Taking up a career in medicine can help you make an impact on thousands of lives which also makes it a huge responsibility.

However, before you practice clinical medicine in an unsupervised setting, you are required to be licensed by the medical licensing board of the state where you plan to practice.

This means that physicians have to meet certain medical licensing requirements and criteria, and complete individual applications for every state where they wish to practice medicine, regardless of the field or form. The licensure process can be very complex depending on the medical license requirements by state laws and regulations.

Medical Licensure Process

During the process of medical licensure, the state medical board primarily looks through each applicant’s qualifications, professional history, and character. In addition to meeting all the medical license requirements by state laws, applicants must also have passed a rigorous three-step examination called the United States Medical Licensing Exam (USMLE) that is designed to test their knowledge, concepts, and principles of health and disease in order to be granted the right to practice medicine. There might also exist a limit to the number of times a prospective candidate can attempt the USMLE exam depending on the state’s medical license requirements.

Additionally, depending upon the medical license requirements of the state, the state board may also ask the practicing physicians to pass the SPEX/COMVEX exam to assess their current competence before they can have their license renewed. Practicing physicians must ensure that their medical license is up to date throughout the time period in which they are practicing. It is illegal to practice medicine without a license or with an expired one. The repercussions of doing so could either land you in jail or keep you from practicing medicine ever again.

Getting Certified: Medical License Requirements by State

While each state’s medical licensure process may differ, there is a growing trend of having uniform medical license requirements across states. When applying for a license at the medical licensing board, you are required to submit details and proof of your education, graduate training, exam scores, references, hospital privileges, and current and past licenses as part of your application. Basic educational requirements for medical licensing include:

  • A medical doctorate from the US or an internationally accredited medical school.
  • Certificate of completion of post-graduate medical residency training in an ACGME-accredited (Accreditation for Graduate Medical Education) program.

All states’ medical licensing requirements include successful completion of all three steps of the USMLE. Applicants are also required to reveal any history of arrests or convictions or any past medical conditions that might affect their ability to practice in their application. In the case of international medical graduates (IMGs), applicants also need to be certified by the Educational Commission for Foreign Medical Graduates (ECFMG) that will evaluate their credentials.

The following is a list of all the state-specific medical license requirements by state including USMLE attempts and time limits, the amount of postgraduate training required, and other possible testing requirements:

  SPEX/ABMS/USMLE required within the last ten years USMLE Attempt Limit   USMLE Time Limit in years Amount of Post Graduate Training Required (AMG/IMG)
Alabama Yes 10 (max 3 attempts for Step 3) 7 or 10 if M.D/Ph.D. 1/3
Alaska No 2 7 or 10 if M.D/Ph.D. 2/3
Arizona No None 7 1/3
Arkansas   No 3 7 or 10 if M.D/Ph.D. 1/3
California Yes (except if you’ve held an unrestricted license in the US/Canada for four years or more) 4 10 1/2
Colorado No None 7 or 10 if M.D/Ph.D. 1/3
Connecticut No None None 2/2
Delaware No 6 None 1/3
District of Columbia No 3 attempts for Step 3; if more than 3, additional training is required 7 1 if graduated from medical school before 1999, otherwise 2/3
Florida No 5 None 1/2
Georgia No 3 7 1/1
Hawaii No None 7 1/2
Idaho No 2 per step 7 1/3
Illinois No 5 7 1/1 if graduated medical school before 1987 2/2 if graduated after 1987
Indiana No 3 attempts per step 10 1/2
Iowa No 3 10 1/2
Kansas No 4 10 1/2
Kentucky No 4 attempts per step 7 2/2
Lousiana Yes 4 None 1/3
Maine No 3 7 2/3 if graduated after July 1st 2004 3/3 if graduated after July 1st 2004
Maryland No 3 10 1/2
Massachusetts No 3 7 2/3
Michigan No None 5 + additional PGY 2/2
Minnesota Yes 3 attempts each step 7 1/2
Mississippi Yes (accepts lifetime ABMS) 3 7 1/3
Missouri No 3 (attempt rule is exempted if you have a Ph.D. or a medical license in another state) 7 (time limit rule is waived if the applicant is or has been a student in a recognized M.D/Ph.D. program in a field of biological sciences) 1/3
Montana No (SPEX required if inactive for 2 years or more) 3 7 (time limit rule is waived if the applicant is or has been a student in a recognized M.D/Ph.D. program in a field of biological sciences) 2/3 1/1 if ABMS
Nebraska No 4 attempts per step 10 1/3
Nevada Yes (accepts lifetime ABMS) 9 7 3/3
New Hampshire No 3 attempts per step None 2/2
New Jersey No 5 7 For AMGs: 1 if graduated before July 1, 2003. 2 years+ contract for 3rd year if grad after July 1, 2003   For IMGs: 1 year if graduated before July 1, 1985. 3 years if graduated between July 1, 1985 and July 1, 2003
New Mexico No 6 per step 7 2/2
New York No None None 1/3
North Carolina Yes (also accepts 60 hours of Category 1 CME in place of 10 year testing requirement) 3 None 1/3
North Dakota No 3 7 1/3
Ohio No 3 10 1/2
Oklahoma No 3 (board may grant waiver if board certified) 10 1/2
Oregon Yes (If worked last 3 years and obtained 150 CMEs in any increment, waiver on SPEX can be given) 4 7 1/3
Pennsylvania No 3 7 2/3
Rhode Island No 3 7 2/3
South Carolina Yes (If worked last 3 years and obtained 150 CMEs in any increment, waiver on SPEX can be given) 4 attempts per step 10 1/3
South Dakota No 3 attempts per step 7 3/3
Tennessee No 3 10 1/3
Texas No 3 attempts per step 7 or 10 if M.D/Ph.D. 1/2
Utah No 3 7 or 10 if M.D/Ph.D. 2/2
Vermont No 3 7 1/3
Virginia No None 10 1/2
Washington No 3 7 or 10 if M.D/Ph.D. 2/2 1/1 if graduated before 1st July 1985
West Virginia No 3 attempts per step 10 1/3
Wisconsin No 3 attempts per step 10 2/2
Wyoming No 7 7 2/2


How Medical License Requirements Protect the Public

It is the job of the state to ensure that every physician upholds their responsibility to provide the best care possible to their patients. Thus, each state in the US has its laws, regulations, and medical license requirements that govern the practice of medicine within its jurisdiction. These regulations are laid out in a state statute called the Medical Practice Act and it is the job of each state’s medical board to serve the public by licensing competent physicians based on the medical license requirements by state and to enforce uniform standards of quality care across the state.

Only those who meet the state’s predetermined medical license requirements and qualifications are granted the privilege to practice medicine in that state. By evaluating and monitoring physicians’ performance, competence, and credibility, the state establishes certain standards of competence and ethical behavior for the profession – thus offering the public protection from unprofessional, compromised, and incompetent physicians who might cause more harm to the public than good, if given the license to practice.

See Also: 15 Qualities That Make a Good Medical Billing Specialist

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