By Dan Kersten
As I enter my junior year of undergraduate studies, it is time for me to start preparing myself for the long and painful experience of applying to medical schools. I have already registered for an MCAT review course and am fully prepared to not sleep for the next fifteen to thirty years. In tandem, I am now faced with a difficult decision: what type of medical school should I attend: a college of medicine (which gives out M.D. degrees) or a college of osteopathic medicine (which gives out D.O. degrees)?
Chances are if you or someone close to you is not in the medical field, you did not even know that there are two types of degrees. Two of my closest friends had no idea that there were two types of degrees, one of whom is planning to go into medicine. In fact, it seems that the American Osteopathic Association, the organization which represents osteopathic medical professionals and schools, has struggled with brand awareness. In 2014, it launched a national campaign to raise awareness of osteopathic medicine, hoping to raise awareness by at least ten percent.
So, what are the differences between the two degrees? They’re slim at best. To get into either type of school, one must take the MCAT and the same prerequisite courses. Both schools teach nearly the same curriculum, with an exception that D.O. schools also teach osteopathic manipulative therapy, the manipulation of bones and muscles in order to promote healing. To this extent, the M.D. approach is often billed as more oriented on the biochemistry behind health, D.O.s use a more “whole body” approach—looking at not only the biochemical but also environmental and social factors of the patient.
Graduates from either school have the same rights, responsibilities, and privileges for practice not only in United States, but also Australia and the United Kingdom (just to name a few). Furthermore, holders of either degree can be members in the American Medical Association. Yet there is one important and upsetting difference: the amount of respect towards the D.O. degree is significantly lower than that of the M.D.
I did not know there was such a difference until a few years prior. My father, a cardiologist, holds a D.O. degree. For the last three years, I have been performing clinical research under the guidance of an electrophysiologist—a specialist in cardiac arrhythmias—who holds an M.D. degree. The two physicians are both kind, funny, caring, and intelligent. The two physicians are also close friends and have been for about twenty years. From early in my childhood, I was aware of the existence of the two degrees. However, based off my father’s relationships with both types of doctor, I thought that the two schools of thought were in harmony with one another. In retrospect, I was quite naïve.
In the United States, it is sad to see that holding an M.D. degree is considered more prestigious than holding a D.O. degree. I remember the first time I heard of such practices. Another physician friend of my father, a fellow cardiologist and an M.D., recalled hearing a speech from a hospital’s chief medical officer, also an M.D., who joked that D.O.’s were of inferior status. My father laughed at this anecdote but I was mortified. How could a physician, a person of healing, hold such a bigoted idea? I hoped he was the only one. Once again, I was wrong.
Steven Salzberg, a professor of biomedical engineering, computer science, and biostatistics at Johns Hopkins University, weighed in on the M.D./D.O. controversy in a Forbes blog post. Sadly, Salzberg seems to fit right in with the crowd. He writes, “…when I’m looking for a doctor, I want someone who went to one of the best medical schools and received strictly science-based training. Colleges of osteopathic medicine do not fit the bill.” It is rather upsetting to hear this from a man who bills himself as a “fighter of pseudoscience.”
Why this schism in the American medical field still exists, I am still not able to quite fully comprehend. Medicine is struggling from increases in regulations and malpractice lawsuits, while simultaneously seeing a decrease in reimbursements from both the federal government and insurance companies. Infighting between the two degrees only inflicts more harm—a violation of the Hippocratic Oath.
In a response to Salzberg’s article, Larry Malerba, D.O., writes in Huffington Post, “… in the not-too-distant future, the medical profession as a whole will eschew the type of fear-based, fundamentalist intolerance epitomized by medical witch hunters like Mr. Salzberg. And when that day comes, medical diversity and tolerance, in the name of providing the best care possible to those in need of healing, will be the norm.” As a prospective physician, I can only hope that the future Dr. Malerba describes indeed comes to fruition.