In the United States, the D.O. and the M.D. are the only two degrees permitting licensure as medical physicians. D.O and M.D. physicians have similar training (both requiring four years of training in the basic and clinical sciences and the successful completion of licensing exams). Osteopathic medical physicians receive additional training in Osteopathic Manual Manipulation. Although U.S. osteopathic medical physicians currently may obtain licensure in 47 countries, osteopathic curricula in countries other than the United States differ. In some countries outside of the United States, D.O.s are known as "osteopaths" and while their scope of practice includes some conventional medical therapies, they rely more exclusively on osteopathic manipulative medicine and other alternative medical modalities.
According to the BIOMEA, in most countries outside the United States, D.O. stands for “diploma of osteopathy,” not “doctor of osteopathic medicine.” The difference is that osteopaths are not trained or licensed as physicians, and therefore do not carry the same practice rights, such as surgery and prescribing medication. However, osteopaths in some countries do act as primary care providers, coordinating treatment with fully licensed primary care physicians.1
International practice rights
International practice rights of U.S. trained D.O.s Practice rights generally recognized as equal to U.S.-M.D.s Unlimited practice rights granted, but difficult to obtain Limited to manipulation-only Unknown or previously denied
Every country has different requirements and a different way of licensing or registering osteopathic physicians and osteopaths. The only osteopathic practitioners that the U.S. Department of Education recognizes as physicians are graduates of osteopathic medical colleges in the United States.2 Therefore, osteopaths who have trained outside the United States are not eligible for medical licensure in the United States. On the other hand, US-trained D.O.s are currently able to practice in 45 countries with full medical rights and in several others with restricted rights.
The following is a table of International Practice Rights of U.S trained Doctors of Osteopathic Medicine, as listed by the American Osteopathic Association.3 An update of this listing was released in December 2007.4
Country
Year of latest policy
Medical Practice Rights
Requirements for Licensure
Argentina
1994
Unlimited.
Full license granted to US-trained D.O.
Australia
2000
Restricted.
Varies by state.
Austria
1994
Unlimited.
Hospital must have position unable to be filled by Austrian physician.
Bahamas
1997
Unlimited.
US license recognized.
Bolivia
1988
Unknown.
No response from embassy.
Brazil
2000
Unlimited.
Completion of Brazilian board exam & some training in Brazilian hospital is required.
US-DOs are permitted to apply for "Short Term Medical Practice" only.
Costa Rica
1993
Unlimited.
Several requirements. (Same as for any foreign MD.)
Denmark
1995
Unknown.
No response from embassy.
Dominican Republic
2000
Unlimited.
US license recognized.
Ecuador
Unlimited.
Several. Same as for any foreign MD.
Finland
1996
Unlimited.
Several. Same as for any foreign MD.
France
1988
Restricted.
OMM only. French government does not recognize osteopathic medicine.
Germany
1993
Unlimited.
No special requirements. Decisions made on individual basis.
Greece
2004
Unlimited.
Difficult. Greek citizenship required.
Hong Kong
1998
Unlimited.
Written examination. Personal interview. Training approval.
India
1999
Undetermined.
Indian nationality status required
Indonesia
1992
Unlimited.
All foreign physicians affiliated with a University project or a mission have unlimited practice rights. No private practice allowed.
Ireland
1999
Under review.
The Irish government has repeated declined to recognize US trained D.O.s as physicians. The American Osteopathic Association president has said that obtaining unlimited practice rights for US-trained D.O.s in Ireland is a top priority in 2007.5
Lebanon
2004
Unlimited.
AOA letter required. Examination required.
New Zealand
2005
Unlimited.
Hearing required. Case-by-case basis.
Nigeria
1999
Unlimited.
An appearance before the Nigerian Medical Council & an oral quiz.
Singapore
1993
None.
Singapore does not recognize US DO degree. Only recognizes US MD degree from 37 US conventional medical schools.6
Spain
1994
None.
No medical practice rights.
Sweden
1996
Unlimited.
US license recognized.
Taiwan
2005
Unlimited.
The ROC government recognizes US D.O. degree. Applicants must take Taiwan Examination Yuan to obtain Taiwanese license.
United Kingdom
2005
Unlimited.
US-trained DOs eligible for full medical practice rights. Applicants must pass the PLAB examination and work for one year in the National Health Service. Following that year, the applicants will be able to apply for a license to practice privately.
Table data from AOA International License Summary.3, updated December 2007.4
^ abAOA International License Summary.American Osteopathic Association. Council on International Osteopathic Medical Education and Affairs. December 2007.[3]
^ Peter B. Ajluni US-Trained DOs in Ireland. AOA president's blog. 12 Mar 2007. [4]