To practice medicine as a physician, you must be a medical school graduate, have experience in an internship or residency, and pass an examination to become licensed to practice medicine. To get into medical school, students typically must hold an undergraduate degree in physics, biology, mathematics, chemistry, or a related field. The program can take anywhere from three to five years to complete, depending on the type of medicine studied and specific program. Once you have graduated from medical school, most physicians are required to participate in an additional three to eight years in an internship or residency program. The final step requires a passing score on the United States Medical Licensing Examination (USMLE) if you hold a doctor of medicine (MD), or the Comprehensive Osteopathic Medical Licensing Exam (COMLEX) if you are an osteopathic physician (DO). After passing the exam, you must submit your scores to the state licensing board where you intend to practice.

Licenses are granted to ensure the public that the physician has successfully completed an appropriate sequence of medical education.

Cheryl GrossDirector for the Division of Certification for the American Osteopathic Association

Getting Physician Licensure and Certification

Physicians are directly responsible for the health and livelihood of their patients, so licensure is important to make certain that all practicing physicians have met an educational and professional standard. This requires extensive medical school experience, as well as the completion of the USMLE, or the COMLEX if you plan to be an osteopathic physician. Both of these examinations are used by state licensure review boards as an evaluative measure for licensure.

The USMLE consists of a three-step testing process that evaluates a physician’s ability to apply knowledge, concepts, and principles of medical knowledge related to patient care. The first step of the process gauges a student's understanding of the scientific principles needed in medicine. The second step consists of two parts: one examines a student's clinical knowledge, while the other evaluates a student's basic patient care skills. Finally, the third and final step of the USMLE testing process involves two days of testing, both of which students must complete within eight hours for each day. This final step assesses the student's ability to independently care for patients. For aspiring osteopathic physicians, the COMLEX is administered in almost an identical fashion to the USMLE and is designed to evaluate a student's knowledge base and skill set, similar to the goal of the USMLE.

Keep in mind that the completion of the USMLE or COMLEX alone does not grant the ability to practice, but instead is used by each individual state's medical licensing board to make their final decision regarding a physician's licensure. We recommend you check the guidelines for the state where you intend on practicing before taking the test. You can check you specific state’s guidelines at the Federation of State Medical Boards website.

"Licenses are granted to ensure the public that the physician has successfully completed an appropriate sequence of medical education," said Cheryl Gross, the director for the Division of Certification for the American Osteopathic Association (AOA). "[License holders] have completed a specified amount of residency training in an accredited program and have demonstrated competence through successful completion of an examination or other certification demonstrating qualification for licensure."

Both MDs and DOs who seek additional certification beyond state licensure can spend up to seven years training in a residency program, depending on the type of medical specialty they enter. The American Board of Medical Specialists (ABMS) represents 24 boards related to specialty fields in medicine. Physicians holding a DO can also gain certification through the AOA, which offers certification in 18 medical specialties. These specialties range from anesthesiology to family practice.

Maintaining Physician Licensure and Certification

Because of the rapid advancements being made throughout modern medicine, physicians will need to participate in continuing education throughout their career to maintain their state licensure. To do so, they must participate in Continuing Medical Education (CME) courses approved by their state licensing board. One of the ways for physicians to complete CME is to participate in programs through the American Medical Association (AMA). Some states do not require CME, however, and only require regular renewals of licensure. Once you're licensed, be sure to check your state’s license renewal requirements.

"Physicians are committed to the health and well-being of their patients," Gross said. "Continuing medical education offerings enable physicians to refine their skills and offer the best in patient care and maintain currency in their specialty."

Physicians who also possess certification through the ABMS or the AOA will also be required to maintain their certification. Physicians who are certified by one of the 24 ABMS boards are required to maintain certification through an ongoing four-part process of continuing education. This requires that you hold a valid, unrestricted medical license, commit to a lifelong self-assessment process determined by your member board, and demonstrate your specialty skills in practice when compared to peers and other national benchmarks set within the specialty. DOs who hold a specialty certification through the AOA are required to renew their certification at least every 10 years and can also pursue CME through the AOA.

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