In the 21st century, the training of osteopathic physicians in the United States is virtually indistinguishable from the training of allopathic physicians (MDs). Osteopathic physicians attend four years of medical school followed by an internship and a minimum two years of residency. They use all conventional methods of diagnosis and treatment. Though still trained in OMT, the modern derivative of Still's techniques, they work in all specialties of medicine. There are ongoing debates about the utility of maintaining separate, distinct pathways for educating physicians in the United States.