View source for Doctor of Osteopathic Medicine

{{Redirect|D.O.|Diploma of Osteopathy|Osteopathy}}
{{Physician education and training in the United States}}
{{CMG}}
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==Overview==
'''Doctor of Osteopathic Medicine''' ('''D.O.''' or '''DO''') is an [[academic degree]] offered in the United States.  It is a [[Postgraduate education|graduate-level]] [[first professional degree]] for [[physicians]] and [[surgeons]], requiring four years to complete.  Holders of the D.O. degree are known as [[Osteopathic medicine in the United States|osteopathic]] physicians. D.O.s are trained much in the same way as [[Doctor of Medicine|M.D.s]], with the [[osteopathic manipulative medicine]] philosophy and techniques woven into the curriculum.  DOs are licensed to practice the full scope of [[medicine]] and [[surgery]] in all 50 states. Depending on state, licensure may be issued from a ''combined'' board (DO & MD) or a separate board of medical examiners;<ref>[http://www.fsmb.org/directory_smb.html/ ''Directory of State Medical and Osteopathic Boards,'' Federation of State Medical Boards]</ref> regardless, ''all'' of the 70 state boards are members of the Federation of State Medical Boards.<ref>[http://www.fsmb.org/index.html/ Federation of State Medical Boards]</ref> Many DOs practice in [[primary care]] ([[family medicine]], [[internal medicine]], [[pediatrics]], [[OB/GYN]]) or [[emergency medicine]], but DOs can be found in every medical specialty, from [[psychiatry]] to [[neurosurgery]].

In the United States, the D.O. and the M.D. are the only two degrees permitting licensure as medical physicians. Osteopathic medical school curricula closely mirrors those of allopathic ([[Doctor of Medicine|MD]]) medical schools, both requiring 4 years of training in the basic and clinical sciences and include licensing exams). The first two years focus on the biomedical and clinical sciences, followed by core clinical training in the clinical specialties.  Osteopathic medical school accreditation standards require training in internal medicine, obstetrics/gynecology, pediatrics, family practice, surgery, psychiatry, emergency medicine, radiology, preventive medicine and public health.<ref>[http://www.aacom.org/docs/default-source/cib/cib_web_full-publication.pdf?sfvrsn=30/ Colleges of Osteopathic Medicine, 2017 College Information Book, American Association of Colleges of Osteopathic Medicine, page 11]</ref> According to [[Harrison's Principles of Internal Medicine]], "the training, practice, credentialing, licensure, and reimbursement of osteopathic physicians is virtually indistinguishable from those of allopathic physicians, with 4 years of osteopathic medical school followed by specialty and subspecialty training and [board] certification."<ref name="Harrisons">Dennis L. Kasper, Eugene Braunwald, Anthony S. Fauci, Stephen L. Hauser, Dan L. Longo, J. Larry Jameson, and Kurt J. Isselbacher, Eds. ''Chapter 10. Complementary and Alternative Medicine'' Harrison's Principles of Internal Medicine, 16th Ed. 2005. McGraw Hill.</ref> However, osteopathic physicians also receive an additional 300 - 500 hours in the study of hands-on manual medicine and the body's musculoskeletal system integrated into the medical curriculum.<ref>[https://www.nlm.nih.gov/medlineplus/ency/article/002020.htm ''Doctor of Osteopathy (D.O.),'' MedLine Plus, National Library of Medicine, National Institutes of Health]</ref> 

Although U. S. osteopathic medical physicians currently may obtain licensure in 65 countries, osteopathic curricula in countries other than the United States differs. D.O.s outside the U. S. are known as "osteopaths" and their scope of practice excludes some conventional medical therapies, relying more exclusively on [[osteopathic manipulative medicine]] and other [[alternative medicine|alternative medical modalities]].

{{see also|Osteopathic medicine in the United States|Comparison of M.D. and D.O.}}

==International variations in the D.O. degree ==
In the United States, doctors of osteopathic medicine are physicians who are also trained in [[osteopathic manipulative medicine]].

The only osteopathic practitioners that the [[United States Department of Education|U.S. Department of Education]] recognizes as physicians are graduates of [[List of medical schools in the United States|osteopathic medical colleges in the United States]].<ref>''Notices.'' Federal Register. Vol. 70, No. 190. 3 Oct 2005. [http://www.ed.gov/legislation/FedRegister/other/2005-4/100305b.pdf]</ref> There are currently ''no'' osteopathic programs located outside of the United States that qualify an individual to practice as an osteopathic physician in the United States. Foreign osteopathic degrees are not recognized as being equivalent to American D.O. degree for the purpose of medical licensure in any US state. On the other hand, US-trained D.O.s are currently able to practice in 65 countries with full medical rights and in several others with restricted rights.

