USA · Professional license

State medical license (physician)

Granted by state medical boards, not by a national exam alone. Bachelor's degree, then a 4-year medical school program leading to an M.D. or a D.O., then residency.

Granted byState medical boards
National exams2USMLE Step 1, Step 2 CK, Step 3 · COMLEX-USA Level 1, Level 2-CE, Level 3
ExperienceResidency of 3 to 9 years depending on specialty; optional fellowship of 1 to 3 years (BLS).
Other statesIMLC40 jurisdictions · Member state, can serve as State of Principal License
See the route Rules in other states

How to get licensed

Bachelor's degree, then a 4-year medical school program leading to an M.D. or a D.O., then residency.

  1. High school diploma
  2. Bachelor's degree with pre-med coursework (any major)
  3. MCAT and medical school applicationExam
  4. Medical school — M.D. or D.O. (4 years)
    M.D. → USMLED.O. → COMLEX-USA
  5. USMLE (M.D.) or COMLEX-USA (D.O.) during and after medical schoolExam
  6. Residency (3–9 years)
  7. State medical licenseLicense
  8. Optional: fellowship and board certificationOptional

The exams

National bodies write the exams; the state board decides who is licensed. USMLE — owned by the Federation of State Medical Boards (FSMB) and the National Board of Medical Examiners (NBME); COMLEX-USA — National Board of Osteopathic Medical Examiners (NBOME).

  • USMLE Step 1, Step 2 CK, Step 3Three-step exam taken at different points in an M.D. student's education and training; results go to state medical boards, which grant the license.
    USMLE
    About the USMLEUSMLE (FSMB and NBME)
    Checked
    7 Oct 2026
    View source
  • COMLEX-USA Level 1, Level 2-CE, Level 3Three-level licensing exam for osteopathic physicians (D.O.). Levels 1 and 2-CE are required to graduate from accredited D.O. programs; NBOME says it is the only licensing exam accepted for D.O.s in all 50 states.
    NBOME
    COMLEX-USANational Board of Osteopathic Medical Examiners
    Checked
    7 Oct 2026
    View source

State rules and other states

Each state medical board sets its own licensure rules. Passing USMLE or COMLEX-USA alone does not grant a license.

Interstate Medical Licensure Compact (IMLC)

The Interstate Medical Licensure Compact offers a voluntary, expedited pathway to licensure for qualified physicians who wish to practice in multiple states.

Member state, can serve as State of Principal License · 40

Processing applications and issuing licenses; a physician can use this state as their State of Principal License.

  • Alabama
  • Arizona
  • Colorado
  • Connecticut
  • Delaware
  • District of Columbia
  • Florida
  • Georgia
  • Guam
  • Idaho
  • Illinois
  • Indiana
  • Iowa
  • Kansas
  • Kentucky
  • Louisiana
  • Maine
  • Maryland
  • Michigan
  • Minnesota
  • Mississippi
  • Missouri
  • Montana
  • Nebraska
  • Nevada
  • New Hampshire
  • New Jersey
  • North Carolina
  • North Dakota
  • Ohio
  • Oklahoma
  • Pennsylvania
  • South Dakota
  • Tennessee
  • Texas
  • Utah
  • Washington
  • West Virginia
  • Wisconsin
  • Wyoming
Member state, not a State of Principal License · 2

Issuing licenses through the compact, but cannot serve as a physician's State of Principal License.

  • Hawaii
  • Vermont
Compact passed; implementation in process or delayed · 4

The state has passed the compact but is not yet issuing licenses through it.

  • Alaska
  • Arkansas
  • New Mexico
  • Rhode Island
Compact legislation introduced · 1

A bill has been introduced; the state is not a member.

  • New York
List as published by Interstate Medical Licensure Compact Commission, checked 7 Oct 2026. Memberships change: confirm with the state board before you rely on it. Read from the IMLC participating-states map. The IMLC says questions about the current status and extent of a state's participation should go to that state's board.
IMLC
IMLC participating statesInterstate Medical Licensure Compact Commission
Checked
7 Oct 2026
Next review
5 Jan 2027
View official list

Good to know

Not always required

  • Board certification is not required to practice (BLS), though it can widen job options.

Changes to watch

  • NBOME is changing how D.O. students show clinical skills for COMLEX Level 3 starting with the Class of 2029.
Checked 7 Oct 2026. Confirm with the licensing body before you plan around a change.

Careers that use this license

Sources: BLS · USMLE · NBOME · AAMC. Checked 7 Oct 2026. How Margdarshan sources its data →