Getting a License: the Basics

Medical Licenses

All pediatric trainees are required to have completed all paperwork and testing for a state medical license by the end of internship. You can choose any of the fifty states to get a medical license. States will not issue licenses until you actually complete internship, however, your paperwork (transcripts, USMLE scores, fees, etc.) for the stat you choose to obtain a license must be completed by SPRING of your intern year. Army and Navy regulations differ slightly here, but our program has one requirement and you should not delay this paperwork until your PL-2 year. Obtaining a medical license requires successfully completing an internship and passing part 3 of USMLE’s or NBOME’s. There is also a significant amount of paperwork that the states require applicants to complete. Some states do not issue licenses to physicians with only one year of post-graduate medical education. If that is the case, PICK ANOTHER STATE. Since the process is time consuming and since there are filing deadlines and deadlines for application of USMLE, it is imperative that you begin the process early, be aware of the deadlines, and complete the process on schedule. Navy residents who have not completed the process by the end of PL-1 year have had adverse comments added to their fitness reports and have had to return from overseas duty assignments AT THEIR OWN EXPENSE to complete unfinished parts of the licensing process. The Army will place you on academic probation if your license is not obtained by the end of your PL-2 year. Please notify the Program Director when you have completed the licensing process. For Army residents, a copy of the license application should be provided to Ms. Bernadette Hicks, pediatric department secretary, and to Ms. Stephenye Tyler in the WRAMC GME office. Both of these individuals need a copy of your license. Once it arrives, please hand-deliver the copies to them. For Navy residents, a copy of your license should be hand delivered to Mr. Jeffery Fennewald in the NNMC Professional Affairs office.

Getting a license: the basics

By the Federation of State Medical Boards

Increasing public demand for protection, coupled with the growth in the number and sophistication of fraudulent practitioners over the past 2 decades, has resulted in stronger and more complex licensing boards and licensing statutes throughout the country. As might be expected, the rate of change differs widely among the states' licensing boards, depending on each jurisdiction's resources and Medical Practice Act, as well as on legislative, media, and public expectations. All medical boards have continued to improve licensure processes, and a trend toward uniformity among licensing boards exists to enhance both the initial licensure process and licensure portability.

Many states have expanded what is considered to be the practice of medicine to address new trends in the medical field that need to be regulated by medical boards. For example, a number of states have passed legislation in recent years that empower medical boards to have jurisdiction over the practice of medicine across state boundaries or treatment decisions made by medical directors of managed care organizations.

Within this context, a physician seeking initial licensure or subsequently applying for a license in other states should anticipate the possibility of delays due to the necessary investigation of credentials and past practice, as well as the need to comply with necessary licensing standards. To assist a physician in the quest for licensure, this article attempts to provide some ground rules. These suggestions will not apply in all cases but generally will help most physicians applying for licensure as well as benefit the licensing board of the state in which the physician wishes to practice.

1. When contacting a licensing board for the first time, ask for a copy of its current licensing requirements and the average time it takes to process applications. This will provide the physician with a solid idea of when to consider closing an existing practice and/or plan a move as well as with information about the potential problem areas to be addressed in completing an application. While initial licensure requirements for domestic and international medical graduates differ somewhat among states, all states will require proof of prior education and training and proof of the completion of a rigorous licensure examination approved by the board. Specifically, all physicians must submit proof of successful completion of all three steps of the United States Medical Licensing Examination (USMLE). However, because some medical students and physicians had completed portions of the National Board of Medical Examiners and Federation Licensing Examination (FLEX) sequences before the implementation of USMLE in 1994, certain combinations of examinations may be considered by medical licensing authorities as comparable to the USMLE. The USMLE program recommends that such combinations be accepted for medical licensure only if completed prior to the year 2000. For information on the USMLE, physicians should contact the USMLE Office of the Secretariat at

