Historically, Doctors of Osteopathic Medicine, or D.O.s, were often seen as primary care providers, focusing on family medicine, pediatrics, and internal medicine. However, in recent years, D.O.s have increasingly stepped into various medical specialties, such as psychiatry. As mental health awareness continues to grow, the demand for highly skilled psychiatrists is on the rise. This opens significant opportunities for D.O.s to bring their unique perspectives to psychiatric care. 

As a newly growing field, there’s still confusion about whether a D.O. can be a psychiatrist. In this blog, we’ll delve into how the journey to becoming a D.O. in psychiatry differs from the traditional Doctor of Medicine (M.D.) one. 

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What is a D.O.?

D.O.s are licensed physicians who take a whole-person approach to care. They look beyond symptoms to understand how lifestyle and environmental factors impact a patient’s well-being. D.O.s practice medicine similarly to M.D.s, diagnosing and treating illnesses, diseases, and injuries. However, they incorporate osteopathic and holistic methods and focus on preventive healthcare as well. When examining patients, they assess diet, environment, exercise, stress, sleep, and mental and physical health. 

As fully licensed physicians, D.O.s can prescribe medication, perform surgeries, and practice in all areas of medicine, including:

  • Primary care,
  • Obstetrics and Gynecology,
  • Surgery,
  • Psychiatry,
  • Emergency medicine.
  • Pediatrics. 

Can a Psychiatrist be D.O.?

After completing their educational and licensing requirements, D.O.s become full-fledged physicians with the same rights and responsibilities as M.D.s. This means after completing medical school, D.O.s can complete a residency in psychiatry. Residency programs in psychiatry typically take four years to complete and include extensive training in diagnosing and treating mental health disorders. 

During their training, D.O.s are trained to view the body as an integrated whole. In psychiatry, this means considering the physical, emotional, and environmental factors that contribute to mental health. Moreover, they learn the importance of preventive care and the role of lifestyle factors such as diet, exercise, and sleep in maintaining mental health. 

What is the Difference Between a D.O. and an M.D. in Psychiatry?

Like two roads diverging in a wood, the journey to becoming a psychiatrist can take two possible routes: a D.O. and an M.D. in psychiatry. While both paths lead to a career as a psychiatrist, there are significant differences between the two. Let’s explore them in detail. 

Educational background

To become licensed to practice as a psychiatrist, D.O.s and M.D.s undergo rigorous medical education. First, they must earn a bachelor’s degree and complete prerequisite courses in biology, biochemistry, chemistry, physics, mathematics, and English. Then, their paths diverge with D.O.s enrolling in osteopathic medical schools and M.D.s in allopathic medical schools.

Both types of medical schools take four years to complete and have a similar structure. In general, medical schools are divided into two phases: preclinical and clinical. The preclinical phase refers to the first two years of medical school, where students gain foundational knowledge in anatomy, pharmacology, pathology, etc., and gain hands-on experience in laboratory settings.

During the last two years of medical school, students transition from the classroom to clinical rotations. During this phase, students gain exposure to specialties like general surgery, internal medicine, neurology, pediatrics, and more. 

However, an inarguable difference between allopathic and osteopathic medical schools is that osteopathic students learn osteopathic manipulative treatment (OMT). Medical students in D.O. programs must complete 200 hours of training in OMT beyond the typical medical curriculum. During this part of training, D.O. students learn how to utilize the relationship between the neuroskeletal systems and the rest of the body to restore functionality and promote healing. 

Besides OMT, from the first days of medical school, D.O.s are trained to look past symptoms to understand the underlying cause of a condition or disease. They also learn of different alternative treatments to complement surgery and pharmaceuticals.

By combining this knowledge with the latest developments in medical technology, D.O.s can offer the most comprehensive care available today. 

Philosophical approach

One key difference between D.O.s and M.D.s is the philosophical approach to care. M.D.s take an allopathic approach, meaning they focus on contemporary, research-based medicine and often use medication to treat and manage conditions.

On the other hand, D.O.s practice an osteopathic approach to care. This means they look at past symptoms to determine how environmental and lifestyle factors may impact patients’ health and well-being.

To provide whole-person care, D.O.s stand by the four tenets of osteopathic medicine:

  1. The human body is able to self-heal and self-regulate;
  2. The human body is a unit made of mind, body, and spirit;
  3. Function and structure are equally interrelated;
  4. Rational treatment is based on a clear understanding of the principles stated above.

