Medical License Direct
State Medical Boards

All international medical graduates (IMG's) must be ECFMG certified

Amt of Required
Post Graduate
Training Years
AMG/IMG
ABMS /
10 Year Rule /
SPEX
Step 3
USMLE
Attempts
/ Years
Alabama State Board of Medical Examiners
1 / 3
YES specialty board
certification,
recertificaiton, SPEX
or USMLE required
within last 10 years
3 attempts
for step 3 / 7
or 10 years
if MD/PhD
Alaska State Medical Board
2 / 3
NO
2 / 7 or 10 if
MD/PhD
Arizona Board of Medical Examiners    
1 / 3
YES
ABMS = exempt
none / 7
Arizona Board of Osteopathic Examiners in Medicine and Surgery
1 / N/A
  N/A
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
1 / 3
No
6 / 7
or 9 if
MDPhD
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.
1 / 2
No
4 / 10
Osteopathic Medical Board of California
1 / N/A
  N / A
Colorado Board of Medical Examiners    
1 / 3
No
none / 7
10 if PhD
waiver
possible
but rare
Connecticut Medical Examining Board
2 / 2
No
none / 7
Delaware Board of Medical Practice
1 / 3
No
6 / none
District of Columbia Board of Medicine
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
No
3 attempts
for step 3, if
more than
3 than add'l
training is
required / 7
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.
1 / 2
No
5 ? / none
Florida Board of Osteopathic Medicine
1 / N/A
  N / A
Georgia Composite State Board of Medical Examiners
1 / 3 or 1 if < 7/85
No
3 / 7
waiver
Hawaii Board of Medical Examiners
1 / 2
No
none / 7
Idaho State Board of Medicine
1 / 3
No
2  per step /
7
Illinois Department of Professional Regulation
1 / 1 if < 1987
2 / 2 if > 1987
No
5 attempts
all steps
combined
/ 7
waiver
Indiana Health Professions Bureau
If more than 5 attempts for any step = ineligible
1 / 2
No
5 attempts
per step / 7
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.
1 / 2
No
3 / 7
or 10 if
MD/PhD
Kansas Board of Healing Arts
1 / 2
No
4 / 10
Waiver
Kentucky Board of Medical Licensure
2 / 2
No
4 attempts
per step / 7
Louisiana State Board of Medical Examiners
1 / 3
Yes
4 / none
Maine Board of Licensure in Medicine
2 if < 7/04 / 3
3 if > 7/04 / 3
No
3 / 7
waiver
Maine Board of Osteopathic Licensure
1 / N/A
No
N / A
Maryland Board of Physician Quality Assurance
total of 3 attempts per step otherwise additional training required
1 / 2
No
3 / 10
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.
1 / 2
No
6 / 7
exception
for MD/PhD
Michigan Board of Medicine
2 / 2
No
none / 5
+ add'l PGY
Michigan Board of Osteopathic Medicine and Surgery
1 / N/A
  N / A
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.
2 / 2
Yes
3 attempts
each step /
7
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.      
1 / 3
Yes
3 / 7
Missouri State Board of Registration for the Healing Arts
1 / 3
No
3 / 7
exception
for MD/PhD
Montana Board of Medical Examiners
2 / 3
1 / 1 if ABMS
No
SPEX required if
inactive 2 yrs.
3 / 7
exception
for MD/PhD
Nebraska Board of Medicine and Surgery
1 / 3
No
4 / 7 or 10 if
MD/PhD
Nevada State Board of Medical Examiners
3 / 3
Yes
9 attempts
combined
all steps / 7
Nevada State Board of Osteopathic Medicine
1 / N/A
  N / A
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.
2 / 2
No
2 attempts
per step/ 7
New Jersey State Board of Medical Examiners    
1yr if < 7/03 2 yrs +
contract for 3rd yr or
3 yrs for AMG and
IMG if > 7/03
No
5 / 7
waiver
New Mexico State Board of Medical Examiners
2 / 2
No
6 per step /
7 or 10 if
MD/PhD
New Mexico Board of Osteopathic Medical Examiners
2 / N/A
  N / A
New York State Board for Medicine
1 / 3
No
none / none
North Carolina Medical Board
1 / 3
Yes
Exception = AMA
PR Award
none / 7
North Dakota State Board of Medical Examiners
1 / 3
No
3/7
State Medical Board of Ohio
1 / 2
No
none / 7
or 10 if
MD/PhD /
waiver
Oklahoma Board of Medical Licensure and Supervision
1 / 2
No
3 / 7
Oklahoma State Board of Osteopathic Examiners
1 / N/A
  N / A
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).
1 / 3
Yes
3 / 7
waiver
Pennsylvania State Board of Medicine
2 / 3
No
3 / 7
waiver or
add'l PGY
Pennsylvania State Board of Osteopathic Medicine
1 / N/A
   
