Physician State Licensing Requirements

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Alabama
SPEX/COMVEX Requirement: May be required by Board order if written licensure or
board certification exam hasn’t been taken in the last ten years.
USMLE Attempt Limit: No attempt limit on Steps I and II. Three attempts for Step III.
Steps I – III must be passed in no more than a total of 10 attempts.
(Further education, training or experience required to repeat Step
III after 3 attempts)
USMLE Time Limit: Must complete all three Steps within 7, within 10 years for
MD/PhD.
PGT US/Canada: 1 year
PGT International: 3 years

Alaska
SPEX/COMVEX Requirement: To restore retired license.
USMLE Attempt Limit: Two attempts for both Steps I and II. Two attempts for Step III.
(If licensed elsewhere, alternative pathway available)
USMLE Time Limit: Must complete all three Steps within 7 years.
PGT US/Canada: 2 years (1 year if completed Med School before January of 1995).
PGT International: 3 years

Arizona
SPEX/COMVEX Requirement: Necessary to assess competence if ordered by Board
(for MD). May be required if written licensure or board
certification exam hasn’t been taken in the last seven years (for
DO).
USMLE Attempt Limit: No attempt limit for Steps I and II. No attempt limit for Step
III.
USMLE Time Limit: Must complete all three Steps within 7 years. If you hold a
medical license in another state, there is no time limit.
PGT US/Canada: 1 year (MD). 1 year AOA or ACGME accredited GME (DO).
PGT International: 3 years

Arkansas
SPEX/COMVEX Requirement: May be ordered by Board to assess current competence.
USMLE Attempt Limit: Each step must be passed in no more than three attempts.
USMLE Time Limit: Must complete all three Steps within 7 years. (May be waived to
10 years if applicant is currently board certified)
PGT US/Canada: 1 year
PGT International: 3 years (or be currently enrolled in a training program with UAMS
and have successfully completed at least one (1) year of U.S.
internship or residency)

California
SPEX/COMVEX Requirement: Required if written licensure or board certification exam hasn
not been taken in the last ten years (for MD). Lifetime Board
certification accepted in lieu of SPEX. May be required by DO
Board to assess competence.
USMLE Attempt Limit: – If exam sequence was passed prior to 01/01/2007: No attempt
limits for Steps I-III.- As of 01/01/2007: No attempt limit for Steps I and II. Four
attempts total for Step III.* Possible waiver with 4 years continuous pratice in another
state with active license and no discipline
USMLE Time Limit: Must complete all three Steps within 10 years.
PGT US/Canada: 1 year (including 4 mo. General Medicine) (MD).

1 year AOA or ACGME accredited GME, including at least 4 mo.
General Medicine (unless applicant completed 1 year of GME before
July 1, 1990) (DO).
PGT International: 2 years (including four months of general medicine)

Colorado
SPEX/COMVEX Requirement: May be ordered by Board to assess current competence.
USMLE Attempt Limit: No attempt limit for Steps I and II. No attempt limit for Step
III.
USMLE Time Limit: Must complete all three Steps within 7 years, within 10 years for
MD/PhD.
PGT US/Canada: 1 year
PGT International: 3 years

Connecticut
SPEX/COMVEX Requirement: May be ordered by Board to assess current competence.
USMLE Attempt Limit: No attempt limit for Steps I and II. No attempt limit for Step
III.
USMLE Time Limit: No Time Limit.
PGT US/Canada: 2 years
PGT International: 2 years

Delaware
SPEX/COMVEX Requirement: May be required if not practicing for several years.
USMLE Attempt Limit: There shall be no more than six attempts to pass each Step without
demonstration of additional experience acceptable to the Board.
USMLE Time Limit: Passing Step 1, Step 2, and Step 3 of the examination must occur
within 7 years.
PGT US/Canada: 1 year
PGT International: 3 years

District
of Columbia
SPEX/COMVEX Requirement: May be ordered by Board to assess current competence.
USMLE Attempt Limit: No attempt limit for Steps I and II. No attempt limit for Step III
(after three failed Step III attempts, 1 additional year GME
required).
USMLE Time Limit: Must complete all three Steps within 7 years. Board may grant
waiver.
PGT US/Canada: 1 years
PGT International: 3 years

