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Determined to remedy a shortage of primary-care physicians in rural and disadvantaged areas on the West Coast, the Orthodox Jewish group that operates Touro Colleges in New York has opened its first osteopathic medical school in San Francisco.

The nonsectarian San Francisco College of Osteopathic Medicine will begin instruction for its first class of 60 students late this summer, a college spokesman said.

From obstetrics and gynecology to orthopedics and surgery, doctors of osteopathy, or D.O.s, practice in the same areas of medicine as allopathic doctors, or M.D.s, and receive the same standard medical training. However, D.O.s are most often primary-care physicians and they place an emphasis on holistic disease prevention and manipulation of the spine and joints.

Chiropractors also align the spine and joints, but they do not enjoy the same medical privileges as D.O.s, who prescribe medication and have greater access to hospitals.

Touro opened the college to expand the practice of osteopathy on the West Coast, where it is not widely recognized, said the school's dean, Dr. Bernard Zeliger.

Throughout the United States, D.O.s, who number about 45,000, comprise little more than 5 percent of all physicians.

The practice was developed by a frontier doctor in Missouri late in the 19th century. But until it was recognized by American medical associations, the military and the courts in the 1950s and 1960s, D.O.s struggled to become legitimate in the eyes of hospital administrators and other medical groups, Zeliger explained.

Osteopathy once thrived in California, but the California Osteopathic Association merged with the California Medical Association in 1962, at which point all D.O.s became M.D.s. A small group of loyal osteopaths eventually won back their D.O. licenses in a 1974 California Supreme Court ruling, but osteopathy has never really bounced back here, Zeliger said.

The Western Addition school will be the 18th osteopathic college in the world and the first of its kind in the region. The significance of its 18th status is uncanny; the college also was approved for business Jan. 18 and will begin instruction on Aug. 18.

"That's three 18s," Zeliger said, noting that in Hebrew, the numeral 18 represents chai, or life. And certainly, the college can use a charmed existence now that it's the only competitor in town to the UCSF Medical Center.

The competition hasn't stopped Touro administrators from cozying up to the local medical establishment. They have affiliated with Highland Hospital in Alameda County and St. Luke's Hospital in the Mission District. They also plan to join the amorphous network of HIV researchers and will share their Scott Street campus, administration and faculty with the California College of Podiatric Medicine.

First- and second-year podiatric and osteopathic students will sit together in basic science classes, share a curriculum and eventually dine from a planned kosher kitchen à la Touro College, said Dr. Barbara Kriz, dean of basic science for both schools.

Once the osteopathy students graduate from their four-year program, many will serve their residencies in the underserved areas, where the college wants to set up permanent clinics.

Zeliger said his first class is only 50 percent full, but that won't prevent him from accepting only the highest undergraduate credentials and entrance exam scores. The fall application deadline has passed, but late applications may be accepted if there aren't enough qualified candidates in the first round .