In recent years, the disparities between doctor of osteopathy (DO) and doctor of medicine (MD) applicants in securing coveted residency slots across various medical subspecialties have garnered increased attention. Despite the acceptance of DO-trained physicians within the broader medical community, there remains a significant discrepancy in match rates between DO and MD applicants in highly competitive specialties. This disparity is complex and multifaceted, requiring efforts from every level of the medical education system to address.

Digging deeper: Unearthing the causes of disparity

Three primary reasons underlie these disparities: historical biases, specialty culture, and disparities in research opportunities.

Historically, MD degrees have held a prestige that DO degrees have struggled to match. Despite DO and MD graduates receiving fundamentally similar training, the perception of DO graduates being less competitive persists, albeit increasingly outdated. This bias can influence program directors’ decisions during the residency selection process.

The culture of certain specialties also plays a significant role. MD-trained physicians have traditionally dominated fields like plastic surgery, neurosurgery, and thoracic surgery, making it harder for DO applicants to penetrate these specialties.

Finally, DO applicants may have fewer research opportunities than their MD counterparts. Research output is a significant factor in the competitiveness of residency applicants, and the fewer research opportunities at DO schools can disadvantage their students.

The hard numbers: a quantitative analysis of disparities

Data underscores the stark disparities in match rates between DO and MD applicants across competitive subspecialties:

Neurosurgery: In 2022, DO applicants had a 30.88% match rate, compared to MD applicants’ 74.82%.
Thoracic surgery: DO applicants had a 16.67% match rate, in stark contrast to MD applicants’ 46.45%.
Plastic surgery: DO applicants had a match rate of a mere 4.17%, while MD applicants saw a strikingly higher rate of 68.84%.
General surgery: DO applicants’ match rate stood at 57.62%, compared to 73.18% for MD applicants.
Vascular surgery: DO applicants achieved a 23.21% match rate, versus 74.18% for MD applicants.
ENT: DO applicants had a 53.10% match rate, compared to MD applicants’ 72.57%.
Orthopedics: DO applicants matched at a rate of 56.92%, whereas MD applicants enjoyed a higher rate of 72.51%.

A close look at dermatology reveals an equally significant disparity. In 2022, 40% of DO applicants secured a dermatology residency, while 60% of MD applicants did the same. This 20% gap signifies a concrete challenge for DO applicants aspiring to a career in dermatology.

Building bridges: strategies to overcome the disparity

To mitigate these discrepancies, several strategies should be employed:

Advocacy and awareness: National organizations and medical schools must promote the equal abilities of DO and MD graduates. The comparable training, clinical skills, and licensing requirements of these two paths should be emphasized.

Research opportunities: There’s a need to increase research opportunities at DO schools. Partnerships with MD institutions or dedicated funding for research projects can improve DO applicants’ competitiveness.

Mentorship and networking: Mentorship programs can be instrumental for DO students aiming for competitive specialties. Networking events can connect them with residency program directors and faculty, creating meaningful relationships and exposure opportunities.

Transparent selection criteria: Residency programs should clarify their selection criteria, enabling all applicants to understand what attributes are valued in the process. Residency programs should also clearly communicate if the type of degree (DO or MD) influences selection decisions.

Disparities between DO and MD match rates across competitive subspecialties underscore a significant issue within the medical community. However, with dedicated efforts, the gap can be bridged, ensuring that all applicants, irrespective of their degree, are evaluated on merit, skills, and dedication to their chosen field. We look forward to a future where the type of medical degree becomes irrelevant in the journey to becoming a competent and caring physician of your choosing.

Hannah Kopelman is a dermatologist.