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JAMA Patient Page
September 15, 2010

Medical Licensure

JAMA. 2010;304(11):1286. doi:10.1001/jama.304.2.1286

In most countries, doctors must have a license to practice medicine. Licenses are granted after a physician has graduated from an accredited (official) medical school and completed additional training. Background checks, review of medical school grades, and consideration of standardized test scores (such as the Federal Licensing Examination [FLEX] or the National Board of Medical Examiners tests) are all part of the licensing process. In the United States, each state has its own individual licensing board and a doctor must obtain a license for each state in which he or she works.

Students become medical doctors (MDs) or doctors of osteopathy (DOs, for osteopathic medical schools) after graduation from medical school, but to become licensed to practice medicine, physicians must complete at least 1 year of post-medical school education and training. The first year of this training is called internship or first-year residency. Most physicians, and any who practice a specialty of medicine, complete a residency. Residencies are several years of further education and training in a specific area of medicine. The September 15, 2010, issue of JAMA is a theme issue about medical education and includes articles about the education and training of physicians.

Obtaining a medical license

An application to obtain a medical license includes proof of graduation from an accredited medical school and detailed personal information. This usually means a copy of the medical school diploma, in addition to having the medical school send a transcript (an official record) of medical school courses completed. The doctor may also need to provide evidence of each training program that he or she completed, as well as a log of all continuing medical education (CME) that the doctor has completed in the last few years. Professional references (individuals who have known and worked with the physician) are required, and the state's medical board contacts those persons to check on the doctor's reputation and ethics. Some states also require further testing or specific course work (for example, a course on human immunodeficiency virus treatment) before issuing a license. Several states also require a face-to-face interview with a member of the state medical board. Doctors are required to pay for their licenses, both an initial licensing fee and another fee each time the license is renewed.

Keeping a medical license

  • Medical licenses must be renewed, usually about every 4 years.

  • Each state has its own timetable for renewal of a doctor's license.

  • Physicians are generally asked to report if they have an alcohol or substance abuse problem or if they have been involved in commission of a felony. A medical board will investigate physicians if the board receives complaints about these issues.

  • Most states in the United States have CME requirements for physicians, including formal course work and more informal study.

  • Any information about malpractice suits must be provided to each state's licensing board.

  • State medical boards review doctors' performances and evaluate complaints against physicians. If a doctor is found to have violated ethical or practice standards, has committed a crime, has an alcohol or substance abuse problem, or has not completed the required CME, his or her medical license can be suspended or revoked (taken away completely). Sometimes restrictions are placed on the doctor's practice or certain conditions must be met before the doctor can regain her or his license.

For more information

Inform yourself

To find this and previous JAMA Patient Pages, go to the Patient Page link on JAMA's Web site at http://www.jama.com. Many are available in English and Spanish. A Patient Page on continuing medical education was published in the September 23/30, 2009, issue; one on medical specialties was published in the September 5, 2007, issue; and one on academic health centers was published in the September 1, 2004, issue.

Sources: Federation of State Medical Boards, Association of American Medical Colleges

The JAMA Patient Page is a public service of JAMA. The information and recommendations appearing on this page are appropriate in most instances, but they are not a substitute for medical diagnosis. For specific information concerning your personal medical condition, JAMA suggests that you consult your physician. This page may be photocopied noncommercially by physicians and other health care professionals to share with patients. To purchase bulk reprints, call 312/464-0776.


This article was corrected online for errors on December 10, 2010.