DO licensing requirement by states

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Source: AOA US Licensing Summary January 2008

For individual questions, or to obtain the latest requirements, please contact the respective state board of medical and/or osteopathic medicine. Physicians who graduated more than 25 years ago may face different requirements - contact your state board for details

ALABAMA
Postgraduate training: 1 year of AOA or ACGME training
Exam accepted: COMLEX, USMLE, NBOME, FLEX

ALASKA
Postgraduate training: 1 year of either AOA or ACGME approved training if graduated from school before 1/1/1995, otherwise the requirement is 2 years of either AOA or ACGME approved training
Exam accepted: COMLEX, USMLE, NBOME, FLEX
Other requirement: In person interview at the discretion of the board

ARIZONA
Postgraduate training: 1 year of AOA or ACGME training
Exam accepted: COMLEX, USMLE, NBOME, FLEX

ARKANSAS
Postgraduate training: 1 year of AOA or ACGME training
Exam accepted: COMLEX, USMLE, NBOME, FLEX
Other requirement: Criminal Background check

CALIFORNIA
Postgraduate training: One year approved by AOA or ACGME, which includes at least four months of general medicine in an approved postgraduate training program. Straight psychiatry, pathology, or anesthesiology residencies will not be accepted. The four months of general medicine shall not apply to applicants who completed their one-year of postgraduate training on or before July 1, 1990.
Exam accepted: COMLEX, NBOME
Other requirements: Applicant should wait 16 weeks to allow fingerprint card to clear proper channels

COLORADO
Postgraduate training: 1 year in a hospital approved by the AOA or ACGME
Exam accepted: COMLEX, NBOME, USMLE, FLEX, State examinations

CONNECTICUT
Postgraduate training: 2 years in an approved AOA or ACGME program
Exam accepted: COMLEX, NBOME, USMLE, FLEX

DELAWARE
Postgraduate training: 1 year in an AOA or ACGME approved program
Exam accepted: COMEX, NBOME, USMLE, FLEX, state examinations taken prior to 1973
Other requirement: Interview with board member, recommendation from Chief of Staff, verification of licensure in good standing on all licenses, and self-query from the NPDB and HIPDB


DISTRICT OF COLUMBIA (DC)
Postgraduate training: 1 year for graduates before 1/1/1990, 2 years for graduates after 1/1/1990
Exam accepted: COMLEX, NBOME, USMLE, FLEX, NBME, LMCC

FLORIDA
Postgraduate training: One year AOA-approved rotating first year. Any applicant who has not completed an AOA-approved internship must apply to the AOA for approval of first year of the ACGME residency for educational equivalence. If the AOA approves the ACGME residency's first year for educational equivalency and denies the demonstration of good cause for having taken the ACGME residency, the FL Board of Osteopathic Medicine shall review the applicant's demonstration of good cause.
Exam accepted: COMLEX, NBOME, COMVEX, State Board Exam
Other requirement: fingerprint

GEORGIA
Postgraduate training: 1 year of AOA or ACGME approved residency
Exam accepted: COMLEX, NBOME, USMLE, FLEX, NBME, LMCC, State Exam


HAWAII
Postgraduate training: 1 year in an AOA or ACGME approved residency
Exam accepted: COMLEX, NBOME, USMLE, FLEX


IDAHO
Postgraduate training: 1 year in an AOA or ACGME approved residency
Exam accepted: COMLEX, NBOME, USMLE, FLEX

Other requirement: Interview may be required

ILLINOIS
Postgraduate training: 12 months in hospital approved by state if applicant entered postgraduate clinical training program prior to 12/31/87; 24 months thereafter.
Exam accepted: COMLEX, NBOME, USMLE, FLEX


INDIANA
Postgraduate training: 1 year of AOA or ACGME training
Exam accepted: COMLEX, NBOME, USMLE, FLEX


IOWA
Postgraduate training: One year in post-graduate training program approved by the board (Two years beginning July 1, 2006 for IMG's only)
Exam accepted: COMLEX, NBOME, USMLE, FLEX, LMCC


