MD vs DO: Which One Wants Me?

Both are four-year programs built on the same basic and clinical sciences, and both lead to residency. DO students also get roughly 200 extra hours of osteopathic manipulative medicine, a hands-on approach to diagnosing and treating the musculoskeletal system.

The licensing exams are different. DO students have to pass the COMLEX-USA series to graduate, and the USMLE is optional for them. Plenty take both anyway. A 2022 study in the Journal of Graduate Medical Education, summarized by the AMA, found that 60 percent of DO students took at least one part of the USMLE.

Residency used to be split too. That ended on June 30, 2020, when the ACGME became the single accreditor for MD and DO residencies. Now MD and DO seniors apply to the same programs through the same NRMP Match.

The MD numbers come from the AAMC's 2025 cycle, and the DO counts from AACOM's 2025-26 data. The DO MCAT^® and GPA averages are from AACOM's 2022 applicant profile report, as reported by Magoosh, so they're a few years old. Treat them as approximate.

So both systems admit a similar share of the people who apply. Does that mean your odds are the same either way? No. Lots of people apply to both, and the two applicant pools aren't alike. The gap that matters for you is in the stats: about seven MCAT^® points and two tenths of a GPA point separate the average MD and DO matriculant.

The DO system is smaller, too. The LCME lists 165 accredited MD programs, 151 of them fully accredited. AACOM counts 48 colleges of osteopathic medicine at 75 teaching locations in 36 states, and DO students now make up nearly 30 percent of U.S. medical students.

One old shortcut is gone, by the way. AACOMAS used to replace a retaken course's grade with the new one. Since May 1, 2017, it averages every attempt, the same way AMCAS does. Applying DO won't erase that C from sophomore year.

The 2026 Match had 20,934 active U.S. MD seniors and 8,503 DO seniors. The DO match rate, 93.2 percent, was the highest on record. For comparison, U.S. citizens who went to international medical schools, a group that includes most Caribbean grads, matched at 70 percent.

Those overall rates hide a big split by specialty.

DO seniors filled 37 percent of emergency medicine spots and 31 percent of family medicine spots, well above their 21 percent share of all matches. In orthopaedic surgery, they filled 13 percent. In otolaryngology, neurosurgery and plastic surgery combined, just 36 DO seniors matched, out of 910 positions.

How much of that is choice, and how much is barriers? The tables can't tell you. Lots of DO students want primary care: 53 percent of osteopathic candidates matched into primary care programs in 2025. So part of the surgical gap is that fewer DOs apply, and part is programs that recruit mostly from MD schools. Either way, if you're a DO student set on plastic surgery, you're facing long odds that a DO student headed for emergency medicine never deals with.

• Your stats are close to the MD averages (around a 510 or higher MCAT^® and a 3.7 or higher GPA): apply broadly to MD schools. You can add DO schools to round out your list, but you don't need them as a backup the way other applicants do. The 3.5 and 510 breakdown shows how MD odds shift around that line.
• Your MCAT is in the low-to-mid 500s and your GPA is solid: your odds are better at DO schools, and lots of people in this range apply to both. The high GPA, low MCAT post covers that profile, and Should You Retake the MCAT? covers when a retake changes your odds.
• You want a surgical subspecialty: the MD route gives you more room. DO seniors do match into orthopaedics (121 this year), but neurosurgery and plastic surgery took just 13 between them.
• You want primary care, emergency medicine, psychiatry or pediatrics: the degree barely changes your options. DO seniors fill these at or above their overall share.
• You're choosing between a Caribbean MD and a U.S. DO: that 93 versus 70 percent match gap comes up again in the Caribbean question.

If you apply DO, expect a secondary asking why you want osteopathic medicine. Shadowing a DO before you apply gives you a real answer to write. It also helps to know how secondaries arrive before the fees start piling up.

Want to check your MCAT^® against these averages? The PurpleCAT MCAT score guide gives the percentile for every total score.