Later in Life Doctor MD/DO

[MSK9]

"A physician must be licensed by the National Board of Medical Examiners to practice as a physician." The NBME does not license physicians! According to its website it offers "High-quality exams from NBME are built in collaboration with content experts to evaluate applicants’ competence for licensure." You are confused! US States and US Territories regulate their licensing requirements. Yes, many States and US territories require the USMLE steps 1 thru 3 and 1 to 3 years of an ACGME accredited residency. However, US territories such as Puerto Rico accepts USMLE exams but also has its own Revalida which is similar to USMLE but offered in Spanish. The Virgin Islands also uses the SPEX instead of the USMLE. The issue I am bringing up deals with state legislation that has alternate pathways of post graduate that will be accepted by a State. Each State has its own legislation on what kind of residency is required for a foreign medical graduate.


For example,
"New Legislative Changes
To address these challenges and physician shortages, several states have enacted laws offering alternative pathways for IMGs:

1. Arizona:
Starting January 2025, IMGs can receive a provisional license if they have an international medical degree, pass USMLE Step 1 and Step 2 CK, and demonstrate English proficiency. They must work in rural areas for four years under supervision to obtain full licensure."

This is a State legislative initiative that becomes a bill, then is voted on and signed by the Governor and not a Federal! Each State or Territory has its own autonomy in regulating professions to ensure consumer safety. You have to go to the State or Territory and look up the licensure requirements for each and every State!

The FSMB is a good starting point but with all the new legislation coming from different States and Territories, you really have to go the State Medical Board for the State you want to be licensed in!
https://www.fsmb.org/step-3/state-licensure/

No, sir/ma'am. I'm not confused. I have a basic medical license in multiple states. USMLE (United States Medical Licensing Exam) / COMLEX (osteopathic equivalent, same accreditation) are literally the licensing exams which states use to grant the ability to work in their respective areas. As you stated with Arizona, passing USMLE Step 1 and Step 2 CK are a requirement; the same as an incoming PGY-1 resident/intern.

You can't go to a state medical board without USMLE certification and expect to get a job. It just isn't going to happen.