warning to IMGs & licensure

[doc_96]

I am an IMG who got into IM residency in June 2001 after completing step 1 in 1995 (in 2nd year med school), and step 2 in 1998 (during internship outside USA) (no repeats and good grades). I couldn't do step #3 until 2 years of residency, and I was offered a contract to work in AL only to find out the 7 year limit.

http://www.albme.org/app-req.htm
(e) To be eligible to sit for USMLE Step 3, an applicant must otherwise possess the qualifications for licensure as a physician in Alabama.

(f) In order to be eligible for licensure, an applicant shall successfully complete USMLE Steps 1, 2 and 3 within seven years or shall successfully complete combinations of examinations as established in Rule 540-X-3-.04(4). The seven year time period begins when the applicant initially passes his or her first Step of the USMLE. The Board shall not accept scores from a re-examination of a previously passed Step of the USMLE.


Anyone with info? Is there any way around the 7 year rule of passing USMLE Step 1,2 & 3 within 7 years?

The only exception to this rule is if you were pursuing an MD/Phd program (10 years) and a quick look at the ABIM indicated a reccommendation for this rule which the majority of states have adopted.

http://www.fsmb.org//USMLE_updates/time_limitations_to_complete.htm
Time Limitations for Completing All USMLE Steps
The Composite Committee, which governs the USMLE program, has made several recommendations to state medical boards for use in establishing policies that support their licensure decisions based on USMLE performance.

One recommendation made to medical licensing authorities by the USMLE program is that all three USMLE Steps be passed within a seven-year period, beginning when the physician first passes a Step

So not only is it getting harder to obtain a residency position, but now your choice of where to practice is being restricted in a most discrimatory way. I will have now to decline a most generous offer.

[wolfvgang22]

Thanks for the heads up. So, what is the earliest one can take the step 3?

[stephew]

this is not just IMGs but ALL Medical students. It is YOUR responsibility to make sure you meet the requirements for a given state. the info can be found here. If you do not pass the three steps in many states within 7 years, you must retake the step one to get all three passed within that time frame. Its not done sucessfully very often for obvious reasons. Good luck in your future endevors.

http://www.fsmb.org/
click usmle step three on the left menu
Then click usmle requirements for licensure