Board of Medical Examiners of Puerto Rico
(787) 782-8937 / Fax:(787) 706-0304
1 / 3
No
none / 7
Rhode Island Board of Medical Licensure and Discipline  
2 / 3
No
5 / 7
South Carolina Board of Medical Examiners
1 / 3
Yes
4 attempts
per step / 7
South Dakota Board of Medical and Osteopathic Examiners
2 / 2
No
3 attempts
per step / 7
waiver
Tennessee Board of Medical Examiners
1 / 3
No
3 / 7
or 10 if
MD/PhD
Tennessee Board of Osteopathic Examiners
2 / N/A
  N / A
Texas State Board of Medical Examiners
1 / 3
Yes
3 attempts
per step / 7
or 10 if
MD/PhD
waiver
Utah Department of Commerce    
Physicians Licensing Board
2 / 2
No
3 / 7
or 10 if
MD/PhD
Utah Department of Commerce    
Board of Osteopathic Medicine
2 / 2
  N / A
Vermont Board of Medical Practice  
1 / 3
No
3 / 7
Vermont Board of Osteopathic Physicians and Surgeons
1 / 3
  N / A
Virginia Board of Medicine
1 / 2
No
3 / 10
waiver
Virgin Islands Board of Medical Examiners
(340) 774-0117/ Fax:(340) 777-4001
Requirements
1 / 3
No
none / 7
SPEX is
required
Washington Medical Quality Assurance Commission
2 / 2
1 / 1 if < 7/1985
No
3 / 7
or 10 if
MD/PhD
waiver
Washington State Board of Osteopathic Medicine and Surgery
1 / N/A
  N / A
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
1 / 3 or 1 if
ABMS
No
3 attempts
per step / 10

West Virginia Board of Osteopathy
1 / N/A
  N / A
Wisconsin Medical Examining Board
1 / 1
No
3 attempts
per step / 7
Wyoming Board of Medicine
1 / 2
No
2 / 7 waiver
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State Medical Board License Requirements
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NOTES:

The LMCC is accepted with the following caveats:
  • Florida requires that the SPEX exam be taken in addition to being licensed in the U.S. or Canada for at least 10 years.
  • Illinois accepts the LMCC if received after 4/1970, otherwise board certification, SPEX or USMLE 3 is required.
  • Iowa requires the LMCC be endorsed by a provincial licensing board.
  • Michigan accepts the LMCC if you hold another U.S. or Canadian license and have practiced for the last 10 years.
  • Missouri requires graduation from a Canadian medical school.
  • New Jersey requires that physicians be licensed in another U.S. state and be board certified.
  • New York requires applicant to have a valid provincial license.
  • Pennsylvania accepts the LMCC if received after 5/1970. English version
  • Puerto Rico accepts the LMCC if you hold another U.S. medical license.
  • Washington accepts the LMCC if received after 1969.
  • Wisconsin accepts the LMCC if received after 1/1/78.

  • Kansas, Louisiana, Guam and Virgin Islands do not accept the LMCC.

ECFMG - Educational Council for Foreign Medical Graduates. This certification is required for all foreign medical graduates.

ABMS - American Board of Medical Specialties. This certification is required for Alabama, Arizona, Louisiana, Minnesota,          
Mississippi, Nevada, North Carolina, Oregon, South Carolina and Texas if you have not taken a major medical exam like the       
USMLE within the last 10 years. You may also take the SPEX exam in lieu of specialty board certification.

IMG - International medical graduate. A doctor that graduated from a medical school outside of the US and Canada.
AMG - American medical graduate. A doctor that graduated from an American medical school.    

State medical board requirements are subject to change without notice.
About State Medical Boards

Purpose

Medicine is a regulated profession because of the potential harm to the public if an incompetent or
impaired physician is licensed to practice. To protect the public from the unprofessional, improper,
unlawful, fraudulent and/or incompetent practice of medicine, each of the 50 states, the District of
Columbia, and the U.S. territories has a medical practice act that defines the practice of medicine
and delegates the authority to enforce the law to a state medical board.

