If you’re a U.S.-trained DO and you’ve got a passport burning a hole in your pocket, we’ve got good news: the world is opening up for U.S.-trained osteopathic physicians.
Thanks to years of advocacy, legal clarity, and global recognition, more countries than ever now recognize U.S. DOs as fully licensed physicians.
Here’s how we got here:
- 2018: The UN’s International Labour Organization officially declared U.S. DOs are physicians—licensed to diagnose, prescribe, and perform surgery—not to be confused with manual therapists.
- 2019: The Association of Medical Councils of Africa (AMCOA) granted DOs full practice rights equivalent to MDs across 20 African nations.
- 2023: The International Association of Medical Regulatory Authorities (IAMRA) passed a resolution supporting the equivalence of US DOs and MDs across its 47 member countries. 47 member countries to recognize DOs and MDs as equals.
In other words: You’re not a “manual therapist.” Not “kind of a doctor.” You’re a physician—period. So where can your degree take you? Let’s dive in.
Where Can You Actually Practice as a DO?
Here’s the official 2024 map from the American Osteopathic Association showing where US-trained DOs have secured medical practice rights, been denied, or where there’s just not enough info yet.
Screenshot of the U.S. DO licensure map, taken from the American Osteopathic Association website (AOA), Retrieved June 2025. Source: https://osteopathic.org/wp-content/uploads/USDO-licensure-map.png
Below is a quick-reference table, focusing on the most popular destinations, and highlighting how they view US DO practice rights. This table combines the 2024 AOA map data with information from their 2006 International Licensure Registry—which gives us useful insight into licensing trends and where DOs have historically been able to practice.
Important: Please note that there may be some differences between the AOA map and the table below. Even if the specific country’s regulations suggest that US-trained DOs should have similar practice rights as MDs, full licensure often remains uncertain until a DO has actually completed the local licensing process.
In non-English-speaking countries, obtaining a license usually requires passing language proficiency and local medical exams, which can make the process lengthy and challenging, even when full licensure is theoretically possible.
DOs Abroad: The Lowdown
Can you practice abroad as a U.S.-trained DO? Yes, absolutely.
Is it straightforward everywhere? No—but progress is accelerating.
You’ll notice Europe is a mixed bag when it comes to the term “osteopath.” In much of Europe, an osteopath refers to a manual therapist—someone who practices hands-on techniques similar to a blend of physical therapy and chiropractic care. They are not considered physicians.
Because of this, recognition for U.S.-trained DOs (Doctors of Osteopathic Medicine) varies widely across Europe—some countries recognize them as fully licensed physicians, while others do not.
How to Make It Happen
✅ Target DO-friendly countries like Canada, the UK, Ireland, India, Australia, New Zealand, Saudi Arabia, South Africa, and many other African nations warmly welcome DOs.
✅ Check licensing requirements early: Many countries, particularly non-English speaking countries, may require language and/or medical exams, making the licensure process lengthier and more challenging.
✅ Obtain & Maintain ABMS Board Certification: Oftentimes, regardless of what type of medical degree you have, it’s your US board certification that will open doors. Make sure to get your board certification and then maintain it.
✅ Lean on the AOA and professional bodies: They can provide official letters and support through complex international licensing processes. You can reach the AOA International Affairs staff at ia@osteopathic.org or call (202) 349-8720.
✅ Don’t count yourself out—try anyway! Even if a country historically doesn’t recognize DOs, reach out anyway. Contact their licensing board, highlight your U.S. residency, board certification, and active license. You might be the trailblazer who opens the door for future DOs!
Remember: Recognition is growing every year. Your chance to practice abroad? Better than ever!
Are you a US-trained DO already practicing abroad or in the process of obtaining a license abroad? Contact us here and let us know where you’re practicing or how the licensure process is progressing. Your experience will help us keep this blog current for other DOs!.
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Ashwini Bapat, MD, is a palliative care doctor and co-founder of Hippocratic Adventure. She lives in Portugal with her husband and 2 kids. When she’s not blogging, you’ll find her swimming in an Olympic-sized pool, frosting a cake, or watching the Korean reality show “Single’s Inferno” with her husband.
