Why the Big Shift from MD to DO Graduates—and What It Means for Us

By Wayne Persky

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In recent years, there has been an explosive growth of DO (Doctor of Osteopathic Medicine) graduates from medical schools. From 1980 to 2005, annual DO graduates jumped over 150%, from about 1000 to 2800 yearly. By 2015, there were 5000 annual DO graduates, according to Wikipedia. In the spring of 2024, over 8200 new DO's graduated, and nearly 10,000 students were enrolled in osteopathic programs.

​Although there are almost four times as many MD schools as DO schools (155 versus 40), DO school enrollment has surged 77% in a decade compared with an 18% growth in MD program enrollments. As a result, approximately one in four current U.S. medical students is a DO.

If you can't beat 'em, join 'em.

​Prior to 2020, DO residencies were often siloed under American Osteopathic Association (AOA), while MDs used the Accreditation Council for Graduate Medical Education (ACGME) pathways. In August of 2020, a merger created single accreditation under ACGME, enabling DOs access to all U.S. residencies. DO graduates now achieve record match rates, nearly matching MD grads. These changes ensure DO and MD doctors receive equivalent residency training, leveling the playing field. Note, however, that this did not apply to med school graduates prior to August 2020.

​Comparing MD versus DO training and practice:

• Both require four-year medical school, licensing boards, residencies.
• Both can become licensed, perform surgery, prescribe medications.

DO training distinctions:

• Whole-person care and Osteopathic Manipulative Medicine (OMM) is emphasized, with 200–500+ hours of hands-on in musculoskeletal treatment
• Traditionally, DO students hear more about preventive care and holistic approaches
• Slight differences in average admissions scores exist—MD students typically have marginally higher Medical College Admission Test/Grade Point Average (MCAT/GPA)

But daily clinical practices between MDs and DOs have converged significantly.

Why this shift matters for patients:

• As more DO physicians enter, especially in primary care, patients gain practitioners emphasizing prevention, holistic health, and community responsivenes. Studies show no meaningful differences in patient outcomes:
• Mortality, readmissions, hospital stay, and Medicare costs are statistically indistinguishable.
• While not universal, Osteopathic Manipulative Medicine (OMM) offers additional treatment options for musculoskeletal issues.

The bottom line suggests that whether MD or DO, your doctor delivers competent, comprehensive medical care.

The takeaway:

​DO graduates are rapidly increasing, and MD numbers are diminishing, especially in primary care. This underscores a broader acceptance and integration of osteopathic practices within mainstream medicine. For the average patient (hopefully, at least), this means more choice, a more holistic perspective, and consistently high-quality medical care, regardless of our doctor’s degree initials.

But what about us?

​For patients with microscopic colitis (MC) or other inflammatory autoimmune diseases, the growing number of DO physicians, alongside MDs, offers several meaningful differences that may impact diagnosis, treatment style, and patient experience. While both MDs and DOs are fully licensed physicians with equivalent prescribing and procedural rights, their training philosophy and clinical emphasis can influence how they approach complex, chronic illnesses like autoimmune conditions.

Will DO's holistic approach help?

DOs are trained to view the body as an interconnected system, emphasizing the relationship between structure and function. For MC and IBD patients, this might mean:

• Greater consideration of diet, stress, sleep, and gut–brain axis interactions
• More willingness to discuss lifestyle interventions such as stress management, elimination diets, or anti-inflammatory protocols alongside medication
• Autoimmune patients often struggle with systemic symptoms that don’t fit cleanly into one organ system. A DO might be more attuned to exploring root causes or overlapping syndromes.

DO training emphasizes prevention and chronic care.

DO training traditionally includes more primary care orientation, and focuses on preventing disease recurrence, not just managing flare-ups. In conditions like MC, this could mean:

• More attention to flare triggers, for example, antibiotic use, food intolerances, emotional stress)
• Greater focus on long-term gut health instead of acute symptom suppression alone

The many hours of musculoskeletal training that DOs eceive should help with:

• Pain management
• Autonomic nervous system balance
• GI motility

​Though not all DOs use osteopathic manipulative treatment (OMT) practice, those who do might offer gentle manual therapy as a complementary treatment — particularly helpful for patients with functional abdominal pain, stress-related GI symptoms, or pelvic floor dysfunction. Of course OMT does not "cure" autoimmune disease, but cit an offer non-pharmacological symptom relief, especially for associated conditions like IBS, fibromyalgia, or joint pain.

And DOs may be more familiar (or open) to patients whose symptoms cross conventional diagnostic boundaries:
​

• For example, the frequent MC related symptoms of fatigue, joint pain, histamine intolerance, or suspected mast cell activation
• This can reduce the risk of being dismissed as “just stress-related” or “too complex” when multiple systems are involved.

At least in theory, this all appears promising.

​I suppose we'll see how it works out in the real world. But whether our doctor is an MD or DO, we need to look for a provider who understands the complexity and individuality of autoimmune conditions, values shared decision-making, and doesn't rush to dismiss unexplained symptoms, because despite having many of the same symptoms, we're all different, in many respects.