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If you’re planning to become a doctor, you may be debating whether to pursue an MD or DO degree. Both are fully qualified, licensed physicians with the same legal authority to diagnose and treat patients, prescribe medication, perform surgery, and practice in any medical specialty. So does earning a DO rather than an MD affect your salary after graduation?
The median or average salary for DO physicians may be lower than that of MD physicians, but this difference is largely related to the types of specialties physicians choose to practice. DOs are more highly represented in primary care specialties, which generally pay less than many technical and surgical specialties. When specialty, location, experience, and practice setting are taken into account, the difference in compensation between DOs and MDs can be relatively small.
Here’s a closer look at DO vs. MD in terms of education, training, and potential salary after graduation.
Key Points
• Both DO and MD degrees are fully licensed qualifications that authorize physicians to treat patients and practice in any medical specialty.
• Salary differences often reflect specialty distribution rather than an inherent pay gap between DO and MD degrees.
• DO programs emphasize a whole-person approach to health care, while MD programs follow a traditional allopathic medical education model.
• Physician compensation depends largely on specialty, location, experience, and practice setting rather than the degree type.
• When choosing between a DO or MD program, students may want to prioritize factors like educational philosophy and residency opportunities over potential salary.
What Is a DO vs an MD?
Doctors of Osteopathic Medicine (DOs) and Doctors of Medicine (MDs) are both licensed physicians who diagnose and treat patients. They complete four years of medical school followed by residency training, and both can pursue any medical specialty.
The primary difference between the two degrees involve their educational approaches and the training physicians receive in medical school.
DO programs emphasize a whole-person approach to care and include education in osteopathic principles and osteopathic manipulative medicine (OMM). Students learn how the body’s systems are interconnected and how musculoskeletal structure can relate to overall health. DO students also typically receive additional instruction and hands-on training in osteopathic manipulative techniques.
MD programs follow an allopathic medical education model, which traditionally emphasize the diagnosis and treatment.
In modern medical practice, however, the distinction between the two approaches is less pronounced than it once was. Both MDs and DOs receive extensive training in anatomy, physiology, pharmacology, pathology, and other medical sciences. Both also use evidence-based medicine and can pursue the same medical specialties after completing residency training.
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Average DO Salary
DO salaries vary widely depending on specialty, geographic location, experience, and practice setting. The average DO physician earns approximately $290,000, which is less than the average MD physician salary of $340,000. However, this may be largely due to differences in specialty rather than degree.
A 2026 analysis by SalaryDr estimated the following average annual salaries for DO physicians in selected specialties:
• Family Medicine: $263,000
• Internal Medicine: $287,000
• Emergency Medicine: $355,000
• Orthopedic Surgery: $690,000
• Anesthesiology: $425,000
• Cardiology: $505,000
• Psychiatry: $298,000
The numbers demonstrate how much specialty can affect physician salaries. A DO who becomes an orthopedic surgeon, for example, may earn substantially more than a DO who practices family medicine. Salary estimates can also vary significantly from one source to another, so it’s important to view these numbers as general estimates rather than guaranteed salaries.
Average MD Salary
While the average MD physician salary is $340,000, MD salaries also vary significantly by specialty, location, experience, and practice setting.
According to the same 2026 SalaryDr analysis, annual salaries for MD physicians in selected specialties are estimated at:
• Family Medicine: $265,000
• Internal Medicine: $290,000
• Emergency Medicine: $360,000
• Orthopedic Surgery: $700,000
• Anesthesiology: $430,000
• Cardiology: $510,000
• Psychiatry: $300,000
The estimated differences between MD and DO compensation in these specialties are relatively small. For example, the analysis estimates a difference of 0.8% in family medicine and 1.4% in orthopedic surgery. This suggests that specialty and other career factors can be much more important to salary than whether a physician has a DO or MD degree.
Why DO and MD Salaries Differ
DO and MD salaries can differ for a number of reasons, including specialty, geographic location, practice setting, experience, and the type of work a physician performs.
Specialization
Specialty is one of the biggest factors affecting physician compensation. DO physicians are more likely than MD physicians to practice in primary care specialties such as family medicine, internal medicine, and pediatrics. MD physicians make up a larger share of physicians in some highly compensated specialties, including certain surgical and procedural fields.
This difference in specialty distribution can make average DO compensation appear lower than average MD compensation. It doesn’t necessarily mean that physicians are paid less because they hold a DO degree. When a DO and an MD work in the same specialty and have similar experience, location, and practice arrangements, their pay may be comparable.
Practice Setting and Location
Where and how a physician practices can also affect pay. Physician salaries vary by geographic region, demand for particular specialties, cost of living, patient population, and practice setting.
For example, physicians practicing in rural or medically underserved areas may receive extra compensation or financial incentives designed to attract and retain health care professionals. Academic medical centers, hospitals, private practices, and outpatient clinics may also have different pay structures.
As a result, an MD working in one location or practice setting could earn less than a DO in another, even if their specialties are similar.
