Alternative Routes to Becoming a Physician: Podiatry School

We’re exploring alternatives to the MD. Check back throughout the week as we provide some facts and figures and guidance on osteopathic, Caribbean, and podiatry programs.

Podiatry School

A podiatrist is a physician or surgeon who treats the feet. Podiatric programs cost less than MD and DO programs, and the surgical residencies are not as long. After graduation, you'd be entering a secure, lucrative field that usually has a humane number of work hours per week.

The average GPA and MCAT requirements for Doctor of Podiatric Medicine (DPM) programs are lower than U.S. MD and DO programs. In 2021, the American Association of Colleges of Podiatric Medicine (AACPM) reported that the mean overall GPA for matriculants was 3.4 (Science: 3.2, Non-Science: 3.5), and the mean MCAT was 494.3

When You Should Apply:

If you’re applying to podiatry school, you want to apply the August before or early fall of your senior year. (If you plan on going to podiatry school right after undergrad.) The American Association of Colleges of Podiatric Medicine Application Service (AACPMAS) begins processing primary applications in August for fall admission the following year. For priority consideration, the AACPMAS says you should submit before March. The final application deadline date is June 30th for fall admission of the same year. But don’t be on this last train out of town!

Where You Should Apply:

The AACPM website is an incredible resource for information on podiatry schools. We're talking breakdowns of each accredited school's mission, cost, special programs and services, demographics, and social media handles. If you're interested in podiatry, check out the info on all 11 accredited schools.

Alternative Routes to Becoming a Physician: Caribbean MD programs

We’re exploring alternatives to the MD. Check back throughout the week as we provide some facts and figures and guidance on osteopathic, Caribbean, and podiatry programs.

Caribbean MD Programs

Students with lower MCAT scores and GPAs are more likely to be accepted to allopathic schools abroad than in the U.S. Schools in the Caribbean are especially interested in students from the U.S., Puerto Rico, and Canada.

It's likely that way more doctors than you think graduated from international schools. From 2010 to 2020, the number of licensed physicians who graduated from international medical schools increased by 24%. "About one-quarter (24.7%) of active physicians in 2020 were international medical graduates (IMGs)," according to the Association of American Medical Colleges. "This includes U.S. citizens who studied abroad."

When You Should Apply:

Off-shore schools have rolling admissions (and have multiple start dates). We think you should start submitting applications to these programs with your U.S.-based allopathic applications in June.

Where You Should Apply:

Of the 80 Caribbean medical schools, we recommend "The Big Four" to clients. All have key international accreditations; they are recognized by the World Federation for Medical Education/Foundation for Advancement of International Medical Education and Research (WFME/ FAIMER). They are also recognized by stricter state medical boards (like California's). These top Caribbean schools also have competitive residency placement rates and other boast-worthy qualities.

St. George's University / Grenada, West Indies: As of December 2020, the average MCAT score of matriculants was 498. Their average undergraduate GPA was 3.3. St. George's has a strong reputation for students passing the USMLE Step 1 (95%), USMLE Step 2 (91%), and for residency placement. SGU secured more than 990 U.S. residencies in 2022. The Grenada-based program has been the largest provider of doctors into first-year U.S. residencies for the last eight years.

Saba University School of Medicine / Saba: Saba told us that as of April 2022, the average GPA of matriculants was 3.19 and the average MCAT was 497. Saba is smaller than SGU, so it has fewer graduates becoming residents—but their stats are strong. Between 2019 and 2021, 94% of graduates obtained residencies. The average first-time pass rate for the USMLE between 2015 and 2020 was 99%.

American University of the Caribbean School of Medicine / St. Maarten: In January 2022, the average GPA for matriculants was 3.27; the average MCAT score was 496. AUC has a 93.2% pass rate for the USMLE Step 1, a 92.8% pass rate for the USMLE Step 2 CK, and 96% of 20212022 graduates attained residencies. AUC's clinical rotations take place at Accreditation Council for Graduate Medical Education-approved hospitals. It has clinical teaching affiliates in the U.S. and the U.K., and students can take global health electives in the Dominican Republic, Russia, Uganda, Vietnam, and Zimbabwe.

Ross University School of Medicine / Bridgetown, Barbados: RUSM emphasizes remedying systemic bias in healthcare in their curriculum—and on campus. Diversity in the student body and faculty is highly valued. They have rolling admissions; prospective students can apply anytime. Matriculants can start school in January, May, or September. The majority of clinical training takes place in the United States. 2022 graduates had a residency match rate of 96% and the school has consistently had a 91% first-time pass rate for the USMLE Step 1 and Step 2.

