Career
Center Resources
Overview of Medicine |
What is Osteopathic Medicine?
| Is a D.O. different than an M.D.?
| What do Osteopathic Medical
Schools Teach? | Schools
and Colleges of Osteopathic Medicine | Nature
of the Work | Working
Conditions | Employment
| Training, Other Qualifications
and Advancement | Job Outlook
| Earnings | Related
Occupations | Sources
of Additional Information Significant
Points Physicians serve a fundamental role in our society and have an
effect upon all our lives. They diagnose illnesses and prescribe
and administer treatment for people suffering from injury or disease.
Physicians examine patients, obtain medical histories, and order,
perform, and interpret diagnostic tests. They counsel patients on
diet, hygiene, and preventive health care. There are two types of physicians: The M.D.-Doctor of Medicine-and
the D.O.-Doctor of Osteopathic Medicine. M.D.s are also known as
allopathic physicians. While both M.D.s and D.O.s may use all accepted
methods of treatment, including drugs and surgery, D.O.s place special
emphasis on the body's musculoskeletal system, preventive medicine,
and holistic patient care. About a third of M.D.s-and more than half of D.O.s-are primary
care physicians. They practice general and family medicine, general
internal medicine, or general pediatrics and are usually the first
health professionals patients consult. Primary care physicians tend
to see the same patients on a regular basis for preventive care
and to treat a variety of ailments. General and family practitioners
emphasize comprehensive health care for patients of all ages and
for the family as a group. Those in general internal medicine provide
care mainly for adults who may have problems associated with the
body's organs. General pediatricians focus on the whole range of
children's health issues. When appropriate, primary care physicians
refer patients to specialists, who are experts in medical fields
such as obstetrics and gynecology, cardiology, psychiatry, or surgery. Osteopathic medicine is a distinctive form of medical care founded
on the philosophy that all body systems are interrelated and dependent
upon one another for good health. This philosophy was developed
in 1874 by Dr. Andrew Taylor Still, who pioneered the concept of
"wellness" and recognized the importance of treating illness
within the context of the whole body. Osteopathic physicians use all of the tools available through modern
medicine Including prescription medicine and surgery. They also
incorporate osteopathic manipulative treatment (OMT) into their
regimen of patient care when appropriate. OMT is a set of manual
medicine techniques that may be used to relieve pain, restore range
of motion, and enhance the body's capacity to heal. Physicians licensed as Doctors of Osteopathic Medicine (D.O.s),
like their medical counterparts (M.D.s), must pass a national or
state medical board examination in order to obtain a license to
practice medicine. D.O.s provide comprehensive medical care to patients
in all 50 states and the District of Columbia . Currently, there are approximately 37,000 D.O.s practicing in the
United States . Reflecting the osteopathic philosophy of treating
the whole person, 57% of D.O.s serve in the primary care areas of
family medicine, general internal medicine, and general pediatrics,
often establishing their practices in medically underserved areas.
Another 43% are found in a wide range of medical specialties including
surgery, anesthesiology, sports medicine, geriatrics, and emergency
medicine. Still others serve as health care policy leaders at the
local, state, and national levels. In addition, increasing emphasis
on biomedcal research at several of the osteopathic colleges has
expanded opportunities for D.O.s interested in pursuing careers
in medical research. The osteopathic philosophy recognizes that the musculoskeletal
system comprises over 60% of the body and that there is a relationship
between body structure and organ functioning, giving a broader base
for the treatment of the patient as a whole. Another integral tenet
of osteopathic medicine is the body's innate ability to heal itself.