Florida
SPEX/COMVEX Requirement: May be ordered by Board to assess current competence.
USMLE Attempt Limit: No attempt limit for Steps I and II. No attempt limit for Step
III.
USMLE Time Limit: No time limit.
PGT US/Canada: 1 year (MD)

1 year AOA approved rotating internship (DO)
PGT International: 2 years

Georgia
SPEX/COMVEX Requirement: May be ordered by Board to assess current competence.
USMLE Attempt Limit: No attempt limit for Steps I and II. Three attempts for Step III.
(1 year of additional Board approved training required if not passed
in designated number of attempts)
USMLE Time Limit: Must complete all three Steps within 7 years, within 9 years for
MD/PhD. Board may grant waiver.
PGT US/Canada: 1 year
PGT International: As of 02/2010, the GA Board uses the list titled Medical
Schools Recognized by the Medical Board of California".
Graduates of schools from this list must complete 1 year
of ACGME accredited postgraduate training. Graduates of schools not
listed in the list must complete 3 years
of ACGME accredited postgraduate training.

Hawaii
SPEX/COMVEX Requirement: Required if MD took a state licensing exam. Not
required for DO.
USMLE Attempt Limit: No attempt limit for Steps I and II. No attempt limit for Step
III.
USMLE Time Limit: Must complete all three Steps within 7 years, within 10 years for
MD/PhD.
PGT US/Canada: 1 year (MD)

1 year AOA or ACGME accredited GME (DO)
PGT International: 2 years

Idaho
SPEX/COMVEX Requirement: May be ordered by Board to assess current competence.
USMLE Attempt Limit: Two attempts for Steps I and II. Two attempts for Step III.
(Remedial training, interview or Board evaluation may be required if
Step III is not passed in designated number of attempts)
USMLE Time Limit: Must complete all three Steps within 7 years, within 10 years for
MD/PhD.
PGT US/Canada: 1 year
PGT International: 3 years

Illinois
SPEX/COMVEX Requirement: Required to restore license after disciplinary action,
if not been practicing for several years, or by board order to
assess current competence.
USMLE Attempt Limit: No more than 4 unsuccessful attempts total (for Steps I – III).
Further education, experience or remedial training required if not
passed in designated number of attempts.
USMLE Time Limit: Must complete all three Steps within 7 years. (Board may grant
waiver)
PGT US/Canada: 2 years (1 year if entered GME before Janurary 1988).
PGT International: 1 year (entered GME pre-1988)

2 years (entered GME post 1988).

Indiana
SPEX/COMVEX Requirement: Required if not practicing for several years, or by
Board order to assess current competence.
USMLE Attempt Limit: Three attempts for each Step. (Board may grant waiver.)
USMLE Time Limit: Must complete all three Steps within 10 years.
PGT US/Canada: 1 year
PGT International: 2 years

Iowa
SPEX/COMVEX Requirement: Required if not practicing for several years, or by
Board order to assess current competence.
USMLE Attempt Limit: Six attempts for Steps I and II. Three attempts for Step III.
(After 3 failed attempts at Step III, 3 years of progressive GME is
required)
USMLE Time Limit: Must complete all three Steps within 10 years (if not, ABMS or
AOA Board certification required).
PGT US/Canada: 1 year AOA, ACGME, RCPSC, CFPC accredited GME
PGT International: 2 years

Kansas
SPEX/COMVEX Requirement: May be ordered by Board to assess current competence.
USMLE Attempt Limit: No attempt limit for Steps I and II. Three attempts for Step III.
(After 3 failed attempts, further education, training, or experience
is required)
USMLE Time Limit: Must complete all three Steps within 10 years.
PGT US/Canada: 1 year
PGT International: 3 years total (2 of which must be ACGME-accredited)

Kentucky
SPEX/COMVEX Requirement: May be ordered by Board to assess current competence.
USMLE Attempt Limit: Four attempts for Steps I and II. Four attempts for Step III.
USMLE Time Limit: No time limit.
PGT US/Canada: 2 years
PGT International: 2 years

Lousiana
SPEX/COMVEX Requirement: Required if no written licensure exam or Board
certification exam taken within 10 years.
USMLE Attempt Limit: No attempt limit for Step I. Four attempts for Step II. Four
attempts for Step III.
USMLE Time Limit: Must complete all three Steps within 10 years.
PGT US/Canada: 1 year allopathic GME
PGT International: 3 years (Fifth Pathway may be counted as one year of required
GME)