State Minimum Postgraduate
Training Required
Number of attempts at USMLE Time Limit for completion
of all USMLE Steps
Alabama
Tel: (334) 242-4116
$20.00 application packet $175.00
non-refundable application fee 1 year; 3 years IMG
4 attempts 7 years
Alaska
(501) 296-1802
Application fee $840.00 2 years; 3 years IMG
2 attempts per Step 7 years
Arizona Medical
(480) 551-2700
Application fee $500.00 1 year; 3 years IMG
NL 7 years
Arizona Osteopathic
(480) 657-7703
Application fee $580.00 No information at this time. NA NA
Arkansas
(501) 296-1802
$500.00 Application fee 1 year 6 attempts 7 years; 10 years for MD/PhD candidates
California Medical
(916) 263-2389
Application - $505.00 1 years; 2 years IMG NL 10 years
California Osteopathic
(916) 263-3100
$256 application fee No information at this time. NA NA
Colorado
(303) 894-7690
The current application fee is $425.00 1 year; 3 years IMG
NL 7 years; 10 years for MD/PhD candidates
Connecticut
(860) 509-7563
Application fee $450.00 2 years NL 7 years
Delaware
(302) 744-4507
See chart on website for fees 1 year; 3 years IMG NL 7 years+
Washington, DC
(202) 442-9200
Application fee $546.00 1 year; 3 years IMG 3 attempts 7 years
Florida Medical
(850) 245-4131
Application fee $552.00 1 year; 2 years IMG 5 attempts for all Steps combined 7 years
Florida Osteopathic
(850) 245-4161
$605 Application fee No information at this time NA NA
Georgia
(404) 656-3913
$400.00 Application fee 1 year; 1-3 years IMG 3 attempts per Step 7 years
Guam
(011) 671-735-7406-8
Contact the state board for licensure information and fees 1 year No information at this time No information at this time
Hawaii
(808) 586-3000
Application & Licensure Fee $290.00 1 year; 2 years IMG NL 7 years
Idaho
(208) 327-7000
Application $400 by endorsement
$300 by examination 1 year; 3 years IMG 2 attempts per Step 7 years
Illinois
(217) 785-0800
Application fee $300.00 2 years 5 attempts per Step 7 years
Indiana
(317) 234-2060
Application fee $250.00 1 year; 2 years IMG 5 attempts per Step 7 years
Iowa
(515) 281-5171
Licensure fee $400.00 1 year; 2 years IMG 6 attempts 7 years; 10 years for MD/PhD candidates
Kansas
(785) 296-7413
Application fee $300.00 1 year; 3 years IMG (minimum 2 years must have been in US program) 3+ attempts 10 years
Kentucky
(502) 429-8046
Licensure $250.00 non-refundable 1 year; 3 years IMG NL 7 years
Louisiana
(504) 568-6820
License fee $382.00 non-refundable 1 year; 3 years IMG NL at Step 1; 4 attempts each at Steps 2 and 3 NL
Maine Medical
(207) 287-3601
Application fee $350.00 2 years; 3 years IMG 3+ attempts 7 years
Maine Osteopathic
(207) 287-2480
Application fee $350.00 by endorsement No information at this time NA NA
Maryland
(800) 492-6836
Licensure US & Canadian $817IMG $717 1 year; 2 years IMG 3+ attempts 10 years
Massachusetts
(800) 377-0550
Licensure $600.00 1 year; 2 years IMG NL 7 years with exceptions for MD/PhD candidates
Michigan Medical
(517) 335-0919
Licensure $235.00
2 years NL NL
Michigan Osteopathic
(517) 373-6873
Licensure $235.00 No information at this time NA NA
Minnesota
(612) 617-2130 Hearing impaired 1-800-627-3529
Licensure fee $392.00 1 year; 2 years IMG 3 attempts 7 years
Mississippi
(601) 987-3079
Licensure fee $500.00 1 year; 3 years IMG 3 attempts 7 years
Missouri
(573) 751-0098
By examination $300.00 1 year; 3 years IMG 3 attempts 7 years (waived for MD/PhD candidates)
Montana
(406) 841-2300
Licensure fee $325.00 1 year; 3 years IMG NL Steps 1 and 2; 3 attempts at Step 3 7 years
Nebraska
(402) 471-2118
Licensure by application $300 + LAP fee
Licensure by Reciprocity $200 + LAP fee 1 year; 3 years IMG 4 attempts 7 years; 10 years for MD/PhD candidates
Nevada
(775) 688-2559
Application and initial licensure fee $500.00 3 years NL NL
Nevada Osteopathic
(702) 732-2147
Application and initial licensure fee $500.00 No information at this time NA NA
New Hampshire
(603) 271-1203
Application fee $250.00 2 years 3 attempts 7 years
New Jersey
(609) 826-7100
Contact the state board for licensure information and fees 1 year; 3 years IMG 5 attempts 7 years
New Mexico
(505) 827-5022
$350.00 direct application 2 years 6 attempts per Step 7 years; 10 years for MD/PhD candidates
New Mexico Osteopathic
(505) 476-7120
Contact the state board for licensure and fee information No information at this time NA NA
New York
(518) 474-3817 Ext. 560
The fee for licensure is $735 1 year; 3 years IMG NL NL
North Carolina
(919) 326-1100
Temp $150.00 then full $125.00 1 year; 3 years IMG NL 7 years+
North Dakota
(701) 328-6500
Application fee $200.00 1 year; 3 years IMG NL 7 years
Northern Mariana Islands
(670) 664-4811
Contact the State Board for licensure or fee information No information available at this time No information available at this time No information available at this time
Ohio
(800) 554-7717
Contact State Board for licensure or fee information 1 year; 2 years IMG NL 7 years+
Oklahoma
(800) 381-4519
Application fee $400 Temp (approved) $200 1 year; 2 years IMG 3 attempts 7 years
Oklahoma Osteopathic
(405) 528-8625
Contact the State board for licensure or fee information No information available at this time NA NA
Oregon
(503) 229-5770
License Application fee $375.00 1 year; 3 years IMG 3+ attempts 7 years (possible waiver for MD/PhD candidates and individuals with personal illness)
Pennsylvania Medical
(717) 787-2381
Application fee accredited medical college $35.00
Unaccredited medical college $85.00 2 years; 3 years IMG 3 attempts 7 years +
Pennsylvania Osteopathic
(717) 783-4858
License application fee $195 1 year NA NA
Puerto Rico
(787) 782-8949
Contact the state board for licensure or fee information 1 year No information available at this time No information available at this time
Rhode Island
(401) 222-3855 / Fax:(401) 222-2158
Application fee $437.50 1 year; 3 years IMG 5 attempts 7 years
American Samoa No information available at this time No information available at this time No information available at this time
South Carolina
(803) 896-4500
Application fee $510.00 1 year; 3 years IMG 4 attempts per Step 7 years
South Dakota
(605) 334-8343
Application fee $200.00 2 years 3 attempts per Step 7 years
Tennessee Medical
(615) 532-4384
Application fee $410.00 1 year; 3 years IMG NL 7 years
Tennessee Osteopathic
(615) 532-3202
Application fee $410.00 No information available at this time NA NA
Texas
(512) 305-7010
Application fee $800.00 1 year; 3 years IMG 3+attempts 7 years+
Utah Medical
(801) 530-6628
Application fee $ 200.00 2 years 3 attempts 7 years; 10 years for MD/PhD candidates
Utah Osteopathic
(801) 530-6628
Application fee $ 200.00 2 years 3 attempts NA
Vermont Medical
(802) 657-4220
Licensure fee $400.00 1 year; 3 years IMG 3 attempts 7 years
Vermont Osteopathic
(802) 828-2373
Licensure fee $400.00 No information available at this time NA NA
U.S. Virgin Isles
(340) 774-0117
Contact the state board for licensure or fee information No information available at this time No information available at this time No information available at this time
Virginia
(804) 662-9908
Licensure fee $302.00 1 year; 2 years IMG NL 7 years
Washington Medical
(360) 236-4788
Application fee $325.00 2 years NL on Steps 1 and 2; 3 attempts at Step 3 7 years+
Washington Osteopathic
(360) 236-4945
Licensure fee $650.00 No information available at this time NA NA
West Virginia Medical
(304) 558-2921, ext. 221
The fee for licensure is $300 1 year; 3 years IMG NL 7 years+
West Virginia Osteopathic
(304) 723-4638
Reciprocity or Endorsement $200.00 No information available at this time NA NA
Wisconsin
(608) 266-2112
Initial fee $125.00 1 year 3+ attempts per Step 7 years
Wyoming
(307) 778-7053 1 year; 2 years IMG 3 attempts 7 years