Many of osteopathic medicine's manipulative techniques are aimed
at reducing or eliminating the impediments to proper structure and
function so the self-healing mechanism can assume its role in restoring
the person to health. OMT is composed of structural and manipulative techniques that
today's osteopathic physicians may use to alleviate pain, restore
freedom of motion, and enhance the body's own healing power. Often
these techniques are used in conjunction with more conventional
forms of medical care, such as prescribing medication and performing
surgery. The following are some of the most commonly used manipulative
procedures: articulatory techniques, counterstrain, cranial treatment,
myrfascial release treatment, lympathic techniques, soft tissue
techniques, and thrust techniques. Osteopathic physicians, better known as D.O.s, work in partnership
with their patients. They consider the impact that lifestyle and
community have on the health of each individual, and they work to
erase barriers to good health. D.O.s are trained to look at the whole person from their first
day of medical school, which means they see each person as more
than just a collection of body parts that may become injured or
diseased. D.O.s are taught that the whole person is greater than
the sum of the parts. This means that osteopathic medical students learn how to integrate
the patient into the health care process as a partner. They are
trained to communicate with people from diverse backgrounds and
they get the opportunity to practice these skills in the classroom
with simulated patients. Because of this whole-person approach to
medicine, approximately 60% of all D.O.s choose to practice in the
primary care disciplines of family practice, general internal medicine,
and pediatrics. While D.O.s account for only 5% of the country's
physicians, they handle 10% of all primary care visit. Osteopathic medical students take courses in all of the subject
areas one would expect any physician to master including anatomy,
physiology, microbiology, histology, osteopathic principles and
practices (including osteopathic manipulative medicine), pharmacology,
clinical skills, doctor/patient communication, and systems courses
that focus on each major system of the body such as cardiology,
respiratory, genitourinary, etc. Many osteopathic colleges have students assigned to work with physicians
beginning early in the first year. This process continues throughout
the second year in conjunction with the basic sciences courses listed
above. In the third and fourth years, osteopathic medical students
spend time learning about and exploring the major specialties in
medicine. One unique aspect of the osteopathic student's education is how
these rotations are conducted in community hospitals and physicians'
offices across the country. Because few osteopathic colleges have
their own hospital, the schools partner with community hospitals
across the country to deliver the third and fourth year curriculum
as well as internship and residency training. This consortium model
of medical education developed by the osteopathic profession has
been touted as the new model for all medical education. Current
pilot studies are being developed on an national level to evaluate
this model of medical education. There are nineteen (19) schools and colleges of osteopathic medicine: Physicians and surgeons serve a fundamental role in our society
and have an effect upon all our lives. They diagnose illnesses and
prescribe and administer treatment for people suffering from injury
or disease. Physicians examine patients, obtain medical histories,
and order, perform, and interpret diagnostic tests. They counsel
patients on diet, hygiene, and preventive healthcare. There are two types of physicians: The M.D.-Doctor of Medicine-and
the D.O.-Doctor of Osteopathic Medicine. M.D.s also are known as
allopathic physicians. While both M.D.s and D.O.s may use all accepted
methods of treatment, including drugs and surgery, D.O.s place special
emphasis on the body's musculoskeletal system, preventive medicine,
and holistic patient care. About a third of M.D.s-and more than half of D.O.s-are primary
care physicians. They practice general and family medicine, general
internal medicine, or general pediatrics and usually are the first
health professionals patients consult. Primary care physicians tend
to see the same patients on a regular basis for preventive care
and to treat a variety of ailments. General and family practitioners
emphasize comprehensive healthcare for patients of all ages and
for the family as a group. Those in general internal medicine provide
care mainly for adults who may have problems associated with the
body's organs. General pediatricians focus on the whole range of
children's health issues. When appropriate, primary care physicians
refer patients to specialists, who are experts in medical fields
such as obstetrics and gynecology, cardiology, psychiatry, or surgery
(table 1). Table 1. Percent distribution of M.D.s by specialty, 1999
(Source: American Medical Association Specialty Percent
Total 100 Primary care Internal medicine 16.1 General and family practice 10.7 Pediatrics 7.5 Medical specialties Allergy 0.5 Cardiovascular diseases 2.5 Dermatology 1.2 Gastroenterology 1.3 Obstetrics and gynecology 4.9 Pediatric cardiology 0.2 Pulmonary diseases 1.0 Surgical specialties Colon and rectal surgery 0.1 General surgery 4.9 Neurological surgery 0.6 Ophthalmology 2.2 Orthopedic surgery 2.7 Otolaryngology 1.1 Plastic surgery 0.7 Thoracic surgery 0.1 Urological surgery 1.3 Other specialties Aerospace medicine 0.1 Anesthesiology 4.4 Child psychiatry 0.7 Diagnostic radiology 2.6 Emergency medicine 2.8 Forensic pathology 0.1 General preventive medicine 0.4 Neurology 1.5 Nuclear medicine 0.2 Occupational medicine 0.4 Pathology 2.3 Physical medicine and rehabilitation 0.8 0.8 Psychiatry 4.9 Public health 0.2 Radiology 1.0 Radiation oncology 0.5 Other specialty 0.7 Unspecified/unknown/inactive 16.0 D.O.s are more likely to be primary care providers than M.D.s,
although they can be found in all specialties. Over half of D.O.s
practice general or family medicine, general internal medicine,
or general pediatrics. Common specialties for D.O.s include emergency
medicine, anethesiology, obstetrics and gynecology, psychiatry,
and surgery. Surgeons are physicians who specialize in the treatment of injury,
disease, and deformity through operations. With patients under general
or local anesthesia, a surgeon operates using a variety of instruments
to correct physical deformities, repair bone and tissue after injuries,
or perform preventive surgeries on patients with debilitating diseases
or disorders. Though a large number perform general surgery, many
surgeons choose to specialize in a specific area. One of the most
prevalent specialties is orthopedic surgery, the treatment of the
skeletal system and associated organs. Others include ophthalmology
(treatment of the eye), neurological surgery (treatment of the brain
and nervous system), and plastic or reconstructive surgery. Surgeons,
like primary care and other specialist physicians, also examine
patients, perform, and interpret diagnostic tests, and counsel patients
on preventive healthcare. Many physicians work in small private offices or clinics, often
assisted by a small staff of nurses and other administrative personnel.