Maine
SPEX/COMVEX Requirement: Required if not practicing for more than 1 year, or by
board order to assess current competence. (MD/DO)
USMLE Attempt Limit: No attempt limit for Steps I and II. Three attempts for Step III.
USMLE Time Limit: Must complete all three Steps within 7 years.
PGT US/Canada: 3 years (for those graduating after July 1, 2004) (MD)

1 year AOA or ACGME accredited GME (DO)
PGT International: 3 years (GME taken in Canada or the British Isles may be
considered qualifying on an individual basis).

Maryland
SPEX/COMVEX Requirement: Required if active licensure was interrupted during
last 10 years and if physician has not passed written licensure exam
within last 15 years and ABMS board certification exam within last
10 years.
USMLE Attempt Limit: Four attempts for Steps I and II. Four attempts for Step III.
(after 3 failed attempts, 1 year additional GME; no more than 3
failures permitted on any one step without additional qualifications
(specialty board certification, etc.)
USMLE Time Limit: Must complete all three Steps within 10 years.
PGT US/Canada: 1 year (plus 1 year GME if candidate failed any part of an exam
three times)
PGT International: 2 years ACGME or RCPSC accredited GME (as of Oct 1, 2000). In
addition, 1 year of GME required if candidate failed any part of an
exam 3 times.

Massachusetts
SPEX/COMVEX Requirement: Not Required.
USMLE Attempt Limit: Three attempts at Step III. A fourth attempt may be allowed with
an additional year of ACGME-accredited training.
USMLE Time Limit: Must complete all three Steps within 7 years. (Board may grant
waiver)
PGT US/Canada: 2 years
PGT International: 3 years

Michigan
SPEX/COMVEX Requirement: May be ordered by Board to assess current competence.
(MD/DO)
USMLE Attempt Limit: No more than three attempts to pass any part of the USMLE.
USMLE Time Limit: An applicant shall successfully pass all components of the USMLE
within 7 years from the date that he or she first passed any
component of the USMLE.
PGT US/Canada: 2 years (MD)

1 year AOA approved GME (DO)
PGT International: 2 years

Minnesota
SPEX/COMVEX Requirement: Required to restore license after disciplinary action,
or if written licensure exam or board certified exam has not been
taken within 10 years. May be ordered by Board to assess current
competence.
USMLE Attempt Limit: Three attempts for Steps I and II. Three attempts for Step III (4
if currently licensed in another state and Specialty Board
certified).
USMLE Time Limit: Step II must be completed within 5 years or before end of
training. Step III must be completed within 5 years of passing Step
II or by end of training.
PGT US/Canada: 1 year
PGT International: 2 years

Mississippi
SPEX/COMVEX Requirement: Required to restore license after disciplinary action,
or if written licensure exam or board certified exam has not been
taken within 10 years. May be ordered by Board to assess current
competence.
USMLE Attempt Limit: No attempt limit for Steps I and II. Three attempts for Step III.
(after 3 failed attempts, 1 additional year ACGME or AOA approved
GME is required)
USMLE Time Limit: Must complete all three Steps within 7 years.
PGT US/Canada: 1 Year
PGT International: 3 years (or 1 year plus ABMS certification). ABMS Board
certificatin required for candidates who completed the Fifth
Pathway.

Missouri
SPEX/COMVEX Requirement: Required to restore license after disciplinary action
or by Board order to assess current competence.
USMLE Attempt Limit: Three attempts for Steps I and II. Three attempts for Step III.
USMLE Time Limit: Must complete all three Steps within 7 years.
PGT US/Canada: 1 year
PGT International: 3 years

Montana
SPEX/COMVEX Requirement: Required if not practicing for the last two years or
by Board order to assess current competence.
USMLE Attempt Limit: No attempt limit for Steps I and II. Three attempts for Step III.
USMLE Time Limit: Must complete all three Steps within 7 years. (exception may be
granted for MD/PhD dual degree candidates)
PGT US/Canada: Successful completion of residency program (at least 2 years); —
If graduated prior to 2000, must have had “experience or training
that in the opinion of the board is at least the equivalent of a
2-year approved residency program"
PGT International: 3 years (or ABMS or AOA certification).