Every country has different requirements and a different way of licensing or registering osteopathic physicians and osteopaths.

In [[France]], [[Germany]],and [[Switzerland]], some osteopathic practitioners are [[Doctors of Medicine|M.D.s]] who take additional courses in [[osteopathy]] after completing their [[Medical Education|medical training]]. In the [[United Kingdom]], [[Canada]], [[Australia]], and [[New Zealand]], “osteopaths" are trained in osteopathic principles and [[Osteopathic manipulative medicine|osteopathic manipulative treatment]] but are not physicians.

According to the BIOMEA, in most countries outside the United States, D.O. stands for “diploma of osteopathy,” not “doctor of osteopathic medicine.”  The difference is that osteopaths are not trained or licensed as physicians, and therefore do not carry the same practice rights, such as surgery and prescribing medication. However, osteopaths in some countries do act as primary care providers, coordinating treatment with fully licensed [[primary care]] physicians.<ref>McNerney, Joseph. Chairman, Bureau on International Osteopathic Medical Education and Affairs. [http://www.jaoa.org/cgi/reprint/107/1/6.pdf ''Osteopathic Degrees Overseas: Response.''] [[J Am Osteopath Assoc]] Jan 2007 Vol 107;No 1 p 7</ref>

===International practice rights for US-trained Osteopathic Physicians===

The following is an '''International Licensure Summary''' for US-trained Doctors of Osteopathic Medicine, as listed by the [[American Osteopathic Association]]:<ref>[http://www.osteopathic.org/inside-aoa/development/licensure/Documents/2015-aoa-international-licensure-summary.pdf/ ''AOA International License Summary,’’ Council on International Osteopathic Medical Education & Affairs, American Osteopathic Association, July 2015''</ref>
{| class="wikitable sortable"
|-
! colspan="2" width="85pt" | Country
! width="85pt" | Year of Latest Policy Update
! width="85pt" | Medical Practice Rights
! Requirements for Licensure
|-
| colspan="2" |Argentina
|2006
|Unlimited
|Foreign physicians must submit credentials to various agencies and then appear before any of the National Universities in order to have their diploma recognized. 
|-
| colspan="2" | Australia
|2013
|Varies by state
|A The Medical Board of Australia has stated that they will now recognize the U.S. DO degree for purposes of registration in Australia. However, this is only for recognition of the degree, in order to be registered (licensed) your training and credentials must be approved by the appropriate specialist college.
|-
| colspan="2" | Austria
|2009
|Unlimited
|Hospital must have position unable to be filled by Austrian physician.
|-
| colspan="2" | Bahamas
|2004
|Unlimited
|US license recognized.
|-
| colspan="2" | Bahrain
|2010
|Unlimited
|US license recognized.
|-
| colspan="2" | Barbados
|1995
|Limited
|OMM only.
|-
| colspan="2" | Belize
|2009
|Unlimited
|-
| colspan="2" | Bermuda
|1997
|Unlimited
|Required at least 2 years of GME and examination or interview by the Council’s Examination Committee.  Non-Bermudans must have approval from the Ministry of Labour & Home Affairs to work on the island.
|-
| colspan="2" | Brazil
|2007
|Unlimited
|Completion of Brazilian board exam, establishing residency & some training in Brazilian hospital is required.
|-
| rowspan="12" | Canada (varies by province)
|Alberta
|
|Unlimited
|Requires at least 2 years of GME accredited by the ACGME or AOA and must have passed the Universities Coordinating Council Exam, a basic sciences exam, and have passed all three parts of the [[Licentiate of the Medical Council of Canada|LMCC]].
|-
|British Columbia
|
|Unlimited
|Requires at least 1 year of GME approved by the AOA or the ACGME, completed at least 1 year of GME in Canada, passed all three parts of the LMCC. 
|-
|Manitoba
|
|Unlimited
|US license recognized.
|-
|New Brunswick
|
|Unlimited
|Requires at least 2 years of GME approved by the AOA or the ACGME and have passed all 3 parts of the LMCC.  Reciprocity pathway for DOs with a Maine license.
|-
|Newfoundland
|
|Pending
|Currently under review. It is anticipated that establishing guidelines may take a couple of years.
|-
|NW Territories
|
|Unlimited
|The government will grant registration to any physician that qualifies for licensure in any other province.
|-
|Nova Scotia
|
|Unlimited
|Requires a Canadian or [[ACGME]] residency.
|-
|Ontario
|
|Unlimited
