How Becoming a Doctor Works

Getting Your Medical License

After completing a residency or fellowship, you must obtain a medical license so that you can practice medicine. Each state has its own individual rules.

For graduates of US medical schools, this is a relatively straightforward procedure. Generally you have to have graduated from an approved medical school. In the US, medical schools are approved or accredited by the Liaison Committee on Medical Education (LCME), which is a joint committee of the Association of American Medical Colleges (AAMC) and The American Medical Association (AMA).


Many states require only one year of training after medical school (internship) in an approved residency program as the bare minimum for obtaining a license. Residency programs are accredited by the Accreditation Council of Graduate Medical Education (ACGME) through the Residency Review Committees (RRC).

You need to have passed one of several exams to prove that you are competent (such as the USMLE). Letters of reference are usually required. A background check of your malpractice history will also be obtained. The rules for graduates of foreign medical schools are more complex and can be obtained from each state medical licensing board.

Board Certification

Board certification is a voluntary designation that demonstrates exceptional expertise in a medical specialty. Becoming a board-certified physician involves the completion of a residency in a given specialty, then completing a comprehensive exam (often a written and oral exam). When you have satisfied the requirements of that particular board you are now board-certified and are called a Diplomate of that board (e.g. Diplomate of the American Board of Emergency Medicine). There are 24 medical specialty boards in the US approved by the American Board of Medical Specialties (ABMS). Maintenance of board certification requires ongoing professional development.

Now it is time to find a real job. You can join a group practice, start your own private practice or join a clinic. Some physicians are hospital-based (emergency physicians, radiologists, pathologists, anesthesiologists) but also can be part of a private practice or an employee.

I hope you have enjoyed our long journey on the road to becoming a doctor. It has been a long and fruitful one for myself and many others.

About the Author:

Carl Bianco, M.D. is an emergency physician practicing at Dorchester General Hospital in Cambridge, Maryland. Dr. Bianco attended medical school at Georgetown University School of Medicine and he received his undergraduate degree from Georgetown University majoring in nursing and pre-med. He completed an internship and residency in Emergency Medicine at Akron City Hospital in Akron, Ohio.

Dr. Bianco lives near Baltimore with his wonderful wife and two wonderful children.

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