My mother, who is from Greece, is visiting us and wasÂ amazed to hear that our program is a combinedÂ osteopathic and allopathicÂ program.Â She had no idea that chiropractors were used in the Emergency Department. In Europe, you see, osteopaths are not trained medical doctors but confine their practice to manipulation and other alternative therapies.Â In the United States, however, osteopaths, who are conferred the DO degree (Doctor of Osteopathic Medicine) are fully trained medical doctors and are without exception completely interchangeble with allopathic physicians, those with the traditional “MD” after their names.Â The confusion arises because osteopaths are far fewer in number than allopathic physicians and in some states, particularly my native Louisiana, are as scarce as hen’s teeth.Â I had never heard of osteopathic medicine before I started applying to medical school.
Osteopathy was founded shortly after the Civil War by Andrew Still,Â a former Army surgeon, in a reaction to the general quackish and barbaricÂ nature of most medicine at that time.Â He developed aÂ theory of medicine that, as it was based on the manipulation of bones,Â did not require drugs or surgery.Â Â His idea wasÂ that manipulation could restore the flow of blood and nervous impulses, the interruption ofÂ which he regarded as the cause of most diseases.Â Osteopathic Manipulative Treatment (OMT) has grown out of his theories into a treatment modality which is still taught at Osteopathic medical schools.Â
I say “still taught” because there is little or no good evidence that manipulation does anything other than make the patient feel subjectively better.Â Â Hell, you can get a topless massage in most cities and even a “happy ending” that probably would make you feel as subjectively better without all of the fanfare and the embarrassing questions about your diet and bad habits.Â Â In light of this there is a considerable sentiment among practicing osteopaths and osteopathic medical students that just as modern medicine has moved away from now discredited but once accepted treaments, it may be time to move away from OMT.Â I have asked many osteopaths if they use OMT and a typical answer is, “I’m not a believer.”
Whatever the case, except for several hundredÂ hours of training in OMT Â the science and clinical curricula areÂ similar enoughÂ between ostepathic and allopathic medical schools that graduation from an osteopathic medical school will lead to full licensure as a physician with no restrictions on your practiceÂ or the ability to receive additional fully accredited training.Â Not only are there osteopathic residency programs in every recognized medical specialty but osteopaths canÂ apply for allopathic residency positions as well (but not vice versa).
Many pre-meds apply to both types of schools to increase their chances of being accepted.Â I didn’t because I’m shallow and didn’t want to explain the initials after my name.Â This is actually not a problem in some parts of the country, particularly the upper midwest where osteopathic physicians are well known and respected.Â
Some people believe that it is easier to get into osteopathic medical schools and decide to use them as “back up” schools.Â This is the conventional wisdom but it’s silly if you think about it.
While the objective qualifications of allopathic matriculants (MCAT scores, GPA) are indeed slightly higher on averageÂ than their osteopathich counterparts, generally, if you’re not qualified for admission to an allopathic medical school you will not get into an osteopathic one either.Â Sure, the fierce partisans are quick to point out the higher average scores but these are the result of outliers.Â Like most things, the subjective qualificatons distribute themselves normally and it is only at the extremes where the curves don’t overlap.Â For my part, since I was an average applicant (at least by MCAT scores and BPCM GPA), almost half of osteopathic matriculants had better qualifications.
So think about this before you get too cocky.Â If you want to be an osteopath go to an osteopathic school.Â Â If you want to have the MD after your name you’d be better served just applying to more allopathic medical schools and taking your chances.Â The best osteopathic schools are alsoÂ better than the worst allopathic schools and they can afford to be more selective.
Osteopathy, aside from OMT, distinguishes itself from allopathy by purporting to be more patient-centered, viewing as they do the patient holisitically and not in the disjointed manner that allopaths are accused of doing.Â There is something to this but not enough to get excited about.Â Osteopathic schools push primary care hard and they’re serious about it, not just paying the usual lip service offered by people who wouldn’t be caught dead in primary care.Â Despite this (or because of it) many osteopaths specialize and have the same reasons to run screaming from primary care as anybody else.Â At our local College of Osteopathic Medicine, the students have related to me that they spend close to eight months of their clinical years on mandatory outpatient and ambulatory clinic rotations which will tend to make pathology look mighty good.
Keep this in mind if you thinkÂ primary careÂ ain’t your bag.
Osteopathy Disadvantages: Metaphysically, none.Â Full-fledged physicians in every specialty from neurosurgery to pediatrics.Â However, lingering prejudice in some states might make licensure more complicated (the requirement for an extra intern year for example).Â Also the COMLEX is reputed to be more difficult thant the USMLE, not to mention that the regulatory body for osteopathic residency programs is a lot more stringent about absolutely everything. (Paperwork, etc.)
Osteopathy Advantages: The ability to match into both allopathic and osteopathic residency programs.Â It’s true that you will have a disadvantage, all other things being equal, in the allopathic match but you won’t in your own and the rest is gravy.Â Not to mention that osteopathy has a certain retro coolness factor to it.