Transition from Resident to Attending

Navigating state medical licensure


A medical license granted by a U.S. state or jurisdiction is required of every practicing physician. Licensing boards can be complex and their requirements can vary from state to state, depending on each jurisdiction’s resources, regulations and laws. 

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While there is a trend toward uniformity of requirements among licensing boards, automatic reciprocity between state medical boards has mostly been discontinued. This means that current licensure processes require physicians to complete individual applications for each state in which they seek to practice medicine in any form, including telemedicine (PDF).

When applying for a state medical license, primary verification of your education and graduate training will be reviewed. Additionally, your exam scores, references, hospital privileges and current and past licenses will also be included in your application. Although each state’s licensing processes may be different, the applications and requested information are usually similar. You can save time by retaining copies of completed materials to reuse on multiple applications.

All states require physicians to submit proof of successful completion of all three steps of the United States Medical Licensing Examination (USMLE). A number of states have also passed legislation that empowers medical boards to have jurisdiction over the practice of medicine across state boundaries or the treatment decisions made by medical directors of managed care organizations.

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 practices.

Physicians should allow at least two months from the time they submit an application for licensure to be granted. Physicians who are graduates of a medical school outside the U.S.—international medical graduates (IMGs)—should anticipate a slightly longer period. It takes time for the state medical licensing boards and their staff to fairly evaluate each application. 

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  • When contacting a licensing board for the first time, ask for a copy of its licensing requirements and the average time it takes to process applications.
  • Provide the licensing board with a résumé or curriculum vitae. This will allow a licensing board to evaluate potential problem areas early in the process.
  • Exercise patience and courtesy in the licensing process. State licensing boards and their staff are charged with protecting the public by approving the most qualified physicians and often have limited resources at hand.
  • Following up with medical schools, training programs and appropriate hospitals can motivate these institutions to verify credentials more expeditiously.
  • Following up with the licensing boards in other states where licenses are held also may assist in shortening the time for licensure. Write a short note to the organization processing your request for information 30 days after the initial request, but avoid frequent phone calls.
  • Even physicians with uncomplicated histories and complete, accurate applications may experience delays in obtaining a medical license.
  • The peak period for licensure applications is April through September, and the volume of applications submitted during this time may affect processing times.
  • Remember that a full and unrestricted license must be awarded before a physician can receive hospital credentialing or qualify for medical malpractice insurance.

A physician should never try to hide derogatory information from a licensing board. It is much better to come forward with the information, help the board obtain records and other necessary data, and provide any justifications that may prevent the denial of a license.

Full 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.

The Federation Credentials Verification Service (FCVS) was created by the Federation of State Medical Boards 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 enables 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 the FCVS.

The FCVS also offers a service to USMLE candidates who complete their Step 3 application online. As a convenience to examinees, information entered on their Step 3 online application can be used to begin a personalized FCVS physician information profile containing their primary source verified credentials. As a USMLE Step 3 applicant, you will benefit from enrolling in FCVS by having your credentials verified and accessible when you are ready to apply for your first full and unrestricted license to practice medicine.

The majority of licensing authorities accept FCVS-verified documents for licensure. Learn more about how to make use of these services during your state licensure process by visiting the FCVS website or calling the Federation of State Medical Boards at (888) 275-3287.

Learn more about the cross-state medical licensing process.