Increasingly, physicians practice in groups or healthcare organizations
that provide back-up coverage and allow for more time off. These
physicians often work as part of a team coordinating care for a
population of patients; they are less independent than solo practitioners
of the past. Surgeons typically work in well-lighted, sterile environments while
performing surgery and often stand for long periods. Most work in
hospitals or in surgical outpatient centers. Many physicians and
surgeons work long, irregular hours. Almost one-third of physicians
worked 60 hours or more a week in 2000. They must travel frequently
between office and hospital to care for their patients. Physicians
and surgeons who are on call deal with many patients' concerns over
the phone, and may make emergency visits to hospitals or nursing
homes. Physicians and surgeons held about 598,000 jobs in 2000. About
7 out of 10 were in office-based practice and about 2 out of 10
were employed by hospitals. Others practiced in the Federal Government,
most in U.S. Department of Veterans Affairs hospitals and clinics
or in the Public Health Service of the Department of Health and
Human Services. A growing number of physicians are partners or salaried employees
of group practices. Organized as clinics or as groups of physicians,
medical groups can afford expensive medical equipment and realize
other business advantages. Also, hospitals are integrating physician
practices into healthcare networks that provide a continuum of care
both inside and outside the hospital setting. The New England and Middle Atlantic States have the highest ratio
of physicians to population; the South Central States have the lowest.
D.O.s are more likely than M.D.s to practice in small cities and
towns and in rural areas. M.D.s tend to locate in urban areas, close
to hospital and educational centers. It takes many years of education and training to become a physician:
4 years of undergraduate school, 4 years of medical school, and
3 to 8 years of internship and residency, depending on the specialty
selected. A few medical schools offer a combined undergraduate and
medical school program that lasts 6 years instead of the customary
8 years. Premedical students must complete undergraduate work in physics,
biology, mathematics, English, and inorganic and organic chemistry.
Students also take courses in the humanities and the social sciences.
Some students also volunteer at local hospitals or clinics to gain
practical experience in the health professions. The minimum educational requirement for entry into a medical school
is 3 years of college; most applicants, however, have at least a
bachelor's degree, and many have advanced degrees. There are 144
medical schools in the United States-125 teach allopathic medicine
and award a Doctor of Medicine (M.D.) degree; 19 teach osteopathic
medicine and award the Doctor of Osteopathic Medicine (D.O.) degree.
Acceptance to medical school is very competitive. Applicants must
submit transcripts, scores from the Medical College Admission Test,
and letters of recommendation. Schools also consider character, personality, leadership qualities,
and participation in extracurricular activities. Most schools require
an interview with members of the admissions committee. Students spend most of the first 2 years of medical school in laboratories
and classrooms taking courses such as anatomy, biochemistry, physiology,
pharmacology, psychology, microbiology, pathology, medical ethics,
and laws governing medicine. They also learn to take medical histories,
examine patients, and diagnose illness. During the last 2 years, students work with patients under the
supervision of experienced physicians in hospitals and clinics to
learn acute, chronic, preventive, and rehabilitative care. Through
rotations in internal medicine, family practice, obstetrics and
gynecology, pediatrics, psychiatry, and surgery, they gain experience
in the diagnosis and treatment of illness. Following medical school, almost all M.D.s enter a residency-graduate
medical education in a specialty that takes the form of paid on-the-job
training, usually in a hospital. Most D.O.s serve a 12-month rotating
internship after graduation before entering a residency which may
last 2 to 6 years. Physicians may benefit from residencies in managed
care settings by gaining experience with this increasingly common
type of medical practice. All States, the District of Columbia , and U.S. territories license
physicians. To be licensed, physicians must graduate from an accredited
medical school, pass a licensing examination, and complete 1 to
7 years of graduate medical education. Although physicians licensed
in one State can usually get a license to practice in another without
further examination, some States limit reciprocity. Graduates of
foreign medical schools usually can qualify for licensure after
passing an examination and completing a U.S. residency. M.D.s and D.O.s seeking board certification in a specialty may
spend up to 7 years-depending on the specialty-in residency training.