3750 Market St
Philadelphia, PA19104-3910
(215) 590-9700
(215) 590-9470 Fax

1. At the initial contact, the physician should provide the licensing board with a resume or curriculum vitae. This will allow a licensing board to evaluate potential problem areas early in the process. In short, the initial contact should be used to develop a set of reasonable expectations about the duration and complexity of the licensing process in a state to avoid frustration about the time required to obtain licensure. Unreasonable expectations can result in financial jeopardy due to the premature closing of a practice or failure to meet a starting date with an employer in the new state.
2. A physician should never try to hide derogatory information from a licensing board. It is much better to come forward with the information, assist the board in obtaining records and other necessary data, and provide information about mitigating circumstances that would prevent license denial. Full and frank disclosure of all information requested is by far the best approach to successful licensure. A physician should remember that in most states, making a false statement on an application for licensure is grounds for denial or future restriction.
3. A physician who is actively involved in the licensing process can often shorten the length of time it takes to obtain a license. Personally contacting and following up with the medical schools, training programs, and appropriate hospitals will motivate these institutions to verify credentials more expeditiously. Following up with the licensing boards in other states where the physician holds or has held a license also may assist in shortening the time for licensure. It is important to note a difference between follow-up and excessive use of phone contact, which often delays the processing of requested verification materials, since the physician's application or request may need to be pulled from the "stack" to answer an inquiry. A short note to the organization processing the request for information 30 days after the initial letter or form was mailed may be a better course to follow than frequent phone contact.

Another option for physicians applying for licensure is the Federation Credentials Verification Service (FCVS). The FCVS was created in 1996 by the Federation of State Medical Boards of the United States to provide a centralized, uniform process for state medical boards—as well as private, governmental and commercial entities—to obtain a verified, primary source record of a physician's core credentials. The FCVS repository of information allows a physician to establish a confidential, lifetime professional portfolio that can be forwarded, at the physician's request, to any entity that has established an agreement with FCVS. Currently, the majority of licensing authorities accept FCVS-verified documents for licensure. For more information on FCVS, call toll free, (888) ASK-FCVS (275-3287).

1. A wise physician will exercise patience and courtesy in the licensing process. State licensing boards and their staff, in most cases, do the best job possible to protect the public with the resources provided them. This requires taking the necessary time to fairly evaluate each application for licensure. In that same context, all actively practicing physicians should be cognizant of state laws; they may be providing care or performing acts that might not, until recently, have required them to hold a license.

Even for physicians with uncomplicated histories who submit complete and accurate applications, delays in obtaining a medical license may be encountered. Physicians should plan for at least a 60-day period from the time they submit a completed application for license and the actual date licensure is granted. Physicians who are graduates of a medical school outside the United States should anticipate a slightly longer period. All physicians should be cognizant of the fact that, in general, the highest volume of licensure applications is received between the months of April and September. This is the peak period because physicians with families want to relocate before the academic school year starts for their children, residents want and need licensure to begin practicing, and state employees with school-age children often take their earned vacation time during this period. Finally, it is important to remember that hospital credentialing and qualification for medical malpractice insurance are based on possession of full and unrestricted licensure. This too may mean additional time before a physician can actually begin practicing.

Physicians informed about the process and working cooperatively with the licensing board need not find licensing an unpleasant experience. Members of the medical profession should always remember that the business of medical licensing boards is to protect the public from unqualified and unfit physicians. However, licensing boards also strive to ensure a process that protects the legal rights and privileges of physicians. While maintaining this balance often appears bureaucratic and cumbersome, the end result is improved health care for the people of the United States.