--------------------------------------------------------------------------------

IMG – international medical school graduates
NA – Not Applicable
NL – No Limit

Attempt Limits – unless otherwise indicated these represent allowable attempts at Step 3

+ indicates more attempts allowed on conditional basis with board approval or a longer time frame is considered for completion of licensing exam sequence, e.g., extended time for MD/PhD candidates.

Additional postgraduate training is required if an individual exceeds the allowable number of attempts for a USMLE Step

[doc_96]

If you do not pass the three steps in many states within 7 years, you must retake the step one

most States do not allow the retaking of a step that has be passed to count. (I asked)

Also for FMG/ MS , many are in programs that require 4.5-6 years medical school followed by 1-2 years internship (required in the respective territory to gain an unrestricted license & a requirement for a residency -USMLE/ECFMG)

Lets say you took step 1 in 2nd year (when basic sciences are still fresh) and immediately entered a residency after internship. the time you can take step 3 is 2-3 years (state dependent) of residency.
The total time therefore is 6 (med school) - 2 (year step 1 taken) + 1 to 2 (internship) + 2 to 3 (residency) = 7-9 years

For a lot of MS/FMG's that's not practical. So this is mainly a warning to those who are in similar programs to delay taking the USMLE (until during internship/ final year med school) until they are sure they wish to work in the US. Unfortunately if you wait a year or 2 to enter residency (as I did working after internship) or if you were unsuccessful in your initial attempts to gain a residency position, it can still happen to you.

[doc_96]

Thanks for the heads up. So, what is the earliest one can take the step 3?
check link previously posted....
Aw heck here!
http://www.fsmb.org//USMLE_updates/time_limitations_to_complete.htm


P.M.

[teratos]

Thanks for the heads up. So, what is the earliest one can take the step 3?

You can take it right after you graduate med shool, I believe. I know a few people who took it before they started residency. G

[anencephalic]

this is not just IMGs but ALL Medical students. It is YOUR responsibility to make sure you meet the requirements for a given state. the info can be found here. If you do not pass the three steps in many states within 7 years, you must retake the step one to get all three passed within that time frame. Its not done sucessfully very often for obvious reasons. Good luck in your future endevors.

http://www.fsmb.org/
click usmle step three on the left menu
Then click usmle requirements for licensure


Hey Steph,

With your super-duper moderator guru powers, you ought to make that a sticky in the State Licensing forum! Thanks for the info!