KANSAS
Postgraduate training: 1 year AOA or Board approved
Exam accepted: COMLEX, NBOME, USMLE, FLEX or state examination taken prior to FLEX


KENTUCKY
Postgraduate training: 2 years of AOA or ACGME training
Exam accepted: COMLEX, NBOME, USMLE, FLEX


LOUISIANA
Postgraduate training: One year. Those serving as interns/residents in Louisiana must register with State Board of Medical Examiners.
Exam accepted: COMLEX, NBOME, USMLE, FLEX
Other requirement:
Fingerprints, $50; all physicians renewing their license for the FIRST time must attend a Board sponsored seminar prior to renewal. The orientation is available 4 times a year and acquaints new licensees with the Louisiana medical Practice Act, function of the Board and its rules, etc. Physicians residing and practicing in another state at the time of initial renewal are exempt.

MAINE
Postgraduate training: 1 year of AOA or ACGME training
Exam accepted: COMLEX, NBOME, USMLE, FLEX (OPP is required if USMLE or FLEX was taken)

MARYLAND
Postgraduate training: One year in program approved by accrediting organization recognized by the Maryland Board, which includes AOA or ACGME
Exam accepted: COMLEX, USMLE, NBOME (after 1/1/1971), FLEX (prior to 1/1/1985)


MASSACHUSETTS
Postgraduate training: 1 year of AOA or ACGME training
Exam accepted: COMLEX, NBOME, USMLE, FLEX
Other requirement: criminal background check


MICHIGAN
Postgraduate training: One year AOA-approved rotating internship for those matriculating after 1 October 1956. Any applicant who has not completed an AOA-approved internship must apply to the AOA for approval of first year of the ACGME residency for educational equivalence. The AOA must submit a letter to the board verifying the program's approval.
Exam accepted: COMLEX or NBOME for initial licensure; USMLE, FLEX and state examinations will be accepted for reciprocity so long as applicant has passed an osteopathic component (a qualified osteopathic component would be an OPP test or passing Part I of the NBOME). If this qualification is met, the osteopathic board will review the application on an individual basis (Michigan osteopathic board does not offer an OPP test).


MINNESOTA
Postgraduate training: 1 year of AOA or ACGME training
Exam accepted: COMLEX, NBOME, USMLE, FLEX, LMCC
Other requirement: Interview

MISSISSIPPI
Postgraduate training: 1 year of AOA or ACGME training
Exam accepted: COMLEX, NBOME (taken after 2/13/73), USMLE, FLEX
Other requirement: Interview


MISSOURI
Postgraduate training: 1 year for graduates of AOA approved schools
Exam accepted: COMLEX, NBOME, USMLE, FLEX
Other requirement: Medical jurisprudence exam


MONTANA
Postgraduate training: Prior to 10/1/2001: One year, approved by AOA, ACGME, or the Board; On or After 10/1/2001[FONT=Times New Roman,Times New Roman][FONT=Times New Roman,Times New Roman]: 2 years of postgraduate training..
Exam accepted: COMLEX, NBOME, USMLE, FLEX

NEBRASKA
[FONT=Times New Roman,Times New Roman][FONT=Times New Roman,Times New Roman]Postgraduate training: 1 year of AOA or ACGME training..
[FONT=Times New Roman,Times New Roman][FONT=Times New Roman,Times New Roman]Exam accepted: COMLEX, NBOME, USMLE, FLEX..


[FONT=Times New Roman,Times New Roman][FONT=Times New Roman,Times New Roman]NEVADA..
[FONT=Times New Roman,Times New Roman][FONT=Times New Roman,Times New Roman]Postgraduate training: Prior to 1/1/1995: one year internship; after 1/1/95: 3 years of ACGME or AOA postgraduate training. A DO who is enrolled in a postgraduate training program in Nevada can receive an unlimited license to practice medicine after completion of 24 months of the program in this state and has committed, in writing, that he/she will complete the program. ..
[FONT=Times New Roman,Times New Roman][FONT=Times New Roman,Times New Roman]Exam accepted: COMLEX, NBOME, USMLE, FLEX..
[FONT=Times New Roman,Times New Roman][FONT=Times New Roman,Times New Roman]Other requirement: Criminal background checks (fingerprint), interview..