Eligibility Requirements
/ USMLE Step 3
/ USMLE Step 1, Step 2 CK
and Step 2 CS
/ Initial Licensure Requirements
/ Licensure Disclaimer
Abbreviations Key
IMG - International medical school graduates
NA - Not Applicable
NL - No Limit
COMLEX - Comprehensive Osteopathic Medical Licensing Examination (Levels 1, 2, 3)
USMLE - United States Medical Licensing Examination (Steps 1, 2, 3)
Attempt Limits - unless otherwise indicated these represent allowable attempts at Step 3
+ - indicates more attempts allowed on conditional basis with board approval or a longer time frame is considered for completion of licensing exam sequence, e.g., extended time for MD/PhD candidates.
* - The Maryland board allows 4 attempts at each USMLE Step. However, after the 3 rd failed attempt at a Step, an individual would be required to complete an additional year of post-graduate training beyond what is listed on the chart.
/ USMLE Step 3
/ Requirements for Initial Medical Licensure
Updated December 2005
See notes on the left of this chart for key to abbreviations.
State / Minimum Postgraduate
Training Required / Number of attempts at Licensing Examination / Time Limit for Completing Licensing Examination Sequence
Alabama
Tel: (334) 242-4116
$20.00 application packet $175.00
non-refundable application fee / 1 year; 3 years IMG / 3+ attempts at USMLE Step 3; No limit on COMLEX / 7 years to successfully complete all USMLE Steps; No limit on COMLEX
Alaska
(907) 269-8163
Application fee $840.00 / 2 years; 3 years IMG / 2 attempts per Step 2 attempts per COMLEX Level / 7 years to complete USMLE; 10 years for MD/PhD candidates; 7 years to complete COMLEX
Arizona Medical
(480) 551-2700
Application fee $500.00 / 1 year; 3 years IMG / No limit on USMLE / 7 years to complete USMLE if initial licensure / NL if already licensed
Arizona Osteopathic
(480) 657-7703
Application fee $400.00 / 1 year / No limit on the COMLEX / NL on the COMLEX
Arkansas
(501) 296-1802
$500.00 Application fee / 1 year; 3 years IMG unless currently enrolled in training program through Univ. of Arkansas for Medical Sciences. / 6 attempts at USMLE Step 3; No information available on COMLEX / 7 years to complete USMLE; 10 years for MD/PhD candidates; No information available on COMLEX
California Medical
(916) 263-2382
Licensing - $600 ($790 effective January 2006); Application fee - $505.00 / 1 year; 2 years IMG / No limit on USMLE / 10 years to complete USMLE
California Osteopathic
(916) 263-3100
$256 application fee / 1 year / No limit on the COMLEX / NL on the COMLEX
Colorado
(303) 894-7690
The current application fee is $425.00 / 1 year; 3 years IMG / No limit on USMLE; No information available on COMLEX / 7 years from first sitting to complete USMLE or COMLEX; 10 years for MD/PhD or DO/PhD candidates
Connecticut
(860) 509-7603
Application fee $450.00 / 2 years / No limit on USMLE; No information available on COMLEX / 7 years to complete the USMLE; No information available on COMLEX
Delaware
(302) 744-4507
See chart on website for fees / 1 year; 3 years IMG / 6 attempts at USMLE Step 3; No limit on COMLEX / 7 years+ to complete the USMLE; No limit on COMLEX
Washington, DC
(202) 724-4900
Application fee $546.00 / 1 year; 3 years IMG / 3 attempts at USMLE Step 3; No limit on COMLEX / 7 years to complete the USMLE; No limit on COMLEX
Florida Medical
(850) 245-4131
Application fee $552.00 / 1 year; 2 years IMG / No limit on USMLE / No limit on USMLE
Florida Osteopathic
(850) 245-4161
