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International Medical Graduates

Guide to Licensure

Mohammed K. Rizvon, MD, FACP
Attending Physician, Department of Medicine
Nassau University Medical Center
Assistant Professor of Medicine, SUNY at Stony Brook

  • The application for licensure begins with passing the Medical Licensing Examinations I, II, III, the proficiency in English test, and Clinical Skills Assessment. Since steps I and II of the Unites States Medical Licensing Examinations and Clinical Skills Assessment are now required prior to joining the residency program, consider taking USMLE III soon after starting residency training. Many residents try to postpone taking this exam to avoid interfering with the hectic schedule of internship. This may not be a good idea as a good basic knowledge in multiple specialties is essential for passing this examination.

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  • USMLE III can be taken in any U.S. state. Consider taking the exam in states that require the least paperwork. One example in the Northeast is Connecticut whose USMLE application is relatively simple. Some of the other states require a completed application form for medical license including all the verifications as a requirement to sit for the exam.

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  • It is essential to identify one state where you would like to practice medicine after your residency training. Application fees are expensive for a resident physician and the application process is a considerably long one that requires a lot of time commitment.

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  • Some of the factors that could help decide on applying to a particular state are the visa requirements of some medical boards or other requirements like fingerprinting or direct verification of credentials, which usually take a lot of time. The New York State Medical Board issues an unrestricted license to practice medicine only to U.S. citizens and permanent residents. Applicants on non-immigrant visas can only apply for limited license to practice medicine and only in qualified medically underserved areas/health professional shortage areas. The NY State Department of Health and the U.S. Federal Register are the sources of information for the updated list of available medically underserved areas.

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  • Direct verification of applicant's credentials is a requirement of many state medical boards. This takes a lot of time, especially for international medical graduates, whose medical schools usually do not have a procedure to deal with these requests. To facilitate this, establish contact in advance with the academic offices of the high school, medical school and your country's licensing board, which will be contacted by the state medical boards for direct verification. Verifying agencies in the U.S. charge a fee for the processing time and postal expenses. However, the international verifying centers do not charge a fee and sometimes hold up the verification process due to lack of payment to cover postal expenses. It is a good idea to appoint a liaison to expedite this process.

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  • Verifications of USMLE scores, ECFMG certification, and residency training are also required. Even though the mechanism of verification of these credentials is simpler, do not assume that they will be automatic. It is a good idea to check with these agencies if the verification has been done and the information forwarded to the state medical board.

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  • Once the direct verifications are complete, the completed application package is then forwarded to the next board meeting when a decision is made on awarding or denying the license. On an average the entire processing time is about four months.

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  • It is essential to keep the registration of the license current. This involves paying the requisite fee at the prescribed time, completing the required continuing medical education credit hours, and complying with the rapidly changing health care management laws. Many state medical boards have web sites where you can check the validity of your license and registration.

Useful Links:
ECFMG: http://www.ecfmg.org/
FSMB: http://www.fsmb.org/
NY State Department of Health: http://www.health.state.ny.us/
U.S. Federal Register: http://fr.cos.com/

Author Bio:

Mohammed K. Rizvon is a graduate of the Madras Medical College, Madras, India. He completed his residency training in Nassau University Medical Center (NUMC), East Meadow, NY and joined the faculty after a year as Chief Resident. He serves as Director of Medical Consultation Service at NUMC and is a Fellow of ACP.

This article was prepared for the ACP IMG Web site in 2000.

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