[FONT=Times New Roman,Times New Roman][FONT=Times New Roman,Times New Roman]NEW HAMPSHIRE..
[FONT=Times New Roman,Times New Roman][FONT=Times New Roman,Times New Roman]Postgraduate training: Two years of formal postgraduate training approved by the board ..
[FONT=Times New Roman,Times New Roman][FONT=Times New Roman,Times New Roman]Exam accepted: COMLEX, NBOME, USMLE, FLEX, LMCC ..


[FONT=Times New Roman,Times New Roman][FONT=Times New Roman,Times New Roman]NEW JERSEY..
Postgraduate training: Graduated from medical school prior to 7/1/2003: 1 year AOA- or ACGME-approved program; graduated after 7/1/2003: 2 years of AOA-or ACGME-approved postgraduate training and has signed a contract for a Third
year (2 years must be in the same field or would, when considered together, be credited toward the criteria for certification by a single specialty board recognized by ABMS or AOA
Exam accepted: COMLEX, NBOME, USMLE, FLEX, individual state licensing examinations taken prior to 12/31/72


NEW MEXICO
Postgraduate training: 1 year of AOA or ACGME training
Exam accepted: COMLEX, NBOME, USMLE, FLEX

NEW YORK
Postgraduate training: 1 year of postgraduate training
Exam accepted: COMLEX, NBOME, USMLE, FLEX

NORTH CAROLINA
Postgraduate training: 1 year
Exam accepted: COMLEX, NBOME, USMLE, FLEX, NBME, LMCC, State Board Written Exam

NORTH DAKOTA
Postgraduate training: 1 year in an AOA, ACGME, or CMA postgraduate training
Exam accepted: COMLEX, NBOME, USMLE, FLEX

OHIO
Postgraduate training: 1 year in an AOA or ACGME program
Exam accepted: COMLEX, NBOME, USMLE, FLEX

OKLAHOMA
Postgraduate training: Completion of a one-year AOA-approved rotating internship or its equivalent thereof, in an accredited internship or residency program acceptable to the Board
Exam accepted: COMLEX, NBOME

OREGON
Postgraduate training: 1 year in an AOA or ACGME program
Exam accepted: COMLEX, NBOME, USMLE, FLEX
Other requirements: Board is authorized to conduct nationwide criminal records background check on applicants and licensees.


PENNSYLVANIA
Postgraduate training: One year AOA approved rotating internshi
Exam accepted: COMLEX, NBOME, FLEX (provided applicant holds a valid license in another state and meets all board requirements)
Other requirement: Examination in osteopathic manipulative therapy required for licensure. Effective 3/29/06, DOs who have passed COMLEX-USA Level 2-PE, the Osteopathic Clinical Skills Examination, are now exempt from taking the state board's OMT examination.

RHODE ISLAND
Postgraduate training: 2 years in an AOA or ACGME approved program
Exam accepted: COMLEX, NBOME, USMLE, FLEX, LMCC
Other requirement: OPP may be required if USMLE or FLEX is presented for licensure; interview.


SOUTH CAROLINA
Postgraduate training: 1 year as approved by the board
Exam accepted: COMLEX, NBOME, USMLE, FLEX, pre-1976 composite state exam if doctor is board-certified


SOUTH DAKOTA
Postgraduate training:
Applicants entering postgraduate training as of July 1, 1987 must successfully complete an approved residency program in its entirety (minimum of 2 years)
Exam accepted: COMLEX, NBOME, USMLE, FLEX

TENNESSEE
Postgraduate training: 1 year of AOA or ACGME training
Exam accepted: COMLEX, NBOME for initial or reciprocal licensure - USMLE and FLEX accepted for reciprocity only

TEXAS
Postgraduate training: 1 year for US/Canadian graduates
Exam accepted: COMLEX, NBOME, USMLE, FLEX, state examinations before 1977)
Other requirements: Medical jurisprudence exam (tests on medical laws in Texas)

