all specialties including surgery, emergency medicine, anesthesiology, radiology, and medical subspecialties.
Primary Care Practices: Many DOs work in private practices, community health centers, or rural clinics providing comprehensive outpatient care. Primary care DOs often serve underserved populations in rural areas and inner cities where physician shortages exist.
Hospital-Based Practice: DOs work as hospitalists, emergency physicians, intensivists, and surgical specialists in hospitals nationwide. Major healthcare systems employ DOs in all physician roles without distinction from MDs.
Academic Medical Centers: DOs teach at both osteopathic and allopathic medical schools, serve as residency faculty, and practice academic medicine at university hospitals. Increasing numbers of DOs hold department chair and dean positions.
Rural and Underserved Areas: DOs disproportionately practice in rural and medically underserved communities. About 20% of DOs practice in communities with populations under 50,000 compared to 12% of MDs.
Work Schedule and Lifestyle
DO work schedules are identical to MDs and vary by specialty. Primary care DOs typically work 45-55 hours weekly with some evening or weekend hours. Hospital-based DOs work shift schedules. Surgical DOs work 60-80 hours weekly including operating time, clinics, and call responsibilities.
Work-life balance challenges affect DOs similarly to MDs. Long training periods, demanding schedules, and documentation burdens contribute to physician burnout affecting 40-50% of all physicians regardless of degree type.
Pros
-
Identical Practice Rights to MDs - Full prescribing, surgical privileges, no scope limitations
-
Equivalent Compensation - Same salaries as MDs in equivalent specialties
-
Holistic Care Philosophy - Whole-person approach appeals to many practitioners
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Additional Treatment Tools - OMT provides non-pharmacologic treatment options
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Primary Care Emphasis - Strong training in comprehensive primary care
-
Growing Profession - Increasing recognition and opportunities
-
Potentially Broader Acceptance Criteria - Slightly lower average admission statistics
Cons
-
Persistent Misunderstanding - Some patients/professionals unfamiliar with DO credential
-
Same Extensive Training - 11-15 years before independent practice
-
Equivalent Medical School Debt - $200,000-$300,000 average debt load
-
Demanding Work Hours - 50-80+ hours weekly depending on specialty
-
Burnout and Stress - Same pressures as all physicians
-
Documentation Burden - Extensive EHR requirements
-
Limited OMT Use in Many Specialties - Surgical and subspecialty DOs rarely use OMT
What’s Next?
Salary and Compensation
Learn about average salaries, factors that influence compensation, and projected demand for Osteopathic Physician (DO) Career Guide.
Salary and Compensation
National Salary Overview
Osteopathic physicians earn salaries equivalent to allopathic physicians. According to compensation surveys, there is no significant salary difference between DOs and MDs in the same specialty and practice setting. Median physician compensation is $229,300 annually across all specialties.
Salary by Experience Level
DO salary follows same specialty patterns as MDs:
Specialty
Annual Salary
Notes
Surgical Specialties
$400,000-$575,000
Orthopedics, plastic surgery, general surgery
Procedural Specialties
$430,000-$490,000
Cardiology, gastroenterology, anesthesiology
Hospital-Based
$340,000-$430,000
Emergency medicine, critical care, radiology
Primary Care
$250,000-$270,000
Family medicine, internal medicine, pediatrics
DOs heavily concentrate in primary care and family medicine, so average DO compensation may appear slightly lower due to specialty distribution rather than degree-based salary differences.
Salary by Experience
Experience
Salary Range
Notes
Resident
$60,000-$70,000
Training salary
Early Career (1-5 years)
80-90% specialty median
Building practice
Mid-Career (6-15 years)
100-120% specialty median
Peak earning
Late Career (16+ years)
Variable
Based on specialty and role
Geographic and Setting Variations
Highest-Paying: Dermatology ($140k-$160k+), Cardiothoracic Surgery ($135k-$155k+), Emergency Medicine ($130k-$150k+), Orthopedic Surgery ($130k-$150k), Neurosurgery ($130k-$155k+)
Moderate: Hospitalist Medicine ($120k-$135k), Urgent Care ($115k-$130k), Occupational Medicine ($115k-$135k)
Primary Care: Family Medicine ($110k-$125k), Internal Medicine ($110k-$125k), Pediatrics ($105k-$120k)
What’s Next?
How to Become an Osteopathic Physician
This section outlines education requirements, licensure, certification, and experience needed to become a OP.
Educational Path
Step 1
Complete Bachelor's Degree (4 years)
Earn bachelor’s degree completing osteopathic medical school prerequisites (identical to MD school requirements):
- Biology with lab (2 semesters)
- General chemistry with lab (2 semesters)
- Organic chemistry with lab (2 semesters)
- Physics with lab (2 semesters)
- Biochemistry (1 semester)
- English (varies by school)
- Mathematics/statistics (varies)
- Social sciences (psychology, sociology)
Maintain strong GPA (3.5+ competitive, 3.3+ minimum). Engage in clinical volunteering, physician shadowing (shadow both DOs and MDs), research, and leadership activities.