State medical boards license physicians, investigate complaints, discipline those who violate the
law, conduct physician evaluations and facilitate rehabilitation of physicians where appropriate. By
following up on complaints, medical boards give the public a way to enforce basic standards of
competence and ethical behavior in their physicians, and physicians a way to protect the integrity of
their profession. State medical boards also adopt policies and guidelines related to the practice of
medicine. There are currently 70 state medical boards authorized to regulate allopathic and
osteopathic physicians.

AUTHORITY and STRUCTURE

The 10th Amendment of the United States Constitution authorizes states to establish laws and
regulations protecting the health, safety, and general welfare of their citizens.  In response to the
10th Amendment, each state legislature enacted a
Medical Practice Act that defines the proper
practice of medicine and responsibility of the medical board to regulate that practice.

The structure and authority of medical boards vary from state to state. Some boards are
independent and maintain all licensing and disciplinary powers, while others are part of a larger
umbrella agency, such as a state department of health. State medical boards are typically made up
of volunteer physicians and members of the public who are, in most cases, appointed by the
governor and paid a nominal stipend for their service. The majority of state boards employ an
administrative staff including an executive officer, attorneys, investigators and licensing staff. The
state legislature determines the financial resources of most boards. Some boards are funded
directly from physician licensing and registration fees.

Protecting the Public: How State Medical Boards Regulate and Discipline
Physicians

Each state charges its medical board with protecting the public from the unprofessional, improper,
unlawful or incompetent practice of medicine. Boards carry out this mission based on the legal
authority defined in their state's Medical Practice Act and their financial resources, which are
determined by the state legislature.

Licensing

Obtaining a license to practice medicine in the U.S. is a rigorous process. State medical boards
ensure that those entering the profession have met predetermined qualifications that include
medical school graduation, postgraduate training, and passage of the United States Medical
Licensing Examination (USMLE), comprising a rigorous three-part written exam and an exam that
tests clinical and communications skills. Applicants must also provide details about their work
history, any arrests and convictions, and reveal information regarding past medical history that may
affect their ability to practice. Only those who meet a state’s predetermined qualifications are
granted permission to practice medicine in that state.

After physicians are licensed, they must re-register periodically to continue their active status.
During this re-registration process, physicians must demonstrate that they have maintained
acceptable standards of professional conduct and medical practice. In a majority of states,
physicians must also show that they have participated in a program of continuing medical education.

Investigatory and Disciplinary Powers

Medical boards also monitor licensed physicians’ competence and professional conduct. They
review and investigate complaints and/or reports received from patients, health professionals,
government agencies, health care organizations and other state medical boards about physicians
who may be incompetent or acting unprofessionally, and take appropriate action against a physician’
s license if the person is found to have violated the law. State laws require that boards assure
fairness and due process to any physician under investigation.

While medical boards sometimes find it necessary to suspend or revoke licenses, regulators have
found many problems can be resolved with additional education or training in appropriate areas. In
other instances, it may be more appropriate to place physicians on probation or place restrictions
on a physician’s license to practice. This compromise protects the public while maintaining a
valuable community resource in the physician. Probation and restrictions of a medical license can
also be in place while a physician receives further training or rehabilitation.

If a board determines a violation has occurred, common actions include:
  • Reprimand or Censure -- physician receives a public admonishment;
  • Administrative Fine/Monetary Penalty -- physician must pay a civil penalty fee imposed by the
    board;
  • Restitution -- physician must reimburse a patient or entity for monies improperly earned;
  • Probation -- physician's license is monitored for a period of time;
  • Limitation or Restriction -- physician's license is restricted in some way (e.g. a physician is
    prohibited from performing specific procedures or prescribing certain drugs);
  • Suspension -- physician may not practice for a period of time;
  • Summary Suspension -- physician's license is suspended immediately, with evidence that
    their medical practice presents a threat to public health and safety;
  • Voluntary Surrender of License -- physician surrenders license to avoid further disciplinary
    action;
  • Denial -- physician isn't granted a license to practice or license isn't renewed;
  • Revocation -- physician's license is terminated; physician can no longer practice medicine.


The articles above are from the FSMB
The Federation of State Medical Boards (FSMB) is a national non-profit organization representing
the 70 medical boards of the United States and its territories. Based in Dallas, the FSMB serves as
the national voice for its member boards and is a recognized authority throughout the United States
on issues related to medical licensure and discipline. Their mission is: To continuously improve the
quality, safety and integrity of health care through developing and promoting high standards for
physician licensure and practice.
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