UTAH
Postgraduate training: 24 months of progressive ACGME or AOA resident training or completion of 12 months in an ACGME or AOA resident training program and continuing on in a progressive resident training program in Utah. For endorsement: if licensed in another state before July 1, 1996 based on only 12 months AOA or ACGME residency training and either passing the national exam within five years, passing the SPEX within 12 months, or current AOA or ABMS board certification.
Exam accepted: COMLEX, NBOME, USMLE, FLEX
Other requirement: Utah Physician Controlled Substance Examination

VERMONT
Postgraduate training: One year internship or a 3-year residency
[FONT=Times New Roman,Times New Roman][FONT=Times New Roman,Times New Roman]..Exam accepted: COMLEX, NBOME, FLEX
Other requirement: OPP required if FLEX was taken - personal interview may be required

VIRGINIA
Postgraduate training: 1 year of AOA or ACGME training
Exam accepted: COMLEX, NBOME, USMLE, FLEX

WASHINGTON
Postgraduate training: 1 year of AOA or ACGME training
Exam accepted: COMLEX, NBOME, USMLE, FLEX, state exam if substantially equivalent
Other requirement: If applicant has taken a state exam, USMLE or FLEX, then additional OPP exam is required

WEST VIRGINIA
Postgraduate training: One year in an AOA-approved 12-month rotating internship
Exam accepted: COMLEX, NBOME
Other requirements: Interview

WISCONSIN
Postgraduate training: One year at an ACGME approved training facility
Exam accepted: COMLEX, NBOME, USMLE, FLEX, state board examinations taken prior to 1972
Other requirement: Medical jurisprudence examination

WYOMING
Postgraduate training: One year of AOA or ACGME training
Exam accepted: COMLEX, NBOME, USMLE, FLEX



PUERTO RICO
Postgraduate training: 1 year approved by board. Applicant must also serve one year in any place designated by board.
Examination: In English or Spanish, at option of applicant. Includes clinical examination, but not obstetrics-gynecology, pharmacology, legal medicine, or tropical diseases.
Reciprocity or Endorsement: For unlimited license, if granted by a US state having reciprocity with Puerto Rico.
Residence: Six months (6) residence in Puerto Rico required

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Last edited:
Good information. Couple of things I'd like to correct...

Tennessee: "8. You must have successfully completed a medical licensure examination or an approved combination of
examinations. If you are submitting USMLE scores, all three steps must be taken and passed within
seven years. Please refer to attachment 4 for information in obtaining scores."

Michigan: While the AOA internship + COMLEX are required to obtain an unrestricted license to practice within the state, the state will allow a DO to enter and complete an ACGME residency without these requirements or a Rule 42 exemption if they subsequently wish to leave Michigan and practice in another state.
 
so can you be lic after the rotating internship? If so do you actually NEED to do res to practice medicine (unrestricted) (and paid;))
 
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so can you be lic after the rotating internship? If so do you actually NEED to do res to practice medicine (unrestricted) (and paid;))
here's my understanding of how to answer your question, so anyone can jump in here and correct me... Yes technically you can be licensed to practice medicine after only doing an internship year and passing your step 3 - However, getting paid by insurance companies, such as becomming a participating provider for them doesn't work if you've only had internship, plus getting credentialed with admitting privaledges at a hospital also is pretty much impossible if you don't have a residency. Basically this can be good for moonlighting as a resident if your programs allows. I'd imagine it's a throw back to the GP's that would just do a rotating internship/transitional year and "hang up their shingle" so to speak and get to work.

Probably the one area that i've heard it happening would be with General Medical Officer slots in the military, which I'm pretty sure they're getting away from actually.

The only thing I really have no idea on is malpractice insurance. Does anyone know how that works if you've only done an internship year and want to just start practicing?
 
so can you be lic after the rotating internship? If so do you actually NEED to do res to practice medicine (unrestricted) (and paid;))

Some states will require 2 years of post-graduate training before granting unrestricted licensure. Most do not. Theoretically if you want an unrestricted license in a state that only requires 1 year, you can do so. If you want to practice independantly after getting that license, legally you can do so.