Step 2
Take MCAT and Apply to Osteopathic Medical Schools
Take Medical College Admission Test (MCAT) – same exam for MD and DO schools. Osteopathic schools have slightly lower average MCAT scores (503-505) than allopathic schools (511-512), though highly competitive DO schools match MD school statistics.
Apply through American Association of Colleges of Osteopathic Medicine Application Service (AACOMAS). Most applicants apply to 10-20 schools. Applications open May; submit early (June-July) for rolling admissions advantage.
Average osteopathic matriculant statistics: 3.54 GPA, 503 MCAT. Acceptance rates vary by school (20-40%). Demonstrate understanding of osteopathic medicine philosophy in application essays and interviews.
Step 3
Complete Osteopathic Medical School (4 years)
Preclinical Years (Years 1-2): Intensive foundational medical sciences identical to MD schools plus additional 200+ hours of OMT training. Courses include anatomy (cadaver dissection), physiology, biochemistry, pharmacology, microbiology, pathology, and osteopathic principles and practice.
OMT training involves learning hands-on manipulation techniques, developing palpation skills, understanding musculoskeletal diagnosis, and practicing treatment approaches. Students practice OMT techniques on classmates and standardized patients.
Take COMLEX-USA Level 1 examination after second year (osteopathic licensing exam). Many DO students also take USMLE Step 1 (MD licensing exam) to enhance residency competitiveness, though this is optional since residency merger.
Clinical Years (Years 3-4): Core clinical rotations identical to MD schools:
- Internal Medicine (8-12 weeks)
- Surgery (8-12 weeks)
- Pediatrics (6-8 weeks)
- Obstetrics/Gynecology (6-8 weeks)
- Psychiatry (4-6 weeks)
- Family Medicine (8-12 weeks)
- Emergency Medicine (4 weeks)
- OMT rotation emphasizing clinical OMT application
Students rotate at teaching hospitals, community hospitals, and clinics gaining hands-on patient care experience. Take COMLEX-USA Level 2 CE (Cognitive Evaluation) and PE (Performance Evaluation) during fourth year. Many also take USMLE Step 2 CK.
Osteopathic Medical School Costs: Tuition averages $50,000-$60,000 annually at public osteopathic schools and $55,000-$70,000+ at private schools. Total debt including living expenses averages $250,000-$300,000 for most DO graduates, slightly higher than MD averages because fewer public osteopathic schools exist.
Step 4
Complete Residency Training (3-7 years)
DOs enter residency through ACGME-accredited programs (merged system) competing with MDs for same positions. Residency duration varies by specialty:
- Family Medicine: 3 years
- Internal Medicine/Pediatrics: 3 years
- Emergency Medicine: 3 years
- General Surgery: 5 years
- Orthopedic Surgery: 5 years
- Neurosurgery: 7 years
Match statistics show DOs successfully match into all specialties, though slightly less competitive in highly selective specialties (dermatology, orthopedics, neurosurgery) compared to top-tier MD students. However, many DOs match into these competitive specialties successfully.
Residency compensation and work hours are identical for DOs and MDs ($60,000-$70,000 annually, 60-80 hours weekly).
Step 5
Board Certification and Licensure
After residency, DOs can pursue board certification through American Osteopathic Association (AOA) specialty boards or American Board of Medical Specialties (ABMS) boards (same boards MDs use). Most DOs now choose ABMS certification for broader recognition.
State medical licensure requires graduation from COCA-accredited osteopathic school (or LCME-accredited MD school), residency completion, passing COMLEX-USA or USMLE exams, and application to state medical board. DOs receive full unrestricted medical licenses identical to MDs.
Total Timeline
High school to independent practice: 11-15 years (4 years undergraduate + 4 years osteopathic medical school + 3-7 years residency + optional fellowship).
What’s Next?
Career Advancement
Understand advancement opportunities and long-term growth potential.
Clinical Advancement
Subspecialty Fellowship: DOs pursue fellowship training in cardiology, gastroenterology, surgical subspecialties, and other areas identically to MDs. Fellowship provides subspecialization and increased earning potential.
Private Practice Partnership: Progress from employed physician to practice partner or owner. Partnership offers higher income, autonomy, and equity.
Hospital Leadership: Advance to medical director, department chair, or chief positions. DOs increasingly hold prominent leadership roles in major healthcare systems.
Academic Career Path
Medical School Faculty: Teach at osteopathic or allopathic medical schools. Both types of schools employ DO faculty, particularly in primary care and OMT departments.
Residency Program Director: Lead residency training programs in various specialties. DOs serve as program directors in both historically osteopathic and allopathic programs.
