Osteopathic Medicine: Take the Pepsi Challenge
by Thomas Kessler
Applying to medical school is a process that generally offers relatively few, if any, options. From the start of freshman year, you must take specific classes, get certain grades, volunteer at one of a few key places, and get outstanding MCAT scores. There is not a whole lot of space for improvisation. It is a precise formula, an unbending law, and a clearly paved path that strongly discourages trailblazing. No; when it comes to applying to medical school, there are hardly any options, but you might be surprised to know that the most important choice available is sadly one few people know about.
The truth is that there are actually two flavors of medical school: allopathic medical school and osteopathic medical school. Think of Coca-Cola and Pepsi. Allopathic medical school is the same Coke soft drink that you have been familiar with since you first realized you wanted to be a doctor. You probably drank it when you took the SAT, when you grabbed a seat at your first biology class, and when you got an A on your first chemistry test. Upon graduation, allopathic medical schools offer you the title “Medical Doctor” (MD).
These schools train physicians for primary and specialized clinical care. Graduates are fully licensed physicians who therefore have the authority to practice all specialties of medicine, order tests, work in hospitals, and prescribe drugs. You might like the taste of Coke. You might still be drinking it now; that is, you might still have a passion for an allopathic education. According to the Association of American Medical Colleges, there are 125 allopathic (MD) schools in the United States, all combining to graduate the great majority of physicians in the U.S.
MD schools may be what most patients and pre-medical students associate with medical institutions of learning, but there is another type of medical school option available. One that you might find offers the same fizz with a slightly different, sweet taste.
Coke might be good, but Pepsi might be better. You have probably heard little, if anything, about Osteopathic medical school. Graduates of this type of medical school are granted the title “Doctor of Osteopathic Medicine” (DO). The origin of this type of medical training came from founder Andrew T. Still’s desire in the late 1800’s to reform medicine into a more holistic and preventative form of care. Indeed, these ideals are still recognized as the two major principles by which DO’s practice.
According to the American Association of Colleges of Osteopathic Medicine (AACOM), there are currently 31 osteopathic medical schools in the United States, combining to account for around 7% of physicians nationwide. Osteopathic medical education has been growing rapidly over the last few decades, as almost one in every five medical students are being trained as DO’s.
Preparing for and applying to osteopathic medical school is very similar to the parallel allopathic process. Pepsi requires the same basic cola ingredients as Coke right? To that end, DO and MD schools both require the same basic qualifications. They both dictate the need for pre-medical students to take the MCAT as well as complete a basic science college curriculum. Generally that curriculum consists of eight credits of general chemistry, eight credits of organic chemistry, eight credits of biology, eight credits of physics, six credits of behavioral sciences, and maybe a few English credits thrown in there for carbonation. Volunteering, research, and shadowing all help to complete the full two liter product. Note that some schools require a letter of recommendation from a DO, which cannot be substituted by a letter from an MD physician.
As some of you may know by now, the entire application process is primarily done these days via an online system. Just as allopathic students use AMCAS (The American Medical College Application Service), osteopathic students use AACOMAS (The American Association Of Colleges Of Osteopathic Medicine Application Service). After primary applications are sent in, secondary applications may be requested by the individual schools, a process that is identical to allopathic applications.
Now for the question that everyone is asking: how difficult is it to get in? The stigma is that it is hardly difficult at all. The reason why I am addressing this issue is that there remains a portion of people in the medical community who believe that Pepsi will never be as good as Coke. That view however is far from the truth. First, the facts. For osteopathic medical schools, the entering class of 2010 demonstrated an average science GPA of 3.32, an average overall GPA of 3.43, and an average MCAT composite score of 25.63. The allopathic numbers for the same year was a average science GPA of 3.6, an average overall GPA of 3.66, and an average MCAT composite score of 30.8. This gap seems to be closing as the years pass.
Although this data seems to validate the stigma to a degree, it does not tell the entire story. Firstly, there are a number of DO schools, such as Des Moines University, Ohio University, and A.T. Kirksville, that expect numbers close to if not above the allopathic average. Secondly, osteopathic medical schools have historically considered applicants on a well rounded basis, stressing the importance of volunteering and shadowing in order to clearly illustrate one’s commitment to osteopathic principles. If you have a 4.0 GPA but lack the commitment to the DO philosophy of treatment, you will never make it to an interview.
Many patients refuse to be seen by DOs because they aren’t “real” doctors. A number of others will be seen only by DOs because of their unique training. Still, many more patients could care less. Which one you choose to be your doctor is your own preference.
The differences between these two camps are minimal at best, and are decreasing with each passing year. As MD’s and DO’s collaborate more frequently as colleagues, they are finding common ground in their universal desire to heal. Just as their allopathic counterparts, osteopathic physicians are fully licensed practitioners who have the authority to work in hospitals, prescribe medicine, and do just about anything else you would expect from a licensed medical doctor. Although they stress the importance and training of primary care physicians to promote preventative care, osteopathic schools do provide the education and clinical experiences necessary for one to pursue a career in any specialty.
The only tangible difference between DO and MD schools is an extra skill set that is taught only to osteopathic students. This skill is known as Osteopathic manual manipulation, OMM. OMM is a chiropractic- like method that gives DO’s an extra tool with which to diagnose and treat. This medical technique is characterized by the manipulation of the skeletal muscular system in various ways that aids in the process of relieving muscle pain and increasing mobility. Clearly, OMM might not cure cancer, but it is an extremely important tool in the bag of medical skills that only an osteopathic physician can use in certain cases.
Although different schools offer slightly different plans of study, it should be noted that the curriculums for osteopathic and allopathic schools are nearly identical. Two years of basic biomedical sciences (gross anatomy, genetics, physiology, etc.) are followed by two years of clinical experiences and rotations. At DO schools however, another class, Osteopathic Principles and Practice, is generally added to each of the first four semesters of education.
Where to go for your medical education is perhaps the greatest decision you will have to make in your pre-medical career. The choice can be a difficult one. All physicians have gone down this road. Many of them saw in themselves a desire to practice primary care medicine, a respect for the holistic nature of a patient, and the willingness to sacrifice precious time in order to develop a close relationship to those patients. Of those students, a number of them decided to go into a DO program because that is what fit them the best in regards to their principles. When considering what medical schools to apply to in the next couple of years, I would strongly encourage you to look into osteopathic medical schools and compare them to your allopathic choices. You might find a cool refreshing Pepsi to be more your fit.