|The Premier of Ontario and the College of Physicians and Surgeons of Ontario (CPSO) now accepts the COMLEX-USA exam (only with the Level 2-PE) and USMLE with USMLE Step 2 CS (Clinical Skills) or ECFMG (Educational Commission for Foreign Medical Graduates) CSA (Clinical Skills Assessment) as equivalent to the Medical Council of Canada Qualifying Examination (MCCQE).
|-
|Prince Edward Island
|
|Restricted
|No provision for licensing US-trained DOs.
|-
|Quebec
|
|Unlimited
|Requires 1 year of GME approved by the AOA or ACGME, 1 year of GME in Quebec passed the written, oral and clinical board examination of the College of Family Physicians of Canada and must speak French fluently.
|-
|Saskatchewan
|
|Limited
|OMM only.
|-
|Yukon Territory
|
|Unlimited
|Government will grant registration to any physician that qualifies for licensure in any other province.
|-
| colspan="2" | Cayman Islands (UK)
|1983
|Unlimited
|US license recognized.
|-
| colspan="2" | Central African Republic
|1990
|Unlimited
|US licensure and annual attendance at the National Congress for Physicians. 
|-
| colspan="2" | Chile
|1993
|Unlimited
|A written exam, in Spanish, is required.
|-
| colspan="2" | China
|2009
|Unlimited
|US-DOs are permitted to apply for "Short Term Medical Practice." 
|-
| colspan="2" | Columbia
|1996
|Unlimited
|Same requirements as other foreign physicians.
|-
| colspan="2" | Costa Rica
|1993
|Unlimited
|Same requirements as other foreign physicians.
|-
| colspan="2" | Dominican Republic
|2000
|Unlimited
|US license & board certification recognized.
|-
| colspan="2" | Ecuador
|1990
|Unlimited
|Same requirements as other foreign physicians. Reciprocity exists with most Latin American countries.
|-
| colspan="2" | Egypt
|2014
|Unlimited
|Degree recognized by the health ministry; recognition of postgraduate training and Board Certification in process.
|-
| colspan="2" | Ethiopia
|2011
|Unlimited
|-
| colspan="2" | Finland
|1996
|Unlimited
|Same requirements as other foreign physicians.
|-
| colspan="2" |France
|2009
|Limited
|OMM only. French government does not recognize full scope of practice osteopathic medicine.
|-
| colspan="2" | The Gambia
|2011
|Unlimited
|-
| colspan="2" |Germany
|2008
|Unlimited
|Same requirements as other foreign physicians. Depends on need. Decisions made on individual basis.
|-
| colspan="2" |Greece
|2009
|Unlimited
|Greek citizenship required, unless in rare instances, there exists a crucial need for certain types of specialist physicians. Further, a work permit must be obtained, a difficult task, and speaking Greek is an unwritten requirement. These are the same requirements as other foreign physicians.
|-
| colspan="2" |Grenada
|2007
|Unlimited
|US license recognized.
|-
| colspan="2" | Guatemala
|2009
|Unlimited
|Same requirements as other foreign physicians.
|-
| colspan="2" |Grenada
|2007
|Unlimited
|US license recognized.
|-
| colspan="2" |Guyana
|1996
|Unlimited
|Case-by case basis.
|-
| colspan="2" |Haiti
|2008
|Unlimited
|US license recognized.
|-
| colspan="2" |Honduras
|2009
|Unlimited
|National Autonomous University must accredit all foreign titles. After accreditation is completed, the applicant must seek registration with the Medical College of Honduras (MCH).
|-
| colspan="2" |Hong Kong
|2012
|Unlimited
|Written examination. Personal interview. Training approval.
|-
| colspan="2" |India
|2012
|Unlimited for short-term work
|Full time licensure continues to be worked on through the Indian Medical Council.
|-
| colspan="2" |Indonesia
|1993
|Unlimited & Restricted
|Foreign physicians affiliated with a university project or a mission have unlimited practice rights.  No private practice allowed.
|-
| colspan="2" |Israel
|2007
|Unlimited
|Same requirements as other foreign physicians.  Hebrew required.
|-
| colspan="2" |Italy
|2009
|Unlimited
|Physicians are discouraged from seeking employment in Italy without firm contracts and work permits. If there is a U.S. state law outlining reciprocity with Italy, a statement to this effect from the Italian Consulate will warrant better chances. 
|-
| colspan="2" |Jordan
|2012
|Unlimited 
|
|-
| colspan="2" |Kenya
| 2012
|Unlimited
| 
|-
| colspan="2" |Lebanon
|2004
|Unlimited
|AOA letter required.  Examination required.
|-
| colspan="2" |Lesotho
|1990s
|Unlimited