DO vs MD Requirements and Training
The paths to becoming a DO and an MD have many similarities. Both require extensive undergraduate education, medical school, residency training, licensing exams, and specialty certification.
How to Become a DO
To become a DO, you generally need to earn a bachelor’s degree, complete the prerequisite coursework required by medical schools, and take the Medical College Admission Test (MCAT). You then apply to an accredited osteopathic medical school.
Osteopathic medical school usually takes four years. Students complete classroom and laboratory instruction followed by clinical rotations. In addition to the standard medical curriculum, DO students receive training in osteopathic principles and osteopathic manipulative medicine.
After medical school, DO graduates complete residency training in their chosen specialty. Residency typically lasts three to eight years, depending on specialty.
DO students and graduates can take the three-part Comprehensive Osteopathic Medical Licensing Examination of the United States (COMLEX-USA). Some DO students also take the United States Medical Licensing Examination (USMLE), particularly if required or preferred by a residency program.
After residency, physicians may pursue specialty board certification. DOs can become board certified through an osteopathic specialty board or, depending on the specialty and eligibility requirements, a member board of the American Board of Medical Specialties (ABMS).
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How to Become an MD
The path to becoming an MD is similar. After high school, you generally complete a bachelor’s degree and the prerequisite coursework required by medical schools. You then take the MCAT and apply to an accredited allopathic medical school.
Medical school generally takes four years. Students complete foundational medical education followed by clinical training in hospitals, clinics, and other health care settings.
MD students typically take the United States Medical Licensing Examination (USMLE), a three-step examination process. Step 1 is generally taken during medical school, Step 2 includes clinical knowledge testing, and Step 3 is generally completed during residency.
After medical school, MD graduates complete residency training in their chosen specialty. Residency typically lasts three to seven years, although some specialties require longer training. Physicians may then pursue board certification in their specialty.
MDs and DOs can both apply for residency programs through the same graduate medical education system and can pursue the same specialties, including surgery, emergency medicine, anesthesiology, cardiology, psychiatry, and family medicine.
As you prepare for the academic rigors of either path, it’s also important to plan for the financial commitment involved. Both MD and DO students typically manage these costs through a combination of scholarships, grants, savings, and federal student loans, potentially turning to private health professions student loans to bridge any remaining funding gaps.
The Takeaway
An MD may have a higher average salary than a DO, but the difference doesn’t necessarily reflect a pay difference based solely on the degree. DO physicians are more likely to practice in primary care specialties, while MD physicians are more heavily represented in some higher-paying procedural and surgical specialties.
Both DOs and MDs are licensed physicians who can prescribe medication, perform surgery, and pursue any medical specialty after completing the appropriate training. Your specialty, location, experience, practice setting, and compensation structure can have a much greater effect on your earnings than whether you earn a DO or MD degree.
If you’re deciding between the two paths, you’ll want to consider factors beyond potential salary, including the medical schools available to you, admissions requirements, educational approach, residency opportunities, and the specialties you may want to pursue.
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FAQ
Can a DO earn as much as an MD?
Yes, a DO can earn as much as an MD, particularly when both physicians practice in the same specialty, location, and type of practice. Differences in average pay between DOs and MDs are influenced more by factors such as specialty, experience, practice setting, and geographic location than by the degree itself. DOs who pursue highly compensated specialties such as orthopedic surgery, anesthesiology, or cardiology can earn salaries comparable to MDs in those fields.
What specialties are available to DO physicians?
DO physicians can pursue any medical specialty, including family medicine, internal medicine, pediatrics, emergency medicine, psychiatry, anesthesiology, radiology, surgery, orthopedic surgery, and cardiology. After medical school, DO graduates apply for residency programs and complete the training required for their chosen specialty. A DO degree does not legally restrict a physician from practicing in a particular specialty.
Do DOs and MDs attend the same residency programs?
Yes, DO and MD graduates can apply to and train in the same residency programs. Since the transition to a single graduate medical education accreditation system, osteopathic and allopathic residency programs have been accredited through the Accreditation Council for Graduate Medical Education (ACGME). DO graduates may apply through the same residency application system as MD graduates. Individual programs can have their own selection criteria, so applicants should research the requirements and preferences of programs they are considering.
How does location affect DO vs. MD pay?
Location can significantly affect physician compensation. Pay can vary based on regional demand for physicians, specialty, cost of living, practice setting, and whether an area is medically underserved. Rural and underserved communities may offer higher compensation or financial incentives to attract physicians. Because DOs are more likely to practice in primary care and in some rural or community settings, their overall salary averages can differ from those of MDs. However, an individual DO can earn more than an MD depending on where each physician works and their specialty and experience.
How much medical school debt do DO and MD students typically graduate with?
Medical school debt varies by school, financial aid, scholarships, and whether students also borrow for undergraduate education. The AAMC reported that the average education debt for medical school graduates in the class of 2025 was $223,130. This figure includes medical education debt and premedical education debt and applies to graduates of MD-granting medical schools. There isn’t a directly comparable national figure from the AAMC for DO graduates, so prospective DO students should review debt and cost data for individual osteopathic medical schools.
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