Alternative Routes to Becoming a Physician: Osteopathic Programs

If your GPA or MCAT is low-ish, it's time to consider all of your options. Osteopathic schools, off-shore MD programs, and podiatry schools are all roads that lead to you becoming a physician. And they are open to folks with lower GPAs and MCAT scores. It's not that these programs aren't competitive—they are—they're just not as competitive as many allopathic schools in the U.S.

This week, we’ll provide some facts and figures and guidance on osteopathic, Caribbean, and podiatry programs.

Osteopathic Programs

Plenty of applicants apply to osteopathic programs because they know they want to be DOs. You may have visions of that MD after your name. But if you're interested in holistic medical practices and primary care especially, one of the 42 accredited DO programs in the United States might be right for you.

In May 2021, the American Osteopathic Association's Physician Masterfile reported that 56.5% of osteopathic doctors practiced primary care. That covers a broad set of opportunities, including becoming an OB/GYN and a pediatrician. In 2022, nine Colleges of Osteopathic Medicine were in U.S. News & World Report's list of the top 10 schools with the most graduates practicing primary care. (Yep, them and one allopathic school.)

There is no shame in the DO game. One in four medical students in the United States attends an osteopathic program, according to the AOA. Much of an osteopathic classroom and clinical medical education is like an allopathic one. Additionally, osteopathic programs involve 200 hours of osteopathic manipulative medicine (OMM) training, which focuses on the spine, bones, and muscles.

You can find out more about osteopathic programs by attending an American Association of Colleges of Osteopathic Medicine (AACOM) virtual fair. Their ChooseDo.org website for prospective students can also give you valuable info on programs, tuition, application deadlines, etc.

Shadowing an osteopathic doctor will give you an idea of their day-to-day practice. And you'll have plenty of DOs to choose from: The 2020-21 Osteopathic Medical Profession (OMP) Report stated that there were 135,000 osteopathic physicians in America in 2021—an 80% increase over the past decade. DOs make up 11% of doctors and 26% of medical students in the country. And according to the American Association of Colleges of Osteopathic Medicine, 99.3% of DO graduates are placed in residencies.

If you're applying to an osteopathic program, you should have shadowed a DO or better yet worked with one. You'll also need a recommendation letter from an osteopathic physician—and we mean need—you must show a real interest here.

When You Should Apply:

The AACOM application opens in May. Deadlines for osteopathic programs are in February and March. You can check out the AACOM Choose DO Explorer for exact dates for each school. But we’d like to see you apply to these programs in October, just as allopathic schools start getting back to applicants.

Where You Should Apply:

No exaggeration: All U.S. osteopathic programs are good. The Commission on Osteopathic College Accreditation (COCA)'s standards are strict. Check out the AACOM site for more information on the 42 accredited colleges of osteopathic medicine, which have 67 teaching locations in 36 states.

Applying to Both Allopathic and Osteopathic Medical Programs? Here’s What You Need to Know.

If you’re a prospective medical student, particularly one interested in primary care, it’s a good idea to consider osteopathic medical programs in addition to allopathic ones. While many students grow up dreaming of an MD behind their name, osteopathic medicine continues to grow in popularity. One in four medical students in the United States attends an osteopathic program, according to the American Osteopathic Association (AOA). 

The program requirements for MD and DO programs are similar, although osteopathic students are required to take an additional 200 hours of osteopathic manipulative medicine (OMM) training, which focuses on the spine, bones, and muscles. “Osteopathic physicians use all of the tools and technology available to modern medicine with the added benefits of a holistic philosophy and a system of hands-on diagnosis and treatment known as osteopathic manipulative medicine. Doctors of osteopathic medicine emphasize helping each person achieve a high level of wellness by focusing on health education, injury prevention, and disease prevention,” the AACOM says.

Additionally, while osteopathic programs are highly competitive, entrants typically have slightly lower GPAs and MCAT scores than their allopathic counterparts.

Mean GPA and MCAT scores for Entering 2023: Osteopathic Students:

• Overall GPA: 3.61

• Science: 3.52

• Non-Science: 3.71

• Overall MCAT: 503.9

• Psychological, Social, and Bio: 126.9

• Bio and Biochemical: 126.1

• Chemical and Physical: 125.7

• Critical Analysis and Reasoning: 125.2

Mean GPA and MCAT scores for Entering 2023 Allopathic Students:

• Overall GPA: 3.77

• Science: 3.71

• Non-Science: 3.85

• Overall MCAT: 511.7

• Psychological, Social, and Bio: 128.9

• Bio and Biochemical: 128.1

• Chemical and Physical: 127.8

• Critical Analysis and Reasoning: 127.0

Recipients of both degrees have similarly high residency match rates (over 90 percent for both in 2023), though DOs tend to specialize in primary care at higher rates. In May 2021, the AOA’s Physician Masterfile reported that 56.5% of osteopathic doctors (DOs) practiced primary care (including specialties like obstetrics and gynecology and pediatrics). And in 2022, nine colleges of osteopathic medicine were in U.S. News & World Report’s list of the top 10 schools with the most graduates practicing primary care. 

