Choosing a career in medicine is a monumental decision, often driven by a passion for healing and a desire for a stable, rewarding profession. For aspiring physicians, a common question arises during the early stages of research: What is the salary difference between a Doctor of Osteopathic Medicine (DO) and a Doctor of Medicine (MD)? The short answer is encouraging: when it comes to compensation, the letters after your name matter far less than your specialty, location, and experience. Both paths lead to a lucrative and respected career, with the U.S. Bureau of Labor Statistics (BLS) reporting a median annual pay for all physicians and surgeons exceeding $239,200 as of May 2023.
This article will break down the nuances of physician compensation, debunk common myths, and provide a data-driven look at what truly influences a doctor's salary.
What Does a DO vs. an MD Do? Unpacking the Roles
Before diving into the numbers, it's crucial to understand that both MDs and DOs are fully licensed physicians in the United States. They undergo similarly rigorous medical training, are held to the same high standards by licensing boards, and can practice in any medical specialty, prescribe medication, and perform surgery.
- Doctor of Medicine (MD): Follows an allopathic approach, which focuses on diagnosing and treating diseases often using medications or surgery. This is the more common of the two degrees in the U.S.
- Doctor of Osteopathic Medicine (DO): Follows an osteopathic approach, which includes all the tools and training of allopathic medicine but adds a philosophy centered on a more holistic view of the patient. DOs receive additional, specialized training in the musculoskeletal system and a hands-on technique called Osteopathic Manipulative Treatment (OMT).
In practice, and especially in the eyes of hospitals, insurance companies, and patients, their day-to-day responsibilities and authority are identical. An orthopedic surgeon with a DO degree performs the same procedures as one with an MD.
Average Physician Salary: A Look at the Data for DOs and MDs
The most persistent myth in the DO vs. MD debate is that of a significant pay gap. However, data from the most reputable industry reports consistently shows this to be false. When factors like specialty, location, and experience are held constant, compensation is virtually the same.
According to the Medscape Physician Compensation Report 2023, one of the most comprehensive surveys in the industry, the difference in average income is minimal and likely influenced by specialty choice rather than degree type.
- Average MD Salary: $357,000 annually
- Average DO Salary: $346,000 annually
This slight difference is not considered statistically significant and is often attributed to the historically higher percentage of DOs who choose to enter primary care specialties, which tend to have lower compensation than surgical or procedural specialties. A DO cardiologist and an MD cardiologist in the same city with similar experience can expect to earn comparable salaries.
Similarly, general salary aggregators reflect high earning potential across the board. Salary.com reports the average "Physician - Generalist" salary in the U.S. to be around $226,719, with a typical range falling between $196,499 and $253,300, before factoring in specialization.
Key Factors That Influence Salary
The real drivers of a physician's salary have little to do with the letters "DO" or "MD." Instead, compensation is determined by a combination of professional choices and market forces.
### Area of Specialization
This is, by far, the most significant factor impacting a physician's earnings. The gap between primary care and specialized fields is substantial. Procedural and surgical specialties command the highest salaries due to the length of training, the complexity of the work, and reimbursement rates.
According to the Medscape 2023 report, the highest-paying specialties include:
1. Plastic Surgery: $619,000
2. Orthopedics: $573,000
3. Cardiology: $507,000
4. Urology: $506,000
5. Gastroenterology: $501,000
In contrast, while still offering excellent compensation, primary care and other non-procedural specialties are on the lower end of the spectrum:
- Family Medicine: $255,000
- Pediatrics: $251,000
- Public Health & Preventive Medicine: $249,000
### Years of Experience
Like most professions, income in medicine grows with experience. A physician's career earnings follow a distinct trajectory:
1. Residency/Fellowship: During this post-graduate training period (3-7+ years), physicians are known as residents or fellows. Their salaries are modest and relatively standardized, typically ranging from $60,000 to $80,000 depending on the institution and location.
2. Early Career (Attending Physician): Upon completing residency, a physician's salary jumps dramatically. This is the largest single pay increase they will experience.
3. Mid- to Senior-Career: Earnings continue to rise with experience, reputation, and potentially, partnership in a private practice. A physician with 15+ years of experience will generally earn more than someone just out of residency.
### Geographic Location
Where you practice matters immensely. Physician salaries are subject to supply and demand. States and regions with a lower cost of living and a higher need for physicians often offer more competitive compensation to attract talent.
The 2023 Doximity Physician Compensation Report highlights the top-paying metropolitan areas, which include cities like Charlotte, NC, and St. Louis, MO—not just major coastal hubs. The Medscape report also reveals significant state-by-state variation. For instance, physicians in states like Wisconsin, Indiana, and Georgia often report higher average incomes than those in states like Maryland, Colorado, and Massachusetts, even though the latter may have a higher cost of living.
### Practice Setting
The type of organization a physician works for also plays a key role in their compensation structure and potential.
- Self-Employed/Private Practice Partner: This setting offers the highest earning potential. According to Medscape, self-employed physicians earn an average of $394,000 per year. However, this comes with the responsibilities and costs of running a business.
- Hospital or Health System Employee: This is an increasingly common model offering a stable, predictable salary, benefits, and relief from administrative burdens.
- Multispecialty Group Practice: These groups offer a balance of autonomy and shared resources, with compensation often tied to productivity.
- Academic Medicine: Physicians working at universities typically earn less than their private-practice counterparts, but their roles often include a rewarding mix of teaching, research, and clinical care.
### Level of Education
For practicing physicians, the "level of education" is effectively the same: a doctorate (DO or MD) followed by post-graduate residency training. The true educational differentiator is the *length and type of post-graduate training*. A neurosurgeon's high salary is a direct result of completing one of the longest and most competitive residency programs. Therefore, the "education" that impacts salary is not the initial degree, but the residency and fellowship training that leads to a specific specialty.
Job Outlook
The career outlook for physicians is exceptionally strong. The U.S. Bureau of Labor Statistics (BLS) projects that employment for physicians and surgeons will grow by 3% from 2022 to 2032. This demand is driven by several factors, including the country's growing and aging population and the retirement of a large number of practicing physicians.
This sustained demand ensures that medicine remains a secure and stable career path for both aspiring DOs and MDs, with ample opportunities across all specialties and geographic regions.
Conclusion
For any student considering a future in medicine, the "DO vs. MD salary" question should be the least of their concerns. The evidence is clear: both degrees provide a pathway to a successful and financially rewarding career as a physician.
The key takeaways are:
- Pay is Virtually Equal: There is no significant, systemic pay gap between DOs and MDs when specialty and other factors are controlled.
- Specialty is King: Your choice of medical specialty is the single biggest determinant of your future income.
- You Control Your Path: Factors like where you choose to practice, your work setting, and your years of experience will have a far greater impact on your salary than your degree type.
Ultimately, the choice between pursuing a DO or an MD should be based on personal preference, educational philosophy, and which medical school is the best fit for you—not on a perceived difference in earning potential. Both paths will equip you to provide excellent patient care and build a prosperous and fulfilling career.