Nebraska
SPEX/COMVEX Requirement: May be ordered by Board to assess current competence.
USMLE Attempt Limit: Four attempts for Steps I and II. Four attempts for Step III.
USMLE Time Limit: Must complete all three Steps within 10 years.
PGT US/Canada: 1 year
PGT International: 3 years

Nevada
SPEX/COMVEX Requirement: Required if written licensure exam or board certified
exam has not been taken within 10 years. May be ordered by Board to
assess current competence.
USMLE Attempt Limit: Must pass Steps I – III in no more than 9 attempts total. Must
pass Step III in no more than 3 attempts.
USMLE Time Limit: Must complete all three Steps within 7 years of first passing any
Step, within 10 years for MD/PhD.
PGT US/Canada: 3 years (MD)

3 years AOA or ACGME accredited program (graduates after 1995)
(DO)
PGT International: 3 years

New Hampshire
SPEX/COMVEX Requirement: May be ordered by Board to assess current competence.
USMLE Attempt Limit: Three attempts for Steps I and II. Three attempts for Step III.
(The Board shall waive this examination requirement for any
applicant who is board certified.)
USMLE Time Limit: No time limit.
PGT US/Canada: 2 years
PGT International: 2 years

New Jersey
SPEX/COMVEX Requirement: Not Required.
USMLE Attempt Limit: No attempt limit for Steps I and II. Five attempts for Step III.
(further education, training, or experience is required if Step III
is not passed in designated number of attempts) (Board may grant
waiver.)
USMLE Time Limit: Must complete all three Steps within 7 years. (Board may grant
waiver.)
PGT US/Canada: 1 year (if graduated before July 1, 2003). 2 years and contract
for Year 3 if graduated after July 1st, 2003.
PGT International: 3 years

1 year (if graduated before July 1, 1985; 3 years (if graduated
between July 1, 1985 and July 1, 2003); 2 years and contract for
year three if graduated after July 1, 2003

New Mexico
SPEX/COMVEX Requirement: Required to restore license after disciplinary action; if not
practicing for several years, or by Board order to assess current
competence (MD).Determined on an individual basis for DO.
USMLE Attempt Limit: Six attempts for Steps I and II. Six attempts for Step III.
USMLE Time Limit: Must complete all three Steps within 7 years, within 10 years for
MD/PhD.
PGT US/Canada: 2 years (MD)

1 year (DO)
PGT International: 2 years

New York
SPEX/COMVEX Requirement: Determined on an individual basis.
USMLE Attempt Limit: No attempt limit for Steps I and II. No attempt limit for Step
III.
USMLE Time Limit: No time limit.
PGT US/Canada: 1 year
PGT International: 3 years

North Carolina
SPEX/COMVEX Requirement: May be required to Board to assess current competence
or if written licensure exam or board certification exam not taken
within the last 10 years. (Applicant may obtain AMA PRA in lieu of
SPEX.)
USMLE Attempt Limit: Three attempts for Steps I and II. Three attempts for Step III.
USMLE Time Limit: No time limit.
PGT US/Canada: 1 year
PGT International: 3 years (less than 3 years of GME may be accepted if applicant is
certified by an ABMS or AOA specialty Board or holds the CFPC, FRCP
or FRCS.

North Dakota
SPEX/COMVEX Requirement: Required if applicant is being considered for GME
exception.
USMLE Attempt Limit: Three attempts for Steps I and II. Three attempts for Step III.
USMLE Time Limit: Must complete all three Steps within 7 years. (Exception may be
granted for MD/PhD or dual degree candidates)
PGT US/Canada: 1 year
PGT International: 3 years of US or Canadian GME. Board may confer eligibility after
1 year of US GME, other professional experience and ABMS Board
certification or SPEX.