Among the more competitive specialties, MDs continue to outnumber DOs in residency placement. But DOs can increase their competitiveness by taking the USMLE (MD accreditation) in addition to the COMLEX (DO accreditation). 

Sounds appealing? Here’s what to keep in mind for your DO application:

• Submit your AMCAS and secondary applications first. Then, turn to your osteopathic applications (AACOMAS), which you’ll want to submit by October. 

• Spend at least 20 hours working alongside a DO and ensure your application demonstrates your understanding of and motivation to pursue a career in osteopathic medicine.

• Request a recommendation letter from a DO. 

• Review the guidelines for any program where you would be considered in-state, as some schools must admit a certain percentage of in-state students.

• Review the residency placements for the DO programs you are considering to ensure the school’s placements align with your goals. 

Applying to Both Allopathic and Osteopathic Medical Programs? Here’s What You Need to Know.

If you’re a prospective medical student, particularly one interested in primary care, it’s a good idea to consider osteopathic medical programs in addition to allopathic ones. While many students grow up dreaming of an MD behind their name, osteopathic medicine continues to grow in popularity. One in four medical students in the United States attends an osteopathic program, according to the American Osteopathic Association (AOA). 

The program requirements for MD and DO programs are similar, although osteopathic students are required to take an additional 200 hours of osteopathic manipulative medicine (OMM) training, which focuses on the spine, bones, and muscles. “Osteopathic physicians use all of the tools and technology available to modern medicine with the added benefits of a holistic philosophy and a system of hands-on diagnosis and treatment known as osteopathic manipulative medicine. Doctors of osteopathic medicine emphasize helping each person achieve a high level of wellness by focusing on health education, injury prevention, and disease prevention,” the AACOM says.

Additionally, while osteopathic programs are highly competitive, entrants typically have slightly lower GPAs and MCAT scores than their allopathic counterparts.

Mean GPA and MCAT scores for Entering 2022 Osteopathic Students:

• Overall GPA: 3.61

• Science: 3.53

• Non-Science: 3.70

• Overall MCAT: 504.8

• Psychological, Social, and Bio: 125.3

• Bio and Biochemical: 127.2

• Chemical and Physical: 126.4

• Critical Analysis and Reasoning: 126.0

Mean GPA and MCAT scores for Entering 2022 Allopathic Students:

• Overall GPA: 3.75

• Science: 3.68

• Non-Science: 3.84

• Overall MCAT: 511.9

• Psychological, Social, and Bio: 128.9

• Bio and Biochemical: 128.2

• Chemical and Physical: 127.9

• Critical Analysis and Reasoning: 127.0

Recipients of both degrees have similarly high residency match rates (over 90 percent for both in 2023), though DOs tend to specialize in primary care at higher rates. In May 2021, the AOA’s Physician Masterfile reported that 56.5% of osteopathic doctors (DOs) practiced primary care (including specialties like obstetrics and gynecology and pediatrics). And in 2022, nine colleges of osteopathic medicine were in U.S. News & World Report’s list of the top 10 schools with the most graduates practicing primary care. 

Among the more competitive specialties, MDs continue to outnumber DOs in residency placement. But DOs can increase their competitiveness by taking the USMLE (MD accreditation) in addition to the COMLEX (DO accreditation). 

Sounds appealing? Here’s what to keep in mind for your DO application:

• Submit your AMCAS and secondary applications first. Then, turn to your osteopathic applications (AACOMAS), which you’ll want to submit by October. 

• Spend at least 20 hours working alongside a DO and ensure your application demonstrates your understanding of and motivation to pursue a career in osteopathic medicine.

• Request a recommendation letter from a DO. 

• Review the guidelines for any program where you would be considered in-state, as some schools must admit a certain percentage of in-state students.

• Review the residency placements for the DO programs you are considering to ensure the school’s placements align with your goals. 

Osteopathic Medicine Continues to Grow in Popularity

Osteopathic medicine is one of the fastest growing segments in healthcare, according to the American Osteopathic Association’s (AOA) Osteopathic Medical Profession Report. The number of osteopathic medical students has grown by 77 percent in the last ten years, which has led to an 81 percent increase in the total number of DOs (including practicing physicians, residents, and medical students). Today, there are an estimated 122,236 in the physician workforce, just over one in four medical students are currently pursuing a Doctor of Osteopathic Medicine (DO) degree, and an estimated 36,500 medical students are expected to matriculate into a DO program this school year (up 2,700 from last year). 

Demographic highlights:

• Practicing DOs predominantly fall within a younger cohort. Just over two-thirds of practicing physicians are under 45 (35 percent are under 35, and 32 percent are between 35 and 44). 