Practically, you will have a hard time finding work. You will run into issues gaining hospital privileges if you are not residency-trained (board eligible/board certified). Insurance companies and HMOs will probably not list you as a provider. Without residency training, most states medicaid will not accept you as a provider. Not sure about being a Medicare requiring residency training before becoming an approved medicare provider.

Medical malpractice insurance premiums will either be very high (since you are high risk with your lack of training) or you are uninsurable (due to the high risk)

Medical groups (either outpatient based, inpatient based, or mixed) will be hesitant to hire you due to your inability to get hospital priviledges, and inability to be eligible for reimbursement from many 3rd party payors, as well as the increase in the group medmal insurance premiums.

However, there is nothing stopping you from openning up your own practice, accepting cash (or any 3rd party payors willing to take/list you) and seeing patients (as long as you conform to all aspect of your state's medical practice act, including any liability requirements).

And you are held to the same standard of care that is in your community (from a legal standpoint). From a legal perspective, the fact that you lack residency training may be used against you (certainly will bias the jury) if you should end up in court.

So while legally you may practice on your own once you meet the bare minimum requirements, for practical reasons, the vast majority do not (and continue to suffer the long hours of residency)
 
Source: AOA US Licensing Summary January 2008



CALIFORNIA
Postgraduate training: One year approved by AOA or ACGME, which includes at least four months of general medicine in an approved postgraduate training program. Straight psychiatry, pathology, or anesthesiology residencies will not be accepted. The four months of general medicine shall not apply to applicants who completed their one-year of postgraduate training on or before July 1, 1990.
Exam accepted: COMLEX, NBOME
Other requirements: Applicant should wait 16 weeks to allow fingerprint card to clear proper channels

What does this mean?
 
Source: AOA US Licensing Summary January 2008

FLORIDA
Postgraduate training: One year AOA-approved rotating first year. Any applicant who has not completed an AOA-approved internship must apply to the AOA for approval of first year of the ACGME residency for educational equivalence. If the AOA approves the ACGME residency’s first year for educational equivalency and denies the demonstration of good cause for having taken the ACGME residency, the FL Board of Osteopathic Medicine shall review the applicant’s demonstration of good cause.
Exam accepted: COMLEX, NBOME, COMVEX, State Board Exam
Other requirement: fingerprint

How hard is it to get your ACGME first year approved? What would be considered a good reason for haven taken the ACGME residency?
 
Michigan: While the AOA internship + COMLEX are required to obtain an unrestricted license to practice within the state, the state will allow a DO to enter and complete an ACGME residency without these requirements or a Rule 42 exemption if they subsequently wish to leave Michigan and practice in another state.
This is really good to know. Can you point me to a source for this info?
I am planning to rank a MI ACGME program, and it would be helpful to have an official source for this info as security just in case I run into trouble getting resolution 42 approved. Thanks.
 
What does this mean?

I believe, from speaking with an anesthesiologist, that this means that your residency isn't straight anesthesia, meaning that you must take 1 year of an internship at a different hospital or program and then do 3 years in anesthesia. Most of the times you must match for both this 1 year program and the 3 year program. The others I'm not so sure on, but this is how it was presented to me.
 
Good information. Couple of things I'd like to correct...

Michigan: While the AOA internship + COMLEX are required to obtain an unrestricted license to practice within the state, the state will allow a DO to enter and complete an ACGME residency without these requirements or a Rule 42 exemption if they subsequently wish to leave Michigan and practice in another state.

Doesn't the exemption apply if they want to stay in Michigan too?
 
Doesn't the exemption apply if they want to stay in Michigan too?

Regarding Michigan:

http://www.kcms.msu.edu/node/747

Download and read the "notes for osteopathic applicants" file.

This doesn't mean that all MI residencies will accept a DO applicant, some have policies that simply will not take them as first years. However, technically, it's possible.
 
Hey, thanks for finding that document. It really helped clear things up for me.
 
Very nice thread full of information. Bookmarked!
 
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