Department Chair/Dean: DOs hold increasing numbers of department chair and medical school dean positions, including at both osteopathic and allopathic institutions.
Research and Leadership
Physician-Scientist: Conduct research investigating disease mechanisms, treatments, and healthcare delivery. DOs contribute to medical research in all fields.
Healthcare Administration: Chief Medical Officer (CMO) or executive leadership in hospitals and health systems. DOs increasingly serve in C-suite healthcare leadership.
Osteopathic Organization Leadership: Lead osteopathic medical associations, serve on AOA boards, or advance osteopathic medicine advocacy.
Industry and Consulting: Medical directors in pharmaceutical companies, healthcare consultants, or medical advisors leveraging clinical expertise in commercial settings.
What’s Next?
Similar Careers
Understand advancement opportunities and long-term growth potential.
Similar Careers
Allopathic Physician (MD)
4 years allopathic medical school + residency
Equivalent to DO physicians
Allopathic physicians receive identical training without OMT component. MDs and DOs have equivalent practice rights, compete for same residencies, and practice identically in clinical settings. Main difference is educational philosophy.
Chiropractor (DC)
4 years chiropractic school (no residency)
$75,380/year median
Chiropractors focus on spinal manipulation and musculoskeletal treatment. Unlike DOs who are full physicians, chiropractors have limited scope (no prescribing, no surgery). Some manipulation techniques overlap with DO OMT.
Physician Assistant
Master's degree (2-3 years)
$126,010/year
Advanced practice providers working with physician supervision. Shorter training pathway but less autonomy than physicians.
Physical Therapist
Doctoral degree (DPT, 3 years)
$97,960/year
Rehabilitation specialists treating musculoskeletal dysfunction and movement disorders through exercise and manual therapy.
What’s Next?
Frequently Asked Questions
Still have questions? The final section addresses common concerns and practical questions about becoming and working as a Osteopathic Physician (DO) Career Guide.
Frequently Asked Questions
What is the difference between DO and MD?
DOs and MDs are both fully licensed physicians with identical practice rights, prescribing authority, and surgical privileges. Both attend 4-year medical schools and complete the same residency training. The main difference is that osteopathic schools teach additional hands-on manipulation techniques (OMT) and emphasize holistic care. In clinical practice, most DOs and MDs function identically. Since 2020, all residency training merged into one system (ACGME), eliminating any training differences.
Can DOs perform surgery and prescribe medications?
Yes, absolutely. DOs have full practice rights identical to MDs. DOs can prescribe all medications including controlled substances, perform surgery in all surgical specialties, and practice in any medical field. DOs work as surgeons, anesthesiologists, emergency physicians, and all other physician roles.
Is osteopathic medical school easier to get into than allopathic?
Osteopathic medical school remains highly competitive. Average admitted students have 3.54 GPA and 503 MCAT, slightly lower than allopathic schools (3.74 GPA, 511 MCAT). However, highly competitive DO schools have statistics matching MD schools. DO schools may be more accessible for strong candidates who don’t gain MD admission, but acceptance rates are still only 20-40%.
Do employers prefer MDs over DOs?
Legally and practically, no. DOs and MDs are hired for identical positions with equivalent salaries. Major healthcare systems, hospitals, and private practices employ both without preference. Some older physicians or international healthcare systems may be less familiar with DO credentials, but within the United States, there is no employment discrimination. The merged residency system (2020) eliminated any training-based distinctions.
How much does osteopathic medical school cost?
Osteopathic medical school tuition ranges from $50,000-$70,000 annually for 4 years. Total debt including living expenses averages $250,000-$300,000, slightly higher than MD school averages because fewer public osteopathic schools exist. Some states have public osteopathic schools (Oklahoma,
Do DOs use OMT in their practice?
It varies. Primary care DOs frequently incorporate OMT treating musculoskeletal pain, headaches, and other conditions. However, DOs in surgical specialties, emergency medicine, radiology, or hospital-based fields rarely use OMT. Many subspecialist DOs don’t regularly practice OMT. All DOs learn OMT in medical school, but clinical use depends on specialty and practice setting.
Can DOs match into competitive residencies?
Yes. DOs successfully match into all specialties including competitive fields like dermatology, orthopedic surgery, and neurosurgery. However, top-tier MD students may have slight advantages in most competitive specialties. Many DOs match into their first-choice specialties. The merged residency system ensures DOs compete equally for positions.
Are DOs recognized internationally?
Recognition varies by country. DOs practice with full physician rights in the United States, Canada, and several other countries. Some countries require additional examinations or have limited recognition of osteopathic credentials. MDs generally have broader international recognition. DOs planning international practice should research specific country requirements.
What’s Next?
Overview
The overview brings together key highlights, role impact, and career context—making it a helpful starting point whether you’re just beginning or refining your decision.