• In 2022, 43 percent of the practicing DOs were female, an upward trend that has continued over time (40 percent in 2015, and 32 percent in 2010). Almost half of practicing physicians (47 percent) are female and under 45. 

• Most DOs tend to practice near where they completed their education, and DO programs are typically located in medically underserved regions. The states with the largest number of DOs include: California (8.3 percent), Pennsylvania (8.1 percent), Florida (7.9 percent), Michigan (6.6 percent), New York (6.4 percent), and Texas (6.1 percent).

• Since 2020, the Accreditation Council on Graduate Medical Education (ACGME) has overseen the accreditation of all graduate medical education (allopathic and osteopathic). DO graduates also participate in the National Resident Matching Program (NRMP). The report notes that 2022 brought a new record level of placement for participating DOs, with 7,049 graduates placing into residency programs in 41 specialties. This is up 7 percent from the previous year. 

• DOs predominantly work in primary care specialties. The top fields include family medicine, internal medicine, and pediatrics. Among the remaining 43 percent who opt into other specialties, the top fields include: Emergency medicine, Anesthesiology, Obstetrics and Gynecology, General surgery, and psychiatry. 

Related: Alternatives to Allopathic Medical Programs in the United States

AAMC Physician Workforce Report Shows an Increasing Number of Women, Physicians Nearing Retirement, and Doctors of Osteopathic Medicine

The proportion of women within the active physician workforce continues to increase, as does the proportion of those nearing retirement age and those with a Doctor of Osteopathic Medicine (DO) degree.  Late last month the Association of American Medical Colleges (AAMC) released its 2020 Physician Specialty Report, which provides demographic and specialty trends within the active physician and resident/fellow workforces. It is important to note that the data used to populate the 2020 report was reflective of the 2019 physician workforce.

Active Physicians

In 2019, over one-third of active physicians were women (36.3 percent); this percentage has been steadily rising since 2007 when women made up just over a quarter of the workforce (28.3 percent). This growth reflects the steady increase in female medical students, with women making up the majority (50.5 percent) in medical school for the first time in 2019. The report notes, however, that women still tend to remain concentrated in specialties pertaining to women and children, including pediatrics (64.3 percent), obstetrics and gynecology (58.9 percent), and pediatric hematology/oncology (55.1 percent), and have marginal representation elsewhere. Women make up less than a quarter of the physician workforce in a great number of specialties, including various surgery sub-specialties where the number ranges from 22 percent in general surgery to just 5.8 percent in orthopedic surgery. About ten percent of physicians in pulmonary disease (12.3 percent) and urology (9.5 percent) are female. There are no specialties where male physicians make up less than 35 percent of the workforce.

Just under half of the physicians were 55 and over (44.9 percent) in 2019, which is a marginal increase from 44.1 percent in 2017 but a more significant increase from 37.6 percent in 2007. Over 50 percent of the following specialties are made up of physicians aged 55 and over: preventative medicine (69.6 percent), thoracic surgery (60.1 percent), orthopedic surgery (57.1 percent), and urology (50.5 percent). Several of the specialties which are populated with older doctors also have the highest percentages of males, and conversely several of those with the lowest percentage of older doctors are among the highest in female doctors.

Another slow-moving trend is the increase in practicing physicians with a DO degree. In 2019, 8.2 percent of physicians held the DO degree, while U.S. MDs made up 66.1 percent of the workforce and international medical degrees made up 24.7 percent. This is subtle, but real growth from 2007, when 69.5 percent of physicians held a U.S. MD, 24 percent held an international medical degree, and just 6.5 percent held a DO. In one of the fastest growing specialties, sports medicine, 18.9 percent of practicing physicians were DOs in 2019.

Residents and Fellows

Among the Residents and Fellows in 2019, 45.8 percent were women, like the 2017 figure (45.6 percent), and up slightly from 44.6 percent in 2007. As seen in the physician workforce, female residents/fellows tend to pursue the care of women and children in high percentages, with obstetrics and gynecology (83.8 percent), neonatal-perinatal medicine (74.9 percent), and pediatrics coming in at the top (72.4 percent). However, large percentages of women are also pursuing specialties in endocrinology (70.8 percent), allergy/immunology (68.2 percent), and geriatrics (67.8 percent).

Just as the percentage of DO graduates increased within the active physician workforce, it was also more prominent within the resident/fellow population. In 2019, 15.7 percent of the resident/fellow workforce had a DO degree, an increase from 12.5 percent in 2017 and 6.4 percent in 2007. The percentage of U.S. MDs showed a relative decline over the same period, with 61.1 percent of the 2019 population compared to 65.9 percent in 2007; similarly, international medical school graduates declined from 27.4 percent of the resident/fellow population in 2007 to 23.1 percent in 2019.