State Medical Boards
All international medical graduates (IMG's) must be ECFMG certified
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Amt of Required Post Graduate Training Years AMG/IMG
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ABMS / 10 Year Rule / SPEX
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Step 3 USMLE Attempts / Years
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Alabama State Board of Medical Examiners
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1 / 3
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YES specialty board certification, recertificaiton, SPEX or USMLE required within last 10 years
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3 attempts for step 3 / 7 or 10 years if MD/PhD
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Alaska State Medical Board
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2 / 3
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NO
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2 / 7 or 10 if MD/PhD
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Arizona Board of Medical Examiners
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1 / 3
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YES ABMS = exempt
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none / 7
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Arizona Board of Osteopathic Examiners in Medicine and Surgery
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1 / N/A
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N/A
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Arkansas State Medical Board For IMGs ONLY - Completion of at least THREE (3) years of internship or residency in an ACGME approved program in the United States – OR – completion of at least ONE (1) year of internship or residency in an ACGME approved program in the United States AND be currently enrolled in a training program with the University of Arkansas for Medical Sciences
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1 / 3
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No
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6 / 7 or 9 if MDPhD
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Medical Board of California CA does not have the "7 year rule" where you must complete all three parts of USMLE in 7 years. But they do have a 10 year limit after which USMLE scores may expire. CA does not have an attempt limit for steps 1 and 2, but they do for step 3. If you started taking step 3 after 1/1/07, you may fail it three times and pass on the 4th attempt. If you fail 4+ times after 1/1/07 you will not get a CA license.
If you attempted step 3 prior to 1/1/07 and failed it doesn't matter how many times you failed it. For step 3 the clock on attempts starts 1/1/07.
If you take more than 10 years to complete USMLE your scores may expire with CA, and you'll have to retake step 3 if you haven't already gone past the limit for step 3 mentioned above.
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1 / 2
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No
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4 / 10
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Osteopathic Medical Board of California
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1 / N/A
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N / A
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Colorado Board of Medical Examiners
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1 / 3
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No
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none / 7 10 if PhD waiver possible but rare
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Connecticut Medical Examining Board
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2 / 2
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No
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none / 7
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Delaware Board of Medical Practice
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1 / 3
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No
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6 / none
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District of Columbia Board of Medicine
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1 if graduated from medical school before 1990 or took step 3 USMLE, otherwise 2 / 2 if practiced for 10 years and has foreign license in good standing, otherwise 3
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No
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3 attempts for step 3, if more than 3 than add'l training is required / 7
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Florida Board of Medicine The board may require an applicant who does not pass the national licensing examination after five attempts to complete additional remedial education or training. The board shall prescribe the additional requirements in a manner that permits the applicant to complete the requirements and be reexamined within 2 years after the date the applicant petitions the board to retake the examination a sixth or subsequent time.
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1 / 2
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No
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5 ? / none
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Florida Board of Osteopathic Medicine
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1 / N/A
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N / A
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Georgia Composite State Board of Medical Examiners
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1 / 3 or 1 if < 7/85
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No
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3 / 7 waiver
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Hawaii Board of Medical Examiners
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1 / 2
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No
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none / 7
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Idaho State Board of Medicine
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1 / 3
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No
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2 per step / 7
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Illinois Department of Professional Regulation
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1 / 1 if < 1987 2 / 2 if > 1987
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No
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5 attempts all steps combined / 7 waiver
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Indiana Health Professions Bureau If more than 5 attempts for any step = ineligible
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1 / 2
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No
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5 attempts per step / 7
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Iowa Board of Medicine Successful completion of a progressive three-year resident training program is required if the applicant passes the examination after more than six attempts on Step 1 or six attempts on Step 2 or three attempts on Step 3.; Board certification by ABMS or AOA is required if the applicant has not met the specified time period or request a waiver.
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1 / 2
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No
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3 / 7 or 10 if MD/PhD
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Kansas Board of Healing Arts
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1 / 2
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No
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4 / 10 Waiver
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Kentucky Board of Medical Licensure
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2 / 2
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No
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4 attempts per step / 7
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Louisiana State Board of Medical Examiners
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1 / 3
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Yes
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4 / none
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Maine Board of Licensure in Medicine
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2 if < 7/04 / 3 3 if > 7/04 / 3
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No
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3 / 7 waiver
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Maine Board of Osteopathic Licensure
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1 / N/A
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No
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N / A
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Maryland Board of Physician Quality Assurance total of 3 attempts per step otherwise additional training required
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1 / 2
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No
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3 / 10
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Massachusetts Board of Registration in Medicine There are no requirements on how many times you may sit for USMLE Steps 1 and 2. However, if an applicant is applying for a full license and fails USMLE Step 3 more than 6 times, the Licensing Committee will review his/her full license application. At that time, the Licensing Committee may require the applicant to provide additional indicia as evidence of clinical knowledge.
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1 / 2
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No
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6 / 7 exception for MD/PhD
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Michigan Board of Medicine
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2 / 2
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No
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none / 5 + add'l PGY
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Michigan Board of Osteopathic Medicine and Surgery
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1 / N/A
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N / A
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Minnesota Board of Medical Practice Beginning August 1, 2007 the USMLE Step 3 must be passed within five years of Step 2 or before the end of Residency training.
