Physicians in the United States hold either the Doctor of Medicine degree (MD) or the Doctor of Osteopathic Medicine degree (DO). Institutions awarding the MD are accredited by the Liaison Committee on Medical Education (LCME) or Educational Commission for Foreign Medical Graduates (ECFMG). Institutions awarding the DO are accredited by the Commission on Osteopathic College Accreditation (COCA). The MD degree is obtained at either domestic or international schools. The DO degree is obtained at domestic schools only. Foreign-trained osteopaths are not recognized as physicians in the United States.