There are four general areas of qualification for doctors of osteopathic medicine:

  1. Professional education
  2. Board certification
  3. Continuing medical education
  4. Licensure

Professional education

Osteopathic physicians must graduate from an accredited osteopathic medical school in the United States. Medical school applicants must complete a course of undergraduate study (usually leading to a B.A. or B.S. degree with specific science courses), take the Medical College Admissions Test (MCAT) and complete a personal interview.

The Bureau of Professional Education of the AOA accredits these schools. The U.S. Department of Education and the Council on Postsecondary Education recognize the accreditation.

The curriculum of osteopathic medical school involves four years of academic study emphasizing preventative, family and community medicine:

  • Years 1 and 2 focus on instruction in the biomedical sciences
  • Years 3 and 4 are devoted to clinical training

Osteopathic manipulative therapy and osteopathic principles are integrated into the four-year curriculum and include 300 to 500 hours of instruction in the study of the body's neuro-musculo-skeletal system.

After medical school, doctors of osteopathic medicine complete a 12-month internship, rotating through all areas of medical care, including:

  • Internal medicine
  • Obstetrics/gynecology
  • General practice
  • Family practice
  • Pediatrics
  • Surgery

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In addition, osteopathic physicians may choose to complete a residency program, requiring 2 to 6 years of additional training, covering any of more than 120 specialty areas, including:

  • Anesthesiology
  • Family practice
  • Internal medicine (cardiology, pulmonology, etc.)
  • Neurosurgery
  • Orthopedic surgery
  • Physical medicine and rehabilitation (physiatry)
  • Radiology
  • Sports medicine

Board certification

Organized in 1939, the Bureau of Osteopathic Specialists of the American Osteopathic Association maintains standards for postdoctoral education and regulations for certification in the various specialty fields of osteopathic medicine.

The levels of certification are:

  • General Certification - the primary certification conferred on diplomates (doctors who have become board certified) who meet the requirements in a specified field of medical practice.
  • Certification of Special Qualifications - a subspecialty certification that requires prior attainment of general certification.
  • Certification of Added Qualifications - a modification of a general or special certification to reflect additional training of at least one year in length and satisfactory completion of a certifying examination in that field.

To be eligible for certification by the AOA, a candidate must:

  • Have completed a residency or internship and applied for eligibility within 6 years;
  • Be a member in good standing of the AOA;
  • Have met all the requirements of the specialty board; and
  • Have been accepted as a registrant by the specialty board.

An alternative pathway to certification exists for candidates who have not completed an internship. For those interested, information can be found by contacting the American Osteopathic Association.

Osteopathic physicians who emphasize the use of OMT in their practice are represented in the American Academy of Osteopathy (AAO), the official arm of the AOA authorized to certify the DO in neuromusculoskeletal medicine and osteopathic manipulative medicine (general certification).

Continuing medical education (CME)

To maintain certification, an osteopathic physician must:

  • Be a member of the AOA;
  • Pay the annual certification registration fee; and
  • Maintain a minimum of 150 hours of Continuing Medical Education credits within a 3-year period, at least one-third of which is in the general specialty.


All osteopathic doctors must pass a state medical board examination to receive a license to practice medicine. The examination and other requirements may vary by state. Most states accept the Comprehensive Osteopathic Medical Licensing Examination-USA for initial licensure. Some states require completion of an internship as a condition of licensure.


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