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2 / 2
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Yes
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3 attempts each step / 7
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Mississippi State Board of Medical If a graduate from a foreign medical school, applicant must present documentation of having completed either (i) three (3) or more years of ACGME-approved postgraduate training in the United States or training in Canada approved by the Royal College of Physicians and Surgeons or (ii) at least one year of ACGME-approved postgraduate training in the United States or training in Canada approved by the Royal College of Physicians and Surgeons, be currently Board certified by a Specialty Board recognized by the American Board of Medical Specialties or the American Osteopathic Association and will be based upon approval by the Mississippi State Board of Medical Licensure.
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1 / 3
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Yes
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3 / 7
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Missouri State Board of Registration for the Healing Arts
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1 / 3
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No
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3 / 7 exception for MD/PhD
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Montana Board of Medical Examiners
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2 / 3 1 / 1 if ABMS
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No SPEX required if inactive 2 yrs.
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3 / 7 exception for MD/PhD
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Nebraska Board of Medicine and Surgery
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1 / 3
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No
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4 / 7 or 10 if MD/PhD
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Nevada State Board of Medical Examiners
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3 / 3
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Yes
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9 attempts combined all steps / 7
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Nevada State Board of Osteopathic Medicine
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1 / N/A
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N / A
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New Hampshire Board of Medicine Applicants who fail to pass any section of the USMLE after the second attempt will require proof of a 3rd year of post graduate training. Applicants who fail to pass after 3 attempts shall be required to repeat the entire examination sequence.
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2 / 2
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No
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2 attempts per step/ 7
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New Jersey State Board of Medical Examiners
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1yr if < 7/03 2 yrs + contract for 3rd yr or 3 yrs for AMG and IMG if > 7/03
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No
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5 / 7 waiver
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New Mexico State Board of Medical Examiners
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2 / 2
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No
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6 per step / 7 or 10 if MD/PhD
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New Mexico Board of Osteopathic Medical Examiners
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2 / N/A
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N / A
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New York State Board for Medicine
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1 / 3
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No
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none / none
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North Carolina Medical Board
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1 / 3
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Yes Exception = AMA PR Award
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none / 7
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North Dakota State Board of Medical Examiners
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1 / 3
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No
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3/7
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State Medical Board of Ohio
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1 / 2
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No
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none / 7 or 10 if MD/PhD / waiver
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Oklahoma Board of Medical Licensure and Supervision
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1 / 2
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No
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3 / 7
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Oklahoma State Board of Osteopathic Examiners
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1 / N/A
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N / A
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Oregon Board of Medical Examiners 3 attempts plus 1 year PGT at USMLE Step 3; (waiver of 1 year PGT plus 4th attempt if ABMS certified).
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1 / 3
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Yes
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3 / 7 waiver
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Pennsylvania State Board of Medicine
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2 / 3
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No
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3 / 7 waiver or add'l PGY
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Pennsylvania State Board of Osteopathic Medicine
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1 / N/A
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Board of Medical Examiners of Puerto Rico (787) 782-8937 / Fax:(787) 706-0304
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1 / 3
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No
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none / 7
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Rhode Island Board of Medical Licensure and Discipline
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2 / 3
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No
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5 / 7
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South Carolina Board of Medical Examiners
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1 / 3
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Yes
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4 attempts per step / 7
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South Dakota Board of Medical and Osteopathic Examiners
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2 / 2
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No
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3 attempts per step / 7 waiver
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Tennessee Board of Medical Examiners
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1 / 3
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No
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3 / 7 or 10 if MD/PhD
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Tennessee Board of Osteopathic Examiners
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2 / N/A
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N / A
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Texas State Board of Medical Examiners
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1 / 3
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Yes
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3 attempts per step / 7 or 10 if MD/PhD waiver
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Utah Department of Commerce Physicians Licensing Board
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2 / 2
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No
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3 / 7 or 10 if MD/PhD
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Utah Department of Commerce Board of Osteopathic Medicine
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2 / 2
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N / A
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Vermont Board of Medical Practice
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1 / 3
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No
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3 / 7
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Vermont Board of Osteopathic Physicians and Surgeons
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1 / 3
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N / A
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Virginia Board of Medicine
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1 / 2
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No
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3 / 10 waiver
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Virgin Islands Board of Medical Examiners (340) 774-0117/ Fax:(340) 777-4001 Requirements
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1 / 3
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No
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none / 7 SPEX is required
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Washington Medical Quality Assurance Commission
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2 / 2 1 / 1 if < 7/1985
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No
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3 / 7 or 10 if MD/PhD waiver
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Washington State Board of Osteopathic Medicine and Surgery
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1 / N/A
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N / A
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West Virginia Board of Medicine An applicant who has failed to successfully complete and pass any one of the three steps of the USMLE in three attempts is required to appear before the Board for a determination by the Board, in its discretion, as to what, if any, further education, evaluation and training is required for further consideration of licensure. 06/08
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1 / 3 or 1 if ABMS
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No
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3 attempts per step / 10
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West Virginia Board of Osteopathy
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1 / N/A
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N / A
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Wisconsin Medical Examining Board
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1 / 1
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No
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3 attempts per step / 7
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Wyoming Board of Medicine
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1 / 2
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No
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2 / 7 waiver
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