Doctor of Osteopathic Medicine

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Physician education and training in the United States
Surgeon operating, Fitzsimons Army Medical Center, circa 1990.JPEG
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [2]


Overview

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, requiring four years to complete. Holders of the D.O. degree are known as osteopathic physicians. D.O.s are trained much in the same way as 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;[1] regardless, all of the 70 state boards are members of the Federation of State Medical Boards.[2] 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 (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.[3] 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."[4] 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.[5]

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 medical modalities.

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 U.S. Department of Education recognizes as physicians are graduates of osteopathic medical colleges in the United States.[6] 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 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.[7]

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:[8]

Country Year of Latest Policy Update Medical Practice Rights Requirements for Licensure
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.
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.
Austria 2009 Unlimited Hospital must have position unable to be filled by Austrian physician.
Bahamas 2004 Unlimited US license recognized.
Bahrain 2010 Unlimited US license recognized.
Barbados 1995 Limited OMM only.
Belize 2009 Unlimited
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.
Brazil 2007 Unlimited Completion of Brazilian board exam, establishing residency & some training in Brazilian hospital is required.
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 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.
Cayman Islands (UK) 1983 Unlimited US license recognized.
Central African Republic 1990 Unlimited US licensure and annual attendance at the National Congress for Physicians.
Chile 1993 Unlimited A written exam, in Spanish, is required.
China 2009 Unlimited US-DOs are permitted to apply for "Short Term Medical Practice."
Columbia 1996 Unlimited Same requirements as other foreign physicians.
Costa Rica 1993 Unlimited Same requirements as other foreign physicians.
Dominican Republic 2000 Unlimited US license & board certification recognized.
Ecuador 1990 Unlimited Same requirements as other foreign physicians. Reciprocity exists with most Latin American countries.
Egypt 2014 Unlimited Degree recognized by the health ministry; recognition of postgraduate training and Board Certification in process.
Ethiopia 2011 Unlimited
Finland 1996 Unlimited Same requirements as other foreign physicians.
France 2009 Limited OMM only. French government does not recognize full scope of practice osteopathic medicine.
The Gambia 2011 Unlimited
Germany 2008 Unlimited Same requirements as other foreign physicians. Depends on need. Decisions made on individual basis.
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.
Grenada 2007 Unlimited US license recognized.
Guatemala 2009 Unlimited Same requirements as other foreign physicians.
Grenada 2007 Unlimited US license recognized.
Guyana 1996 Unlimited Case-by case basis.
Haiti 2008 Unlimited US license recognized.
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).
Hong Kong 2012 Unlimited Written examination. Personal interview. Training approval.
India 2012 Unlimited for short-term work Full time licensure continues to be worked on through the Indian Medical Council.
Indonesia 1993 Unlimited & Restricted Foreign physicians affiliated with a university project or a mission have unlimited practice rights. No private practice allowed.
Israel 2007 Unlimited Same requirements as other foreign physicians. Hebrew required.
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.
Jordan 2012 Unlimited
Kenya 2012 Unlimited
Lebanon 2004 Unlimited AOA letter required. Examination required.
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.
Liberia 1990s Unlimited Same requirements as other foreign physicians.
Luxembourg 1987 Unlimited The practice of medicine in Luxembourg by a doctor who is not an EU national is very rare.
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.
Malawi 1991 Unlimited
Mexico 1998 Unlimited & Restricted Requires work permits - only available in conjunction with the association of a short-term medical mission project.
Micronesia 1993 Unlimited Statutes specifically include DOs
Nepal 2008 Unlimited Approval by the Nepal Medical Council & a visa from the Immigration Department.
Netherlands 2009 Unlimited Same requirements as other foreign physicians.
New Zealand 2008 Unlimited Hearing required. Case-by-case basis.
Nigeria 2010 Unlimited US Licensure and completion of specialty training required.
Norway 2009 Limited OMM only.
Pakistan 2011 Unlimited & Restriced Practice is confined to one hospital and may not engage in private practice.
Panama 2009 Unlimited Panamanian citizenship required.
Papua New Guinea 2010 Unlimited Work permit required. Short-term or a long-term volunteer service license also available.
Peru 2011 Unlimited
Poland 2009 Unlimited Examination & Polish required.
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.
Russia 2006 Unlimited Foreign physicians make arrangements to practice through Russian sponsors, such as hospitals or businesses.
Saint Lucia 2000 Unlimited US credentials recognized.
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.
Sierra Leone 1993 Unlimited Notarized US credentials.
South Africa 2009 Unlimited for outreach
Sweden 2005 Unlimited US license recognized.
Taiwan 2008 Unlimited The ROC government recognizes US DO degree. Applicants must take Taiwan Examination Yuan to obtain Taiwanese license.
Tanzania 1985 Unlimited Licensure will be granted to applicants with medical school degrees who have completed a required, although unspecified, residency.
Uganda 2008 Unlimited
United Arab Emirates 2009 Unlimited Examination required.
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.
Venezuela 2007 Unlimited Recognized legal status under the “law of the practice of medical.”
Vietnam 1995 Unlimited Foreign physicians can fill vacancies in hospitals that are in need of certain specialists.
Zambia 2012 Unlimited US licensure required.
Zimbabwe 2009 Limited OMM only.
Table data from AOA International Licensure Summary(updated July 2015).
OMM:Osteopathic Manipulative Medicine

See also

References

  1. Directory of State Medical and Osteopathic Boards, Federation of State Medical Boards
  2. Federation of State Medical Boards
  3. Colleges of Osteopathic Medicine, 2017 College Information Book, American Association of Colleges of Osteopathic Medicine, page 11
  4. 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.
  5. Doctor of Osteopathy (D.O.), MedLine Plus, National Library of Medicine, National Institutes of Health
  6. Notices. Federal Register. Vol. 70, No. 190. 3 Oct 2005. [1]
  7. 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
  8. [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

External links

  • US-Trained DOs in Ireland. American Osteopathic Association President's Blog. [3]




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