U.S. Medical Licensing Requirements: A Step-by-Step Overview
Becoming a licensed physician in the United States is a structured but multi-layered process. While the journey shares core milestones across states, each licensing board has unique nuances worth knowing. Here's what healthcare administrators and providers should understand.
Quick Summary: Core Licensing Requirements
Step 1: Earn a Medical Degree
You must graduate from an accredited medical school—either U.S./Canadian (LCME for MDs, COCA for DOs) or hold an ECFMG certification if you're an international medical graduate (IMG).
Step 2: Pass National Licensing Exams
Physicians must pass the USMLE (Steps 1, 2 CK, and 3) or COMLEX-USA for osteopathic doctors. Some states enforce completion of all steps within a 7-year window.
Step 3: Complete Postgraduate Training
Residency training of at least one year (more for IMGs or certain states) is required to demonstrate clinical readiness.
Step 4: Gather and Verify Credentials
Before applying, collect your educational history, exam scores, and residency documentation. Many use the Federation Credentials Verification Service (FCVS) to simplify this process.
Application Process: What You’ll Need to Submit
Once the core steps are complete, the formal application begins. Though specifics vary by state, applicants typically need to provide:
Completed Application Form: Many states now offer online submission.
Application Fee: Ranges from ~$200 to over $1,000 (see chart below).
Proof of Education and Training: Medical school diploma, transcripts, and residency verification.
Exam Results: USMLE or COMLEX scores must be sent directly from official testing services.
Work History & References: A full employment timeline and professional references may be required.
Past Licenses & Disciplinary History: Disclose all licenses held and any prior disciplinary actions.
FCVS Profile (if applicable): A centralized record of verified credentials that can be sent to multiple states.
Processing time ranges from 4 to 12 weeks, depending on the state and completeness of your application.
State-Specific Requirements to Watch For
In addition to the universal steps, many states impose unique licensing conditions, such as:
Jurisprudence Exams: Required in states like Texas and California, testing your knowledge of local medical laws.
Background Checks & Fingerprinting: Mandatory in most states; delays are common if not completed early.
CME or Ethics Training Proof: Some states request recent continuing education or specific ethics coursework.
English Proficiency: IMGs may need to demonstrate language competency.
Interstate Medical Licensure Compact (IMLC): Participating states offer a fast-track licensing option if you're already licensed in another IMLC state. A separate $700 compact fee applies, on top of individual state license fees.
State-by-State Medical Licensing Fee Chart (Initial MD/DO Licensure)
Complete chart available at FSMB.org.
Final Tips for Providers and Practices
Start your application process months before you plan to begin work.
Encourage use of FCVS for providers seeking multi-state licensure.
Be prepared for additional costs: fingerprinting, exam transcripts, and compact fees if applicable.
Sources
Federation of State Medical Boards (FSMB): https://www.fsmb.org/
USMLE: https://www.usmle.org/
ECFMG: https://www.ecfmg.org/
Interstate Medical Licensure Compact: https://www.imlcc.org/