According to these principles, the human body is capable of incredible things when functioning at optimal levels mentally, physically, and spiritually. 

Clinical training and residency

Residency training is a valuable experience for both M.D.s and D.O.s. During their clinical training, both learn how to diagnose and treat mental health issues and gain valuable skills in various forms of psychotherapy.

Furthermore, they learn how to utilize psychiatric medications and other treatments to enhance patient outcomes. However, the clinical training for M.D.s and D.O.s still differs significantly, as osteopathic residencies have a greater emphasis on holistic approaches to mental health treatment. 

As of 2020, the American Osteopathic Association (AOA), the American Association of College of Osteopathic Medicine (AACOM), and the Accreditation Council for Graduate Medical Education (ACGME) implemented a single system for accrediting residency programs. This means all D.O. and M.D. graduates have access to the same pool of residency programs, including those in psychiatry. 

After graduating from medical school, D.O.s who pursue psychiatry can be trained in allopathic or osteopathic residency programs. These programs have equivalent criteria, allowing D.O.s to provide all the services M.D.s are licensed to provide.

D.O.s can also pursue residency programs that maintain Osteopathic Recognition, allowing them to learn osteopathic practice and principles at the graduate medical education level. Or they can pursue AOA-Legacy programs, former AOA programs that have transitioned to ACGME Accreditation. 

Certification and licensing

Both D.O.s and M.D.s undergo rigorous certification and licensing processes to practice psychiatry. D.O.s have the advantage of choosing between osteopathic-specific certification through the American Osteopathic Board of Neurology and Psychiatry (AOBNP) and the more widely recognized American Board of Psychiatry and Neurology (ABPN) certification. M.D.s, on the other hand, are certified exclusively through the ABPN. 

They also differ on the exams they need to pass to obtain their medical license. While M.D.s must take the three steps of the United States Medical Licensing Examination (USMLE), D.O.s must take the three levels of the Comprehensive Osteopathic Medical Licensing Examination of the United States (COMLEX-USA).

Many D.O.s also take the USMLE Step 1 in tandem with COMLEX Level 1 to provide a comparative measure that residency programs can use to assess their applications. 

Practice and treatment modalities

While the main goal of psychiatry for both M.D.s and D.O.s is to provide high-quality mental health care, their treatment modalities vary. M.D.s in psychiatry typically focus on identifying specific illnesses and conditions and using evidence-based treatments such as medication, hospitalization, and psychotherapy.

While D.O.s also utilize these treatments, they can also perform OMT, which can reduce anxiety and alleviate physical discomfort. OMT can also help blood circulation, so medications like antidepressants or antipsychotics have more perfusion into the brain. 

Furthermore, D.O.s are trained to evaluate the patient’s overall health, including the underlying biological, psychological, and social factors that contribute to mental health issues. They also consider the unique genetic, environmental, and lifestyle factors that can influence patients’ mental health. 


D.O.s have a unique perspective on patient care and can significantly contribute to the field of psychiatry, providing holistic care for mental health issues. While the path D.O.s must take to become psychiatrists may differ from the M.D. one in terms of education, clinical training, and certification requirements, both routes lead to a career as a psychiatrist.  

So, whether you’re an osteopathic student or a professional considering other specialties, psychiatry presents a viable and rewarding career path. By utilizing your osteopathic training, you can offer comprehensive care to mental health care, profoundly impacting your patients’ lives. 

Frequently Asked Questions

What does D.O. stand for in psychiatry?

The title D.O. in psychiatry stands for Doctor of Osteopathic Medicine. This title is awarded to physicians who have graduated from an osteopathic medical school. 

Should a psychiatrist be a D.O. or M.D.?

A psychiatrist can be either a D.O. or an M.D., both of which provide extensive knowledge and skills in the field. The choice between a D.O. and an M.D. often comes down to personal preference, as both types of physicians are well-equipped to diagnose and treat mental health conditions. 

Are there specific residency programs for D.O.s in psychiatry?

There are many psychiatry residency programs with osteopathic recognition or AOA-Legacy programs. 

Is there a difference in salary between D.O. and M.D. psychiatrists?

Generally, there are no significant differences in salary between D.O and M.D psychiatrists. Both undergo similar training, including medical school, residency, and any additional fellowship training, and they perform the same roles and responsibilities in clinical practice.

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