In the United States and its territories, the individual medical licensing authorities ("state medical boards") of the various jurisdictions grant a license to practice medicine. Each medical licensing authority sets its own rules and regulations and requires passing an examination that demonstrates qualification for licensure. Results of the USMLE are reported to these authorities for use in granting the initial license to practice medicine. The USMLE provides them with a common evaluation system for applicants for initial medical licensure.

The USMLE is sponsored by the Federation of State Medical Boards of the United States, Inc. (FSMB), and the National Board of Medical Examiners® (NBME®).

The USMLE assesses a physician's ability to apply knowledge, concepts, and principles, and to demonstrate fundamental patient-centered skills, that are important in health and disease and that constitute the basis of safe and effective patient care. Each of the three Steps of the USMLE complements the others; no Step can stand alone in the assessment of readiness for medical licensure. Because individual medical licensing authorities make decisions regarding use of USMLE results, physicians seeking licensure should contact the jurisdiction where they intend to apply for licensure to obtain complete information. Also, the FSMB can provide general information on medical licensure.

USMLE Bulletin of Information

The USMLE Bulletin of Information provides information about the USMLE, the three-step examination for medical licensure in the United States. Applicants for examination are required to read the applicable edition of the Bulletin of Information.

The Accreditation Council for Graduate Medical Education (ACGME) is responsible for the Accreditation of post-MD medical training programs within the United States. Accreditation is accomplished through a peer review process and is based upon established standards and guidelines. 

The Educational Commission for Foreign Medical Graduates (ECFMG) 

Certification by ECFMG is the standard for evaluating the qualifications of these physicians before they enter U.S. graduate medical education (GME), where they provide supervised patient care. ECFMG Certification also is a requirement for IMGs to take Step 3 of the three-step United States Medical Licensing Examination (USMLE) and to obtain an unrestricted license to practice medicine in the United States. Click on the title for more information.

Areas of Expertise:

National Board of Medical Examiners^® (NBME^®)

Founded in 1915, the National Board of Medical Examiners^® (NBME^®) is an independent, not-for-profit organization that serves the public through its high- quality assessments of healthcare professionals. The NBME develops and manages the USMLE. While the individual licensing boards grant the license to practice medicine, all medical boards in the US accept a passing score on the USMLE as evidence that an applicant demonstrates the core competencies to practice medicine.

The American Association of Colleges of Osteopathic Medicine (AACOM)

The American Association of Colleges of Osteopathic Medicine (AACOM) was founded in 1898 to lend support and assistance to the nation's osteopathic medical schools, and to serve as a unifying voice for osteopathic medical education. Having grown from a handful of college administrators a century ago, the organization today represents the administration, faculty and students of all of the osteopathic medical colleges in the United States.

REGULATION OF THE PROFESSION

Medicine, like many other professions, is regulated at two different levels:

• Licensure is a process that takes place at the state level in accordance with specific state laws
• Certification is established through national organizations with consistent national requirements for minimal professional practice standards

Licensure: All states require that applicants for MD licensure be graduates of an ACGME approved medical school and complete the United States Medical Licensing Exam (USMLE) Steps 1 - 3. Steps 1 and 2 are completed while in medical school and step 3 is completed after some medical training (usually between 12 - 18 months, depending on the state). People who earned their medical degrees in other countries also must satisfy the requirements of ECFMG certification before practicing medicine in the United States.

Certification: MDs who wish to specialize must complete an additional 3 - 9 years of postgraduate work in their specialty area, then pass board certification examinations. Doctors who claim to practice in one specialty should be board-certified in that specific area of practice.

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