Call for application fee / 1 year in an AOA-approved program / No Limit on COMLEX / No Limit on COMLEX
Georgia
(404) 656-3913
$400.00 Application fee / 1 year; 1-3 years IMG / 3 attempts per USMLE Step; No limit on COMLEX / 7 years to complete the USMLE; 9 years to complete the USMLE if in MD/PHD program; No limit on COMLEX
Guam
(011) 671-735-7406-8
Contact the state board for licensure information and fees / 1 year / No information at this time / No information at this time
Hawaii
(808) 586-3000
Call for application and license fee information. / 1 year; 2 years IMG / No Limit on USMLE or COMLEX / 7 years to complete the USMLE; No limit on COMLEX
Idaho
(208) 327-7000
Application $400 by endorsement
$300 by examination / 1 year; 3 years IMG / 2 attempts per USMLE Step; No limit on COMLEX / 7 years to complete the USMLE (10 years for MD/PhD candidates); No limit on COMLEX
Illinois
(217) 782-8556
Application fee $300.00 / 2 years / 5 attempts at all USMLE Step combined; 5 attempts at all levels of COMLEX combined / 7 years to complete the USMLE; No limit on COMLEX
Indiana
(317) 234-2060
Application fee $250.00 / 1 year; 2 years IMG / 5 attempts per USMLE Step; 5 attempts per COMLEX Level / 7 years to complete the USMLE; No limit on COMLEX
Iowa
(515) 281-5171
Licensure fee $446.00 / 1 year; 2 years for IMGs starting July 1, 2006 / 6 attempts at both USMLE Step 1 and 2; 3 attempts at USMLE Step 3; 6 attempts at both COMLEX Levels 1 and 2; 3 attempts at COMLEX Level 3. Three years of postgraduate if outside the attempt limit. / 7 years to complete USMLE or COMLEX; 10 years for MD/PhD or DO/PhD candidates. Note: Board certification by ABMS or AOA is required if the applicant has not met the specified time period.
Kansas
(785) 296-7413
Application fee $300.00 / 1 year; 3 years IMG (minimum 2 years must have been in US program) / 3+ attempts at USMLE Step 3 or COMLEX Level 3 / 10 years to complete the USMLE or the COMLEX
Kentucky
(502) 429-7150
Licensure $250.00 non-refundable / 2 years / No limit on the USMLE or COMLEX / 7 years to complete the USMLE or COMLEX
Louisiana
(504) 568-6820
License fee $382.00 non-refundable / 1 year; 3 years IMG / No limit at Step 1or COMLEX Level 1; 4 attempts each at Steps 2 and 3 or COMLEX Levels / NL on the USMLE or COMLEX
Maine Medical
(207) 287-3601
Application fee $450.00 / 2 years; 3 years IMG / 3+ attempts at USMLE Step 3 / 7 years to complete the USMLE
Maine Osteopathic
(207) 287-2480
Application fee $350.00 by endorsement / 1 year / No limit on COMLEX / No limit on COMLEX
Maryland
(800) 492-6836
Licensure $817/$917 for IMGs / 1 year; 2 years IMG / 4 attempts at each USMLE Step or COMLEX Level / 10 years to complete the USMLE or COMLEX
Massachusetts
(800) 377-0550
Licensure $600.00 / 1 year; 2 years IMG / 6 attempts at USMLE Step 3; No limit on COMLEX / 7 years to complete the USMLE with exceptions for MD/PhD or DO/PhD candidates; No limit on COMLEX
Michigan Medical
(517) 335-0918
Licensure $235.00 / 2 years / No limit on USMLE / 5 years to complete USMLE Step 3
Michigan Osteopathic
(517) 335-0918
Licensure $150.00 / 1 year in AOA approved program / No limit on COMLEX / No limit on COMLEX
Minnesota
(612) 617-2130 Hearing impaired 1-800-627-3529
Licensure fee $392.00 / 1 year; 2 years IMG / 3 attempts at each USMLE Step; No limit on COMLEX / 7 years to complete the USMLE; 10 years for MD/PhD candidates; No limit on COMLEX
Mississippi
(601) 987-3079
Licensure fee $500.00 / 1 year; 3 years IMG / 4 attempts at USMLE Step 3; No limit on COMLEX / 7 years to complete the USMLE; No limit on COMLEX
