As a physician in training, your medical school degree may seem like the gold standard. But as a resident, you quickly learn it’s the first of many benchmarks one must reach during a career in medicine.
Obtaining a medical license and earning medical board certification are also key achievements for young physicians. While state licensure is a legal requirement for physicians to practice, board certification is not. However, many employers expect that if a physician is not already board certified, they will be soon.
What do these processes entail and why are they necessary? And what, precisely, is a board-certified physician? Let’s take a look.
When and how to get licensed
Physicians are licensed on a state-by-state basis. Depending on which state you’re in, requirements will vary. The AMA offers introductory information on the medical licensure process.
In order to be licensed, applicants must document passage of a licensing examination, either the United States Medical Licensing Examination (USMLE) or Comprehensive Osteopathic Medical Licensing Examination of the United States (COMLEX-USA). Depending on the state, there may be a maximum number of attempts allowed to pass the licensing exams and a time window within which they must be completed. Both exams take place in three parts and the third portion is typically completed during residency training.
If you do have leeway in terms of the timing of getting your license, John Andrews, MD, believes doing so sooner offers more flexibility.
“I’d encourage most people to seek licensure when they have completed the [exams] and necessary education, so shortly after their internship,” said Dr. Andrews, the AMA’s vice president for GME innovations. “Other than the expense, there’s no reason not to, and it creates more latitude in what you are able to do.”
It’s important to note, however, that licensure requirements vary by state, and they also vary by type of medical graduate.
“In most states, if you are a U.S. medical school graduate, you can obtain a license with just a single year of graduate medical education training—so, essentially, at the conclusion of your internship—provided you've passed the necessary exams,” Dr. Andrews said. “For international medical graduates, the requirements may be different. In some states, you may need one year of U.S. graduate medical education, while in others you may need two, for example.”
As with licensing requirements, the cost of obtaining a license varies by state. On the low end, it’s less than $100. On the high end, residents could spend in excess of $1,000.
Dive deeper:
- Credentialing 101: What resident physicians need to know
- Obtaining a medical license
- Final-year residents: Are you up to speed with your job search?
- In transition to practice, know these 8 steps for evaluating jobs
Getting doctor board certification
Board certification for doctors is specific to specialties and subspecialties, each with its own set of requirements.
While every physician must be licensed to practice medicine, board certification is a voluntary process. Medical licensure sets the minimum competency requirements to diagnose and treat patients and is not specialty specific. Board certification, on the other hand, demonstrates a physician’s “exceptional expertise in a particular specialty and/or subspecialty of medical practice,” according to the American Board of Medical Specialties.
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Speaking generally, board certification will require a physician to have a full medical license and to have completed an accredited residency or fellowship program. You are also going to need to pass a board-certification examination, which can be pricey. Fees for the initial written exam vary by specialty, with some under $1,000 but others exceeding $2,000. Meanwhile, some medical specialty boards also require an oral exam for initial certification, and this may carry substantial additional cost.
In some instances, physician practices will offer to pay for board certification as part of their recruitment efforts—this goes hand in hand with their expectation that you will become board certified within a certain amount of time after joining the practice. There is also typically some latitude for new physicians in terms of the amount of time one has to pass the boards.
“The expense is a barrier, and some people put off taking their board exams for that reason,” Dr. Andrews said. “But it’s important to take the exam when you complete your [residency] training. With all the knowledge fresh in your head, you’re as prepared as you’ll ever be at that point.”
Keep in mind that you can’t just take a board exam whenever you want.
“The biggest barrier to board certification is sitting the exam because it will only be offered on certain dates,” Dr. Andrews said. “But once you’ve taken the exam, the results are typically turned around pretty quickly, usually within a month or two.”
For residents preparing to enter the job market, the AMA provides many resources to help physicians understand employment contracts, such as the Annotated Model Physician-Group Practice Employment Agreement (PDF) and the AMA Physicians’ Guide to Hospital Employment Contracts (PDF), both free to AMA members.
Also, take time to learn about the “AMA Principles for Physician Employment” adopted by the AMA House of Delegates, which are designed to help physicians and employers address challenges such as contracting, conflicts of interest, payment agreements, and advocacy for patients and the profession.