|Applicants must appear before the Medical, Dental and Pharmacy Council to answer some medical questions and present their credentials.  The Council will also make a recommendation about where the applicant’s skills would be most helpful in the country.
|-
| colspan="2" |Liberia 
|1990s
|Unlimited
|Same requirements as other foreign physicians.
|-
| colspan="2" |Luxembourg
|1987
|Unlimited
|The practice of medicine in Luxembourg by a doctor who is not an EU national is very rare. 
|-
| colspan="2" |Malta
|2010
|Unlimited
|Accepted on a case by case basis, if training meets the minimum educational requirements for physicians in the EU (Article 24 of Directive 2005/36/EC).  Examination required.
|-
| colspan="2" |Malawi
|1991
|Unlimited
| 
|-
| colspan="2" |Mexico
|1998
|Unlimited & Restricted
|Requires work permits - only available in conjunction with the association of a short-term medical mission project. 
|-
| colspan="2" |Micronesia
|1993
|Unlimited
|Statutes specifically include DOs
|-
| colspan="2" |Nepal
|2008
|Unlimited
|Approval by the Nepal Medical Council & a visa from the Immigration Department. 
|-
| colspan="2" |Netherlands 
|2009
|Unlimited
|Same requirements as other foreign physicians.
|-
| colspan="2" |New Zealand
|2008
|Unlimited
|Hearing required. Case-by-case basis.
|-
| colspan="2" |Nigeria
|2010
|Unlimited
|US Licensure and completion of specialty training required.
|-
| colspan="2" |Norway
|2009
|Limited
|OMM only.
|-
| colspan="2" |Pakistan
|2011
|Unlimited & Restriced
|Practice is confined to one hospital and may not engage in private practice. 
|-
| colspan="2" |Panama
|2009
|Unlimited
|Panamanian citizenship required. 
|-
| colspan="2" |Papua New Guinea
|2010
|Unlimited
|Work permit required. Short-term or a long-term volunteer service license also available.
|-
| colspan="2" |Peru
|2011
|Unlimited
|
|-
| colspan="2" |Poland
|2009
|Unlimited
|Examination & Polish required.
|-
| colspan="2" |Qatar
|2011
|Unlimited
|All physicians who apply to be registered under a general scope of practice must pass (i) the NHA oral examination and (ii) the NHA written examination or equivalent.
|-
| colspan="2" |Russia
|2006
|Unlimited
|Foreign physicians make arrangements to practice through Russian sponsors, such as hospitals or businesses.
|-
| colspan="2" |Saint Lucia
|2000
|Unlimited
|US credentials recognized.
|-
| colspan="2" |Saudi Arabia
|2009
|Unlimited
|Foreign physician must be recruited by a government agency, a corporation or a private health care entity, such as a hospital.
|-
| colspan="2" |Sierra Leone
|1993
|Unlimited
|Notarized US credentials.
|-
| colspan="2" |South Africa
|2009
|Unlimited for outreach
|
|-
| colspan="2" |Sweden
|2005
|Unlimited
|US license recognized.
|-
| colspan="2" |Taiwan
|2008
|Unlimited
|The [[Republic of China|ROC]] government recognizes US DO degree.  Applicants must take Taiwan Examination Yuan to obtain Taiwanese license.
|-
| colspan="2" |Tanzania
|1985
|Unlimited
|Licensure will be granted to applicants with medical school degrees who have completed a required, although unspecified, residency.
|-
| colspan="2" |Uganda
|2008
|Unlimited
|
|-
| colspan="2" |United Arab Emirates
|2009
|Unlimited
|Examination required.
|-
| colspan="2" |United Kingdom
|2005
|Unlimited
|For GMC registration as a specialist, postgraduate training will need to be separately recognized by the Postgraduate Medical Education and Training Board (PMETB). GOsC registration is also required.
|-
| colspan="2" |Venezuela
|2007
|Unlimited
|Recognized legal status under the “law of the practice of medical.”
|-
| colspan="2" |Vietnam
|1995
|Unlimited
|Foreign physicians can fill vacancies in hospitals that are in need of certain specialists.
|-
| colspan="2" |Zambia
|2012
|Unlimited
|US licensure required.
|-
| colspan="2" |Zimbabwe
|2009
|Limited
|OMM only.
|-
| colspan="5" | '''Table data from ''AOA International Licensure Summary'''(updated July 2015).
|-
| colspan="5" | '''OMM:[[Osteopathic Manipulative Medicine]]'''
|}

==See also==
* [[List of Osteopathic Medical Schools]]

== References ==
{{reflist|2}}

==External links==
* ''US-Trained DOs in Ireland.''  American Osteopathic Association President's Blog. [http://blogs.do-online.org/aoapresident.php?itemid=2311]


{{Academic degrees|state=uncollapsed}}

{{Medicine|state=uncollapsed}}

[[Category:Osteopathic medicine]]
[[Category:Doctoral degrees|Osteopathic medicine]]
[[Category:Medical degrees|Osteopathic medicine]]

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