Missouri
(573) 751-0098
By examination $300.00 / 1 year; 3 years IMG / 3 attempts at USMLE Step 3; COMLEX -- 3 attempts / 7 years to complete the USMLE (waived for MD/PhD candidates); No limit on COMLEX
Montana
(406) 841-2364
Licensure fee $325.00 / 2 years; 3 years IMG / 3 attempts at USMLE Step 3; No limit on COMLEX / 7 years to complete the USMLE (exceptions possible for MD/PhD candidates); No limit on COMLEX
Nebraska
(402) 471-2118
Licensure by application $200 + LAP fee
Licensure by Reciprocity $200 + LAP fee / 1 year; 3 years IMG / 4 attempts+ at each USMLE Step; 4 attempts+ at each COMLEX Level / 7 years to complete the USMLE or COMLEX; 10 years for MD/PhD candidates.
Nevada
(775) 688-2559
License and Registration Fees: Initial licensure $400; registration fee $600; criminal background investigation $75 / 3 years / Combined 9 attempts for all USMLE Steps / 7 years to complete the USMLE
Nevada Osteopathic
(702) 732-2147
Application and initial licensure fee $545.00 / 3 years / No limit on COMLEX / No limit on COMLEX
New Hampshire
(603) 271-1203
Application fee $250.00 / 2 years / 3 attempts at each USMLE Step or COMLEX Level / No limit on USMLE or COMLEX
New Jersey
(609) 826-7100
Contact the state board for licensure information and fees / 1 year; 3 years IMG / 5 attempts on USMLE Step 3; No information available on COMLEX / 7 years to complete the USMLE; No information available on COMLEX
New Mexico Medical
505-476-7220
Contact the board for specific fee info or check / 2 years / 6 attempts per USMLE Step / 7 years to complete the USMLE; 10 years for MD/PhD candidates
New Mexico Osteopathic
(505) 476-7120
Contact the state board for licensure and fee information / 1 year / No limit on COMLEX / No limit on COMLEX
New York
(518) 474-3817 Ext. 560
The fee for licensure is $735 / 1 year; 3 years IMG / No limit on USMLE or COMLEX / No limit on USMLE or COMLEX
North Carolina
(919) 326-1100
Temp $150.00 then full $350.00 / 1 year; 3 years IMG / 6 attempts per USMLE Step; No limit on COMLEX / 7 years to complete the USMLE; 10 years for MD/PhD candidates; No limit on COMLEX
North Dakota
(701) 328-6500
Application fee $200.00 / 1 year; 3 years IMG / 3 attempts at each USMLE Step or COMLEX Level / 7 years to complete the USMLE or COMLEX
Northern Mariana Islands
(670) 664-4811
Contact the State Board for licensure or fee information / No information available at this time / No information available at this time / No information available at this time
Ohio
(614) 466-3934
Contact State Board for licensure or fee information / 1 year; 2 years IMG / No limit on USMLE or COMLEX / Seven years to complete the USMLE or COMLEX (possible waiver for MD/PhD degree candidates and individuals with personal illness)
Oklahoma Medical
(800) 381-4519
Application fee $400 Temp (approved) $200 / 1 year; 2 years IMG / 3 attempts at each USMLE Step / 7 years to complete the USMLE
Oklahoma Osteopathic
(405) 528-8625
Contact the State board for licensure or fee information / 1 year / No limit on COMLEX / No limit on COMLEX
Oregon
(503) 229-5770
License Application fee $350.00 / 1 year; 3 years IMG / 3+ attempts at USMLE Step 3; 3+ attempts at COMLEX Level 3 / 7 years to complete the USMLE or COMLEX (possible waiver for dual degree candidates and individuals with personal illness)
Pennsylvania Medical
(717) 787-2381
Application fee accredited medical college $35.00
Unaccredited medical college $85.00 / 2 years; 3 years IMG / 3 attempts at USMLE Step 3 / 7 years+ to complete the USMLE
