In the United States, the 21st century training of osteopathic physicians (who practice osteopathic medicine, not osteopathy) is equivalent to that of Doctor of Medicine (MD) physicians.[13][14] While osteopathic manipulation is still included in the curricula of osteopathic physicians, and is promoted as a unique aspect of DO (Doctor of Osteopathic Medicine) training, this has been described as nothing more than "'extra' training in pseudoscientific practices".[15] In the US, graduates of osteopathic medical schools have the option to sit for both the osteopathic physician-specific COMLEX medical licensing exam and the general USMLE licensing exam.