Medicine is a licensed profession in the United States, with separate states regulating it. Issuing licenses to physicians is one of the essential tasks of the nation’s 71 medical boards. State medical boards ensure that all practicing physicians have the necessary education and training and adhere to established professional conduct standards while serving their patents through licensing.
Obtaining a license to practice medicine in the United States is a lengthy and challenging process. Medical school graduation, postgraduate study, and passing a stringent national medical licensure examination that measures their understanding of health and disease management and competent patient care are prerequisites for entry into the profession. Applicants must give documentation of their education and training and information about their employment history. They must also give information about their health, malpractice judgments, and criminal convictions that may jeopardize their ability to practice. Permission is issued only to individuals who meet a state’s requirements.
Physicians must renew their licenses regularly, usually every one or two years, to maintain their active status. Physicians must demonstrate that they have maintained acceptable ethics and medical practice standards and have not engaged in unethical conduct during the license renewal procedure. Physicians must also certify that they have completed a continuing medical education program in practically all states. Here are the steps to complete before getting a license:
- Medical education
Candidates for physician licensing in all jurisdictions must have earned an MD or DO degree. A post-baccalaureate four-year program of instruction is required for most medical education programs in the United States. International medical school (IMG) graduates may provide the equivalent of an MD degree (e.g., MBBS).
It’s worth noting that earning an MD or DO does not guarantee that you’ll be able to practice medicine in the United States. In most jurisdictions, individuals with a physician credential are prohibited from publicly advertising themselves as physicians unless they have a medical license in that area.
- Medical Training
To be eigible for a complete and unrestricted medical license, all state medical boards require licensure candidates to complete one year of postgraduate training. In certain states, obtaining a license is more stringent: the physician must finish two or three years of residency training. In more than a dozen jurisdictions, progress through postgraduate training requires a physician to pass the licensing examination sequence and receive a full, unrestricted license before reaching a defined point in their postgraduate training.
Most state medical boards grant physicians a resident or training permit to practice within their residency program’s limited, supervised environment during their postgraduate training period, which is often the first official encounter of prospective physicians with a state medical board. The AOA, ACGME, and AACOM agreed in 2014 to create a unified accreditation system for graduate medical education programs in the United States, which went into effect in 2020 and currently unites multiple programs. Depending on the specialty, these programs might last three to seven years.
- Licensing Examination
All practitioners are expected to complete The United States Medical Licensing Examination (USMLE) or the Comprehensive Osteopathic Medical Licensing Examination (COMLEX-USA). Physicians with an MD or DO degree are eligible to take the USMLE. The COMLEX-USA program is typically completed by physicians having a DO degree.
These are multi-part national exams that aspiring physicians take at various periods in their careers to measure their knowledge, clinical, and communication abilities. Many boards restrict how many times a physician can take the USMLE or COMLEX-USA.
Additional attempts are frequently permitted, but only if physicians have been referred to additional training before retaking the exam. Most boards also limit the amount of time you have to complete the examination sequence. These time and attempt limits are in place to guarantee that newly licensed physicians’ knowledge is current and adequate.
- Fitness to Practice
Potential license candidates’ physical, mental, and moral fitness is a concern for all state medical boards. Many boards define the practice of medicine expressly in their licensure applications to ensure that physicians know the minimum standards of performance. Each state’s licensure application typically includes questions on the applicant’s personal history and backgrounds, such as job history and medical and mental disorders that could affect their ability to practice medicine safely.
The physician’s license will be for the general, undifferentiated practice of medicine, which a state medical board will issue. In the United States, physicians are not licensed based on their specialization or area of practice. However, other practical concerns, such as getting hospital privileges, motivate most physicians to pursue specialist certification. The majority of physicians in the United States are board-certified by the American Board of Medical Specialties (ABMS) or the American Osteopathic Association’s Board of Specialties (AOA BOS).