A medical license is a legal credential issued by a state government that grants a physician the right to diagnose and treat patients within that state’s borders. Without one, practicing medicine is illegal. Every state and U.S. territory has its own licensing board, and there are 70 such boards across the country, each operating under its own set of rules.
Who Issues Medical Licenses
Medical licensing is a state-level power, not a federal one. Under the Tenth Amendment to the U.S. Constitution, states have the authority to protect public health and safety, which includes regulating who can practice medicine. The U.S. Supreme Court confirmed this authority in the landmark case Dent v. West Virginia, ruling that states can regulate medical practice through professional licensing boards.
Each state has a medical practice act, a law that defines what counts as practicing medicine and gives the state medical board the power to issue licenses, set standards, and discipline physicians. These boards handle everything from reviewing initial applications to investigating complaints about licensed doctors. The Federation of State Medical Boards (FSMB) is a nonprofit that represents all 70 state and territorial licensing boards but doesn’t issue licenses itself.
What It Takes to Get Licensed
The path to a medical license involves three core requirements: a medical degree, passing scores on a national licensing exam, and supervised postgraduate training (residency).
Physicians who graduate from allopathic medical schools (earning an MD) take the United States Medical Licensing Examination, known as the USMLE, which has three steps. Physicians from osteopathic medical schools (earning a DO) take an equivalent series called COMLEX. Both exams test medical knowledge and clinical reasoning, and all three steps must be passed. States limit how many times you can attempt each step, ranging from as few as two attempts per step in Alaska to unlimited attempts in states like Arizona, Colorado, and Florida.
After passing the exams, physicians must complete a minimum amount of supervised residency training in an accredited program. Most states require at least one year for U.S. graduates, though some, like Alaska and Connecticut, require two. International medical graduates face stricter requirements, typically needing two to three years of accredited training before they can apply. These extra requirements exist because the boards need to verify the quality of training received outside the U.S. system.
Beyond exams and training, applicants go through a thorough background check. This includes verification of their medical school credentials, letters of reference, and a criminal background screening.
How Much It Costs
Application fees vary widely by state. Alabama charges just $75, while Washington, D.C. charges $805 and Maryland charges $790. Most states fall in the $300 to $500 range. These fees are non-refundable regardless of whether the application is approved.
Physicians who want to practice in multiple states can use the Interstate Medical Licensure Compact, which streamlines the process. The Compact charges a $700 base fee on top of each participating state’s individual license fee, so a physician seeking licenses in several states can expect to pay several thousand dollars total.
Medical License vs. Board Certification
These two credentials are often confused, but they serve different purposes. A medical license is a legal requirement. You cannot see patients without one. It sets the minimum standard of competency to practice medicine and is not tied to any particular specialty.
Board certification, on the other hand, is voluntary. It signals that a physician has demonstrated expertise in a specific specialty, like cardiology or orthopedic surgery, by passing additional exams administered by organizations like the American Board of Medical Specialties. Many hospitals and insurance networks prefer or require board certification, but a physician can legally practice without it as long as they hold a valid state license.
What a License Allows You to Do
A medical license authorizes a physician to practice “medicine and surgery, or any of its branches,” as most state laws phrase it. In practical terms, this means diagnosing conditions, prescribing medications, performing procedures, and managing patient care. The license is not specialty-specific. A licensed physician is legally permitted to practice outside their area of training, though hospitals and malpractice insurers impose their own restrictions based on credentials and experience.
The critical limitation is geography. A license issued in one state is only valid in that state. A physician licensed in California cannot treat a patient in New York without also holding a New York license. This is why the Interstate Medical Licensure Compact exists, and why telemedicine has made multi-state licensing a growing concern.
Keeping a License Active
A medical license isn’t permanent. Physicians must renew it on a regular cycle, typically every one to two years, and meet continuing medical education (CME) requirements to stay current. Texas, for example, requires 48 CME credits every two years, including mandatory training in topics like medical ethics and human trafficking prevention. Some of those credits must come from formal educational activities, while others can be earned through self-study, hospital lectures, or case conferences.
Failing to complete required CME hours can result in fines or suspension. Continued non-compliance can eventually lead to losing the license altogether.
How Licenses Get Suspended or Revoked
State medical boards exist primarily to protect the public, and they have broad authority to discipline physicians. The most common reasons a doctor loses their license include:
- Substance abuse: Practicing while impaired by drugs or alcohol. Many states offer rehabilitation programs, but repeated violations or refusal to participate triggers revocation.
- Fraud: Billing insurance for services never provided, upcoding procedures, or participating in kickback arrangements with pharmaceutical or medical device companies.
- Criminal convictions: Felonies involving controlled substances, financial crimes, or violent offenses commonly result in license loss.
- Sexual misconduct or patient abuse: Any breach of the physician-patient relationship involving exploitation or harm.
- Repeated malpractice: A pattern of negligent care or multiple malpractice settlements signals a danger to patient safety that boards take seriously.
- Ignoring board orders: If a physician has already been sanctioned and fails to comply with the board’s conditions, the situation typically escalates to full revocation.
Disciplinary actions are a matter of public record. Before the license is revoked, a physician usually faces a formal investigation, and they have the right to a hearing. But state boards have the final say, and their primary obligation is patient safety.
How to Verify a Doctor’s License
Anyone can check whether a physician holds a valid license and whether they’ve faced disciplinary action. The FSMB operates a free public tool called DocInfo, which contains professional background information on more than one million licensed physicians in the U.S. You can search by name and state to see a doctor’s license status and any actions taken against them by state boards. Individual state medical board websites also offer their own searchable databases, often with more detailed records of complaints and outcomes.