In the United States and Canada, the term doctor describes all medical practitioners holding a professional medical degree. The American Medical Association, established in 1847, as well as the American Osteopathic Association, founded in 1897, both currently use the term physician.
A physician trained in the United States has either a Doctor of Medicine degree, and uses the initials “M.D.” or has a Doctor of Osteopathic Medicine degree and uses the initials “D.O.” After finishing their medical school education both a Doctor of Medicine (MD) and Doctor of Osteopathic Medicine (DO), with license, have the same practicing rights in the specialties and sub specialties of medicine. United States osteopathic medical schools have a curriculum very similar to MD schools with the addition of osteopathic manipulative medicine, which focuses on extra instruction in the musculoskeletal system.
Many countries in the developing world have the problem of too few physicians. A shortage of doctors can lead to diseases spreading out of control as seen in the Ebola virus epidemic in West Africa.
All boards of certification now require that physicians demonstrate, by examination, continuing mastery of the core knowledge and skills for a chosen specialty. Recertification varies by particular specialty between every seven and every ten years.
Graduates of osteopathic medical schools in the United States (osteopathic physicians) should not be confused with osteopaths, who are trained in the European and Commonwealth nations. Osteopaths (the term used for non-American-trained practitioners who practice osteopathic manipulation) are not physicians. Their training is similar to physical therapy and they are not licensed to prescribe medications or perform surgeries.
Also in the United States, the American Podiatric Medical Association (APMA) defines podiatrists as physicians and surgeons that fall under the department of surgery in hospitals. They undergo training with the Doctor of Podiatric Medicine (DPM) degree. This degree is also available at one Canadian university, namely the Université du Québec à Trois-Rivières. Students are typically required to complete an internship in New York prior to the obtention of their professional degree.