A final examination immediately after residency, or after 1 or 2
years of practice, also is necessary for board certification by
the American Board of Medical Specialists (ABMS) or the American
Osteopathic Association (AOA). There are 24 specialty boards, ranging
from allergy and immunology to urology. For certification in a subspecialty,
physicians usually need another 1 to 2 years of residency. A physician's training is costly and, whereas education costs have
increased, student financial assistance has not. More than 80 percent
of medical students borrow money to cover their expenses. People who wish to become physicians must have a desire to serve
patients, be self-motivated, and be able to survive the pressures
and long hours of medical education and practice. Physicians also
must have a good bedside manner, emotional stability, and the ability
to make decisions in emergencies. Prospective physicians must be
willing to study throughout their career to keep up with medical
advances. They also will need to be flexible to respond to the changing
demands of a rapidly evolving health care environment. Employment of physicians and surgeons will grow about as fast as
the average for all occupations through the year 2010 due to continued
expansion of the health care industries. The growing and aging population
will drive overall growth in the demand for physician services.
In addition, new technologies will permit more intensive care: Physicians
will be able to do more tests, perform more procedures, and treat
conditions previously regarded as untreatable. Although job prospects may be better for primary care physicians
such as general and family practitioners, general pediatricians,
and general internists, a substantial number of jobs for specialists
will also be created in response to patient demand for access to
specialty care. The number of physicians in training has leveled off and is likely
to decrease over the next few years, alleviating the effects of
any physician oversupply. However, future physicians may be more
likely to work fewer hours, retire earlier, have lower earnings,
or have to practice in underserved areas. Opportunities should be
good in rural and low income areas, because some physicians find
these areas unattractive due to lower earnings potential, isolation
from medical colleagues, or other reasons. Unlike their predecessors, newly trained physicians face radically
different choices of where and how to practice. New physicians are
much less likely to enter solo practice and more likely to take
salaried jobs in group medical practices, clinics, and integrated
healthcare systems. Physicians have among the highest earnings of any occupation. According
to the latest data available from the American Medical Association,
median income, after expenses, for allopathic physicians was about
$160,000 in 1998. The middle 50 percent earned between $120,000
and $240,000 a year. Self-employed physicians-those who own or are
part owners of their medical practice-had higher median incomes
than salaried physicians. Earnings vary according to number of years
in practice, geographic region, hours worked, and skill, personality,
and professional reputation. As shown in table 2, median income
of allopathic physicians, after expenses, also varies by specialty. Table 2. Median net income of M.D.s after expenses, 1998
(SOURCE: American Medical Association) All physicians $160,000 Surgery 240,000 Radiology 230,000 Anesthesiology 210,000 Obstetrics/gynecology 200,000 Emergency medicine 184,000 Pathology 184,000 General internal medicine 140,000 General/Family practice 130,000 Psychiatry 130,000 Pediatrics 126,000 Physicians work to prevent, diagnose, and treat diseases, disorders,
and injuries. Professionals in other occupations requiring similar
skills and critical judgment include chiropractors, dentists, optometrists,
physician assistants, podiatrists, speech-language pathologists
and audiologists, and veterinarians. For a list of medical schools and residency programs, as well as
general information on premedical education, financial aid, and
medicine as a career, contact: Association of American Medical Colleges American Association of Colleges of Osteopathic Medicine For general information on physicians, contact: American Medical Association American Osteopathic Association Information on Federal scholarships and loans is available from
the directors of student financial aid at schools of medicine. Information
on licensing is available from State boards of examiners. Osteopathic Medicine
OVERVIEW OF MEDICINE
WHAT IS OSTEOPATHIC
MEDICINE?
Is a A D.O. different than an M.D.?
WHAT DO OSTEOPATHIC
MEDICAL SCHOOLS TEACH?
SCHOOLS AND COLLEGES OF OSTEOPATHIC
MEDICINE
Nature of the Work
Working Conditions
Employment
Training, Other Qualifications,
and Advancement
Job Outlook
Earnings
Related Occupations
Sources of Additional Information
Section for Student Services
2450 N St. NW.
Washington , DC 20037-1126
Internet: http://www.aamc.org/
5550 Friendship Blvd., Suite 310
Chevy Chase , MD 20815-7321
Internet: http://www.aacom.org
Department of Communications and Public Relations
515 N. State St.
Chicago , IL 60610
Internet: http://www.ama-assn.org
Department of Public Relations
142 East Ontario St.
Chicago , IL 60611
Internet: http://www.aoa-net.org
