Evidence-based · For exam prep, not medical advice
update Updated October 2026
Date of last content change
Built by surgery and anesthesiology residents·Written for USMLE Step 1
Category
MD (Allopathic)
DO (Osteopathic)
Administered by
LCME-accredited medical schools
COCA-accredited osteopathic schools
Who takes it
Allopathic medical school graduates
Osteopathic medical school graduates
Pass rate
USMLE Step 1: 93% of first-time US MD examinees passed in 2025
COMLEX Level 1 rates published by NBOME; USMLE Step 1: 89% of first-time US DO examinees passed in 2025
Key differences
compare_arrowsBoth degrees grant full medical licensure — no clinical privileges are restricted by degree type
compare_arrowsDO programs require additional training in osteopathic manipulative medicine (OMM)
compare_arrowsResidency match pools merged in 2020 — both MD and DO compete in NRMP
compare_arrowsDO applicants may take USMLE to be competitive for certain programs; MD applicants cannot take COMLEX
compare_arrowsMatch rates differ by specialty — highly competitive specialties still favor USMLE scores
error Common mistakes
× Believing DO graduates cannot enter competitive specialties — match data shows DOs match into every specialty, including surgical subspecialties
× Assuming DO school is 'easier to get into' — DO schools evaluate the same academic metrics with similar rigor
× Thinking COMLEX and USMLE are interchangeable — many residency programs still request USMLE scores from DO applicants
quiz Test yourself
Quick check
1. Which licensing exam pathway is required for DO graduates to practice medicine in the US?
Explanation. DO graduates are required to pass COMLEX (administered by NBOME) for licensure. USMLE is optional for DO students but is taken by many pursuing competitive residencies. States accept either pathway for medical licensure.
2. Since 2020, DO graduates applying to residency must:
Explanation. The AOA and NRMP matches merged in 2020. DO graduates now apply through the NRMP along with MD graduates in a unified match process.
Frequently asked questions
Do DO doctors have the same prescribing authority as MD doctors?expand_more
Yes. DOs have full, unrestricted prescribing authority in all 50 states and can practice in any clinical setting as attending physicians. The DO degree grants the same medical licensure as the MD in the United States.
Should a DO student take the USMLE in addition to COMLEX?expand_more
For students pursuing highly competitive specialties (dermatology, orthopedic surgery, radiology, ENT, neurosurgery), taking USMLE is strongly recommended — many programs require or prefer USMLE scores for initial screening. For less competitive specialties or primary care, COMLEX alone is typically sufficient.
Did the residency match really merge for MD and DO graduates?expand_more
Yes. In 2020, the AOA (osteopathic) match merged with the NRMP (allopathic) match. All residency programs now participate in a single match, meaning MD and DO graduates compete for the same positions. Some osteopathic-specific programs still exist for OMM-intensive training, but the general match is unified.
Apply what you know
Reinforce with spaced practice
Progress Note adapts to your knowledge gaps — so you spend time on what actually moves the needle.