For years, the comprehensive exams that followed their training programs separated osteopathic physicians, or DOs, and their medical-doctor counterparts, or MDs. In addition, some states didn't allow osteopaths to practice in the same variety of health settings.
Since 1985, residency programs have had the option to be dual-accredited by both MD and DO organizations. In 2015, all DO and MD programs will be accredited by the Accreditation Council for Graduate Medical Education, eliminating any legal or licensing distinction between the two.
And the changes are not just on paper: Few osteopathic graduates seem to experience the backlash of a system that used to favor conventional physicians.
Marc Bertrand, the associate dean for graduate medical education at Dartmouth-Hitchcock Medical Center, said that osteopathic graduates are being admitted to competitive residency programs across various specialties and are filling about 5 percent of all residencies at Dartmouth.
He also pointed out that osteopathic physicians, including the center's chief executive, James Weinstein, hold several leadership positions in the nation's academic health system. "If you need a reflection of what we think of DOs, that's a good one," he said. "We're just looking for the folks who have demonstrated ability to excel."
Even so, osteopathic medical schools have come under scrutiny for having lower overall admission test scores and grades than traditional programs. On forums such as StudentDoctor.net, medical school applicants have discussed whether DO schools serve solely as backups for MD schools. And only one, the Michigan State University School of Osteopathy, is ranked by U.S. News and World Report in the highest tiers of medical school programs for primary care.
James Wolfe, president of Edward Via College of Osteopathic Medicine in Blacksburg, Va., said these perceptions do not reflect the quality of training available. Osteopathic physicians participate in almost every prestigious medical residency program and have recently started to publish more research with their MD peers, he said.