Pennsylvania Osteopathic
(717) 783-4858
License application fee $195 / 1 year / No limit on COMLEX / No limit on COMLEX
Puerto Rico
(787) 782-8949
Contact the state board for licensure or fee information / 1 year / No information available at this time / No information available at this time
Rhode Island
(401) 222-3855 / Fax:(401) 222-2158
Application fee $437.50 / 2 years; 3 years IMG / 3 attempts at each USMLE Step; 3 attempts at each COMLEX Level / 7 years to complete the USMLE; No information available on COMLEX
American Samoa / No information available at this time / No information available at this time / No information available at this time
South Carolina
(803) 896-4500
Application fee $510.00 / 1 year; 3 years IMG / 4 attempts per USMLE Step; No information available on COMLEX / 7 years to complete the USMLE; No information available on COMLEX
South Dakota
(605) 367-7781
Application fee $200.00 / Completion of residency program / 3 attempts per USMLE Step or COMLEX Level / 7 years to complete the USMLE or COMLEX
Tennessee Medical
(615) 532-4384
Application fee $410.00 / 1 year; 3 years IMG / No limit on USMLE / 7 years to complete the USMLE
Tennessee Osteopathic
(615) 532-3202
Application fee $410.00 / None / No limit on COMLEX / No limit on COMLEX
Texas
(512) 305-7010
Application fee $805.00 / 1 year; 3 years IMG / 3 attempts at each USMLE Step or COMLEX Level / 7 years+ to complete the USMLE or COMLEX
Utah Medical
(801) 530-6628
Application fee $ 200.00 / 2 years / 3 attempts at USMLE Step 3 / 7 years to complete the USMLE; 10 years for MD/PhD candidates
Utah Osteopathic
(801) 530-6628
Application fee $ 200.00 / 2 years / 3 attempts at each level of COMLEX / 7 years to complete the COMLEX; 10 years for DO/PhD candidates
Vermont Medical
(802) 828-2373
Licensure fee $400.00 / 1 year; 3 years IMG / 3 attempts at USMLE Step 3 / 7 years to complete the USMLE
Vermont Osteopathic
(802) 828-2373
Licensure fee $400.00 / 1 year rotating internship or 3 year residency program / No information available at this time / No information available at this time
Virgin Islands
(340) 774-0117
SPEX Exam Fee $800.00 / 6 months required after 2 attempts for SPEX exam / Must take SPEX (only given in May and November) and an oral exam. 2 attempts / 3 years allowed in which to pass the 2 attempts allowed re-examinations. 1 year limitation to take the oral exam after passing written.
Virginia
(804) 662-9908
Licensure fee $302.00 / 1 year; 2 years IMG / No limit on USMLE / 7 years to complete the USMLE
Washington Medical
(360) 236-4788
Application fee $325.00 / 2 years / 3 attempts at USMLE Step 3 / 7 years+ to complete the USMLE
Washington Osteopathic
(360) 236-4945
Licensure fee $650.00 / 1 year / No limit on COMLEX / No limit on COMLEX
West Virginia Medical
(304) 558-292 ext. 221
The fee for licensure is $300 / 1 year; 3 years IMG / No limit on USMLE / 7 years to complete the USMLE; the board may allow 10 years for MD/PhD candidates
West Virginia Osteopathic
(304) 723-4638
Reciprocity or Endorsement $200.00 / 1 year / No limit on COMLEX / No limit on COMLEX
Wisconsin
(608) 266-2112
Initial fee $125.00 / 1 year / 3+ attempts per Step; N/A on COMLEX / 7 years to complete the USMLE; N/A on COMLEX
Wyoming
(307) 778-7053
Licensure fee $350.00 / 1 year; 2 years IMG / No limit on USMLE or COMLEX / No limit on USMLE or COMLEX
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Directory of State Medical Boards