To DO or not to DO? – Should I Apply to Osteopathic Medical School?

Categories Medical Education, Medical School, Osteopathic

So you've taken all your pre-requisite classes, took the Medical College Application Test (MCAT), and have spent the recommended time volunteering/shadowing/being a lab minion. It's time to apply to medical school! But wait... something's wrong. Maybe it was a "C+" in Organic Chemistry, or a less than stellar MCAT score (or even a combo of the two), but you find that your stats are below average for your dream school. Is it possible to repair the damage? The answer is, of course, YES! You can still become a physician, but it's may take some doing to get there. Here we will outline some of the steps you can take to bolster your application.


In the United States there are three distinct tiers of medical schools. These are, in order of prestige and competitiveness: US Allopathic (MD) Universities, US Osteopathic (DO) Universities, and Caribbean Allopathic (MD) Universities. There are definitely sub-tiers within these groups, but for simplicity sake I am going to ignore them for now. US Allopathic schools are typically the most competitive, with an average accepted GPA of 3.70 and average MCAT score of 31.4 (the new MCAT scoring method does not have any published data in regards to average accepted score, but preliminary reports show that 508 is a competitive score). But if you don't have these credentials, all hope is not lost. Osteopathic schools offer a way to repair your GPA, and have a slightly lower MCAT average acceptance score (average matriculate score was 499.32 in 2016).

For full disclosure, I was in the position outlined above and opted to attend an Osteopathic medical school. (For those of you who have never heard of an Osteopathic Physician, here is a brief summary.) Like hundreds of medical school hopefuls every year, my priorities during my undergrad years caused me to have a less than stellar GPA. I was able to fix the deficiencies in my application, gain an acceptance, and am now only a few months shy of finally graduating with my medical degree. If you want to be a physician in the United States, there are always options! However, the steps to get there vary based on the weaknesses in your application. Here are some of the most common questions and our suggestions for how to address them:

1. What do I do if my MCAT score is too low to be competitive?

This is a common situation that hundreds (if not thousands) of people find themselves in every year. Unfortunately, during medical school you will be constantly assessed via multiple choice exams, and your performance on them can dictate your future specialty choices. For these reasons, medical schools highly value your test-taking ability and demand extremely high performances (i.e. the 85th percentile or higher). Plus, because they occur so frequently, it's in your best interest to gain some proficiency in taking these kinds of tests. During my first year of medical school, we averaged at least one 150 question exam per week. The students who struggled with time management or overall test recall struggled significantly harder than the students who developed the skills to do well.

However there is good news! These skills can be learned! Studies have shown that students who take a test skills class perform significantly better than students who do not on multiple choice exams. Testing is a skill, and it pays to maximize your ability before you enter medical school. This is one of the primary benefits to taking an MCAT prep class. They have analyzed the test format and question styles, and teach strategies for answering each type.

But let's say you have taken a class (or two), retook the MCAT at least once, and feel like you score isn't likely to improve any more. Hopefully you close to, or at least not too far away from the average score of 500. Osteopathic medical schools will typically accept scores slightly below those taken by Allopathic medical schools. The average accepted Osteopathic MCAT score for the 2016 year was 27.2.

Overall: If a low MCAT score is the only major flaw in your application, then we highly recommend taking some time to solidify the your knowledge/exam skills and retake the test. There is no reason not to maximize your test score and apply/re-apply to US medical schools if your GPA is competitive. If you hover near the average, then Osteopathic medical schools can be a good option.

2. Help! My GPA ended up lower than I had hoped and now I'm afraid I won't get in anywhere! What can I do?

This problem is a little trickier than simply retaking the MCAT. You see, Allopathic and Osteopathic schools calculate your grades a little differently, which greatly affects how easy it will be to improve your GPA. From our previous example, say you retook Organic Chemistry (where you previously received a "C+") and by working harder than you ever have before, you receive an "A". Allopathic schools will see your improved grade, but will average it against your previous result. Thus, you will have an overall GPA in the 3.5 range for those two classes. If you only have one or two classes that gave you some trouble, then it is 100% possible to bring your GPA into a competitive range. But, if you are a science major (A.K.A. have many units worth of science classes) with sub-par grades, then this type of repair will result in only modest increases in your GPA at best.

However, sometimes you need more than just a little boost. Instead of averaging your retakes, Osteopathic schools will replace your previous grades with your new ones. That means instead of averaging out to a 3.5, that "A" you received in the second try at Organic Chemistry is now the only score that is included. Calculating your grades in this way allows for a quick and significant increase in your Overall and Science GPA. In the year before applying to medical school, I retook several classes and was able to increase my Science GPA over 0.5 points based on the Osteopathic grade calculation. Those same retakes would have resulted in only a 0.2 increase for the Allopathic application.

Overall: Osteopathic schools are a great option for people with significant GPA problems. Fix whatever academic problems you were facing, and use grade replacement to your advantage. If you have only minor grade problems, then the Allopathic averaging of your GPA can be sufficient. 

3. What about applying to Caribbean medical schools?

As a soon to be DO grad, I realize that my opinion here is biased. However, before I started the application process, I looked heavily into the "Big Three" Caribbean schools. I attended some of the information sessions held at my undergrad, met some recent graduates from their schools currently in residency, and even spoke on the phone with a student currently living on one of the islands. It sounds like an amazing option for those who struggle with gaining acceptance to US Allopathic programs; the required MCAT scores and GPA are very low, you get to study on a tropical island, the third and fourth year rotations are spent at US hospitals, and at first glance their residency placements seem strong. It almost sounds too good to be true right? (Hint, hint...)

The truth of the matter is that it CAN be an amazing option for a very limited subset of students. Hundreds of people graduate from these schools every year and go on to complete US residencies. However, these schools are notorious for providing very little support for their students, and often leave their graduates with few options in terms of residency locations and specialization. I won't go into the high attrition rate, or their students having to move all across the US during their 3rd and 4th years to find rotations, or even the pitfalls of living on one of the islands. Instead, I will focus on the much more important part: residency matching.

Almost every one of these schools with tout high match percentages in every specialty. When I was looking into going to Ross, the representative even told me that their match rate was higher than the average US school. Unfortunately all published data (not including the data from the schools' websites) points to the fact that a large portion of their students do not obtain residencies, and those that do end up in only a few specialties (specifically Pediatrics, Family Medicine, and Internal Medicine). In fact, the average match percentage for US IMGs (US Citizens who attend foreign schools, primarily Caribbean) is around 50-60% for most specialties. 

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Almost 4 in 10 of their graduates are left with hundreds of thousands of dollars in debt with no ability to pay it back. They technically have an MD after their name, but in order to practice medicine, they need continued training. Odds like these ultimately caused me to pursue attending an Osteopathic medical school. Osteopathic graduates have an 85-95% chance of matching into an Allopathic residency, and this number approaches 100% when the Osteopathic residencies are taken into account. I like these odds much better.

Overall: We only recommend applying to Caribbean medical schools as a last resort. These schools can and do provide a pathway to becoming a physician, but the risks are great. Only apply after attempting to attend a US medical school, or if you absolutely cannot stand the idea of a patient asking what a D.O. is once a week. 

Are you currently applying to medical school? How is it going? Are you considering applying to an Osteopathic or Caribbean school? Let us know in the comments!

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