Doctor of Osteopathic Medicine (D.O. or DO) is an academic degree offered in the United States. It is a graduate-level first professional degree for physicians and surgeons, usually requiring four years to complete. Holders of the D.O. degree are known as osteopathic physicians, while holders of the similar, but more common M.D. degree are known as allopathic physicians. The existence of this distinction and of D.O.s as licensed physicians is not widely known.[1]
Although U. S. osteopathic medical physicians currently may obtain licensure in 47 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 allopathic medical therapies and relies more exclusively on osteopathic manipulative medicine and other alternative medical modalities.
In France, Germany,and Switzerland, some osteopathic practitioners are M.D.s who take additional courses in osteopathy after completing their medical training. In the United Kingdom, Canada, Australia, and New Zealand, “osteopaths" are trained in osteopathic principles and 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.[2]
Current status and scope of practice
While there are approximately 55,000 D.O.s practicing within the United States, this number represents only 6% of all practicing physicians. D.O.'s may obtain licensure in any of the fifty states and practice in all medical specialties including, but not limited to, family medicine, internal medicine, emergency medicine, dermatology, surgery, and radiology. The D.O. degree is the legal and professional equivalent of the M.D. degree and as such there is no difference in compensation between allopathic and osteopathic physicians.
International practice rights
Every country has different requirements and a different way of licensing or registering osteopathic physicians and osteopaths. The only osteopathic practitioners that the U.S. Department of Education recognizes as physicians are graduates of osteopathic medical colleges in the United States.[3] Therefore, osteopaths who have trained outside the United States are not eligible for medical licensure in the United States. On the other hand, US-trained D.O.s are currently able to practice in 45 countries with full medical rights and in several others with restricted rights.
The following is a table of International Practice Rights of U.S trained Doctors of Osteopathic Medicine, as listed by the American Osteopathic Association.[4]
Country
Year of latest policy
Medical Practice Rights
Requirements for Licensure
Argentina
1994
Unlimited.
Full license granted to US-trained D.O.
Australia
2000
Restricted.
Varies by state.
Austria
1994
Unlimited.
Hospital must have position unable to be filled by Austrian physician.
Bahamas
1997
Unlimited.
US license recognized.
Bolivia
1988
Unknown.
No response from embassy.
Brazil
2000
Unlimited.
Completion of Brazilian board exam & some training in Brazilian hospital is required.
Canada (varies by province)
Alberta
Unlimited.
LMCC, Step 1&2 required
British Columbia
Unlimited.
LMCC required
Manitoba
Unlimited.
US license recognized.
New Brunswick
Unlimited.
LMCC required, except DOs registered in Maine
Newfoundland
Pending.
Currently under review.
NW Territories
Unlimited.
US license recognized.
Nova Scotia
Unlimited.
Only D.O.s from ACGME (US or Canadian) residency.
Ontario
Unlimited.
Only D.O.s from ACGME residency.
Prince Edward I.
Restricted.
No provision for US D.O.
Quebec
Unlimited.
1 year GME in Quebec & French fluency required.
Saskatchewan
Limited.
OMM only.
Yukon Territory
Unlimited.
US license recognized.
Cayman Islands (UK)
1983
Unlimited.
US license recognized.
Chile
1993.
Unlimited.
A written exam, in Spanish, is required.
China
1994
Unlimited.
US-DOs are permitted to apply for "Short Term Medical Practice" only.
Costa Rica
1993
Unlimited.
Several requirements. (Same as for any foreign MD.)
Denmark
1995
Unknown.
No response from embassy.
Dominican Republic
2000
Unlimited.
US license recognized.
Ecuador
Unlimited.
Several. Same as for any foreign MD.
Finland
1996
Unlimited.
Several. Same as for any foreign MD.
France
1988
Restricted.
OMM only. French government does not recognize osteopathic medicine.
Germany
1993
Unlimited.
No special requirements. Decisions made on individual basis.
Greece
2004
Unlimited.
Difficult. Greek citizenship required.
Hong Kong
1998
Unlimited.
Written examination. Personal interview. Training approval.
India
1999
Undetermined.
Indian nationality status required.
Indonesia
1992
Unlimited.
All foreign physicians affiliated with a University project or a mission have unlimited practice rights. No private practice allowed.
Ireland
1999
Under review.
The Irish government has repeated declined to recognize US trained D.O.s as physicians. The American Osteopathic Association president has said that obtaining unlimited practice rights for US-trained D.O.s in Ireland is a top priority in 2007.[5]
Lebanon
2004
Unlimited.
AOA letter required. Examination required.
New Zealand
2005
Unlimited.
Hearing required. Case-by-case basis.
Nigeria
1999
Unlimited.
An appearance before the Nigerian Medical Council & an oral quiz.
Singapore
1993
None.
Singapore does not recognize US DO degree. Only recognizes US MD degree from 37 US allopathic schools.[6]
Spain
1994
None.
No medical practice rights.
Sweden
1996
Unlimited.
US license recognized.
Taiwan
2005
Unlimited.
The ROC government recognizes US D.O. degree. Applicants must take Taiwan Examination Yuan to obtain Taiwanese license.
United Kingdom
2005
Unlimited.
US-trained DOs eligible for full medical practice rights. Applicants must pass the PLAB examination and work for one year in the National Health Service. Following that year, the applicants will be able to apply for a license to practice privately.
Table data from AOA International License Summary.[4]
References
^ Gevitz N. Visible and recognized: osteopathic invisibility syndrome and the 2% solution. The DO. March 1997:23-4, 26-7. PMID: 9107129
^ McNerney, Joseph. Chairman, Bureau on International Osteopathic Medical Education and Affairs. Osteopathic Degrees Overseas: Response. J Am Osteopath Assoc Jan 2007 Vol 107;No 1 p 7
^Notices. Federal Register. Vol. 70, No. 190. 3 Oct 2005. [1]
^ abAOA International License Summary. American Osteopathic Association. Council on International Osteopathic Medical Education and Affairs.[2]
^ Peter B. Ajluni US-Trained DOs in Ireland. AOA president's blog. 12 Mar 2007. [3]
^Registrable Basic Medical Degrees. Singapore Medical Council accessed Oct 2007.