Ohio
SPEX/COMVEX Requirement: Required if not practicing for 2 years or by Board
order to assess current competence.
USMLE Attempt Limit: Four attempts for Step I and II. Four attempts for Step III.
(successful completion of 1 additional year of GME; retake entire
exam sequence if Step III is not passed in designated number of
attempts)
USMLE Time Limit: Must complete all three Steps within 10 years. (if not passed
within 10 years, and not failed any step more than 3 times,
applicant may 1) retake the appropriate steps to bring the testing
sequence within the required 10 year period; or 2) Demonstrate good
cause, as determined by the board, for not having passed all three
steps within the 10 year period.)
PGT US/Canada: 1 year
PGT International: 2 years (through the 2nd year level)

Oklahoma
SPEX/COMVEX Requirement: May be required by Board to assess current competence
(MD/DO).
USMLE Attempt Limit: Three attempts for Steps I and II. Three attempts for Step III.
(Board may grant waiver if Board Certified.)
USMLE Time Limit: Must complete all three Steps within 10 years.
PGT US/Canada: 1 year (MD)

1 year AOA approved rotating internship or equivalent (DO)
PGT International: 2 years

Oregon
SPEX/COMVEX Requirement: Required if not practicing for one year, or if no
training or ABMS certification within the last 10 years, or if
applicant took a state board examination before 1968.
USMLE Attempt Limit: No attempt limit for Steps I and II. Four attempts for Step III
for applicants who are ABMS certified (must complete 1 year of GME
after three failed Step III attempts).
USMLE Time Limit: Must complete all three Steps within 7 years, within 10 years for
MD/PhD. Additional options for eligibility are available.
PGT US/Canada: 1 year
PGT International: 3 years (must have completed at least 3 years of progressive GME
in not more than two specialties in not more than 2 US or Canadian
hospitals accredited for such training).

Pennsylvania
SPEX/COMVEX Requirement: Required to restore license after disciplinary action
or if not practicing for several years. May be ordered by Board to
assess current competence (MD/DO).
USMLE Attempt Limit: No attempt limit for Steps I and II. No more than 3 attempts at
Step III. Board may grant waiver.
USMLE Time Limit: 7 year limit. Board requires explanation and waiver request if
beyond 7 years.
PGT US/Canada: 2 years (1 year if GME in US before July 1987) (MD)

1 year AOA approved rotating internship (DO)
PGT International: 3 years (1 year if GME taken in US before July 1987)

Rhode Island
SPEX/COMVEX Requirement: Not Required.
USMLE Attempt Limit: Three attempts for Steps I and II. Three attempts for Step III.
USMLE Time Limit: Must complete all three Steps within 7 years.
PGT US/Canada: 2 years
PGT International: 3 years

South Carolina
SPEX/COMVEX Requirement: Required to restore license after disciplinary action
or if no written licensure examination or ABMS Board certification
taken within the last 10 years. (SPEX may be waived if applicant
provides documentation of 150 Cat I CME hours within the last three
years – 75% of which must be related to practice specialty).
USMLE Attempt Limit: Three attempts for Steps I and II. Three attempts for Step III.
(Board may allow fourth attempt on any step given individual
circumstances.)
USMLE Time Limit: Must complete all three Steps within 10 years.
PGT US/Canada: 1 year
PGT International: 3 years (ABMS/AOA Board certification required for candidates who
completed the Fifth Pathway)

South Dakota
SPEX/COMVEX Requirement: Not Required.
USMLE Attempt Limit: Three attempts for Steps I and II. Three attempts for Step III.
USMLE Time Limit: Must complete all three Steps within 7 years, 10 years for
MD/PhD.
PGT US/Canada: Completion of residency program.
PGT International: Completion of residency in the US or Canada (1 year if GME taken
in US before July 1987)

Tennessee
SPEX/COMVEX Requirement: Required if not practicing for more than five years,
or to restore license after disciplinary action. May be ordered by
Board to assess current competence (MD).
USMLE Attempt Limit: No attempt limit for Steps I and II. No attempt limit for Step
III.
USMLE Time Limit: Must complete all three Steps within 7 years (extension for
MD/PhD combined program students). Board will not grant any waivers.
PGT US/Canada: 1 year (MD)

1 year AOA approved or ACGME accredited GME (DO)
PGT International: 3 years

Texas
SPEX/COMVEX Requirement: Required if written licensure or board certification exam has not
been taken in the last ten years (lifetime ABMS Board
certification NOT accepted in lieu of SPEX). Required to restore
license after disciplinary action or by Board order to assess
current competence. (MD)
USMLE Attempt Limit: Three attempts for Steps I – III.
If you held, or had a pending application for Training permit on
9/1/05, or have been licensed in good standing in another state
for at least 5 years:

  • Fourth attempt allowed on one step only.
  • Fifth/Sixth attempt allowed if Board certified and add’l 2 years
    of GME (beyond what is required) have been completed in Texas.
USMLE Time Limit: Must complete all three Steps within 7 years (excluding MD/PhD
graduates). Limits may be expanded to 10 years if applicant is Board
certified or holds a faculty temp license in Texas for 12+ months.
PGT US/Canada: 1 year
PGT International: 2 years

Utah
SPEX/COMVEX Requirement: Required if not practicing for several years or to restore
license after disciplinary action. May be ordered by Board to
assess current competence. (MD/DO)Required if no written licensure exam or board certification exam
taken within the last ten years (DO only).
USMLE Attempt Limit: Three attempts for Steps I and II. Three attempts for Step III.
(remedial training required if Step III is not passed in the
designated number of attempts)
USMLE Time Limit: Must complete all three Steps within 7 years, within 10 years for
MD/PhD.
PGT US/Canada: 2 years
PGT International: 2 years

Vermont
SPEX/COMVEX Requirement: Not Required. (MD)

Required if not practicing for more than one year. (DO)
USMLE Attempt Limit: No attempt limit for Steps I and II. Three attempts for Step III.
USMLE Time Limit: Must complete all three Steps within 7 years, 10 years for
MD/PhD.
PGT US/Canada: 1 year (Canadian GME accepted if program accredited by RCPSC or
CFPC) (MD)1 year AOA approved rotating internship or 3 year AOA or ACGME
accredited GME program (DO)
PGT International: 3 years

Virginia
SPEX/COMVEX Requirement: May be ordered by Board to assess current competence.
USMLE Attempt Limit: No attempt limit for Steps I and II. No attempt limit for Step
III.
USMLE Time Limit: Must complete all three Steps within 10 years. Time limit may be
waived if candidate is ABMS Board certified.
PGT US/Canada: 1 Year
PGT International: 2 Years

Washington
SPEX/COMVEX Requirement: Required to restore license after disciplinary action, if not
practicing for more than two years, or by Board order to assess
current competence. (MD)May be ordered by Board to assess current competence. (DO)
USMLE Attempt Limit: No attempt limit for Steps I and II. Three attempts for Step III.
(remedial training required if Step III is not passed in the
designated number of attempts)
USMLE Time Limit: Must complete all three Steps within 7 years, within 10 years for
MD/PhD.
PGT US/Canada: 2 years (1 year if med school completed before July 28th, 1985)
(MD)1 year AOA approved or ACGME accredited GME (DO)
PGT International: 2 years (1 year if medical school completed before July 28, 1985)

West Virginia
SPEX/COMVEX Requirement: May be ordered by Board to assess current competence.
(MD/DO)
USMLE Attempt Limit: Six attempts for Steps I – III.
USMLE Time Limit: Must complete all three steps within 10 years.
PGT US/Canada: 1 year (MD)

1 year AOA approved or ACGME accredited GME (plus 40 hours of
osteopathic manipulative management and treatment are required)
(DO)
PGT International: 3 years (or 1 year plus ABMS certification)

Wisconsin
SPEX/COMVEX Requirement: May be ordered by Board to assess current competence.
USMLE Attempt Limit: Three attempts for Steps I and II. Three attempts for Step III.
(Must reapply for license and present evidence of further education
or training if Step III is not passed in the designated number of
attempts)
USMLE Time Limit: Must complete all three Steps within 10 years, 12 years for
MD/PhD or dual degree candidates.
PGT US/Canada: 1 year
PGT International: 1 year

Wyoming
SPEX/COMVEX Requirement: May be ordered by Board to assess current competence.
USMLE Attempt Limit: Must complete Steps I – III in no more than 7 total attempts.
USMLE Time Limit: Must complete all three Steps within 7 years, 8 years for MD/PhD.
PGT US/Canada: 2 years (or 1 year and Specialty Board certified; or 1 year and
licensed in another jurisdiction for the five years preceding the
application
PGT International: 2 years (or 1 year and Specialty Board certified; or 1 year and
licensed in another jurisdiction for the five years preceding the
application

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