Aloha,

[stephew]

this is not just IMGs but ALL Medical students. It is YOUR responsibility to make sure you meet the requirements for a given state. the info can be found here. If you do not pass the three steps in many states within 7 years, you must retake the step one to get all three passed within that time frame. Its not done sucessfully very often for obvious reasons. Good luck in your future endevors.

http://www.fsmb.org/
click usmle step three on the left menu
Then click usmle requirements for licensure


Hey Steph,

With your super-duper moderator guru powers, you ought to make that a sticky in the State Licensing forum! Thanks for the info!

Aloha,
I dont think even I, gurumod, have that power. But ill check.
And as per prior post; no you cant retake a passed step for a hgiher score.

[rdecastro]

Thanks for the heads up. So, what is the earliest one can take the step 3?

As soon as you've passed both steps 1 and 2.

[doc_96]

see next post

[doc_96]

Thanks for the heads up. So, what is the earliest one can take the step 3?

As soon as you've passed both steps 1 and 2.

http://www.usmle.org/bulletin/2004/eligibility.htm

Step 3

To be eligible for Step 3, prior to submitting your application, you must

meet the Step 3 requirements set by the medical licensing authority to which you are applying, obtain the MD degree (or its equivalent) or the DO degree,
pass Step 1, Step 2 CK, Step 2 CS (if required based upon rules referenced on page 2), and
obtain certification by the ECFMG or successfully complete a “Fifth Pathway” program if you are a graduate of a medical school outside the United States and Canada.

A FEW States (i.e NY) allow you to sit step 3 without being in a residency, but MOST states require 2-3 years of residency training!

[wolfvgang22]

Thanks everybody for the info so far!

Now my next questions are:
If you only do two years of residency and get licensed in Maryland, for example, you would not be eligible for licensure in other sates that require 3 years post-grad training, such as Texas. Right?

And if that's true, can one get licensed in one state that requires two years, and continue doing residency for one more year in order to meet other states requirements?

Thanks in advance for your input!

[sean]

If you are an IMG u can apply to take step 3 as soon as u are ECFMG certified. Yes, u are right that some state boards will not approve an application without some residency training but u can always apply through a state board that does allow one to apply for step 3 without residency training.
If you are an AMG, then u would have taken step 1 at end of 2nd year, step 2 at beginning of 4th year, and can either take Step 3 in 1st year of residency (again apply through a state board that allows this) or wait till your particular state board allows it.
Remember one can apply through, for example, the CT state board (one of the states that allows Step 3 to be taken w/o residency training) and at the same time, physically take the test in any state/city of your choice (assuming they have a Prometric center). - S

[smalcon]

Just an update/correction. I recently called Colorado and they have 3 limit pass attempt for the USMLE i was told , not unlimited as was stated

[Picard]

Eligibility for Step III and eligiblity for licensure are two separate issues.

Eligibity for Step III is based on the PHYSICAL location where you sit for Step III. You don't have to do anything else in that state (internship, residency, licensure... etc). Yes, some states require you to turn in an application for their licensure when you apply for Step III through them, but that does not mean you need to follow through and complete the licensure process. There are several states that will allow you to take Step III with only your diploma, California is one such state. And NO, you don't need to apply to CMB for licensure to qualify for step III in California. I know many people who simply apply and take Step III in California as soon as they graduate from med school. These are people who have no ties whatsoever in California, who are not doing internship/residency/licensure in California, who have no intents to ever practice in California. All they do is register through California, and fly in for two days and take the test, and then leave.

As for Permenent licensure and Residency completion/Specialty Board eligibility -- again these are two completely separate issues. When a state requires you to complete certain number of years in post graduate training before licensure, they don't care what specialty those PGY years are, NOR DO THEY CARE exactly how many years those specialty requires for residency training. Heck, most states don't even care if your required PGY trainings are all done in the same program, or even same specialty. I know someone who completed a surgical internship and switched to internal medicine. He got licensed at the end of his internal medicine internship because his surgical internship counted as a PGY year so he met the two year requirement (surgical internship + medicine internship) as far as the licensing boards are concerned. And OF COURSE, your training does NOT end when you obtain your permenent license. In order to be board-certified (which has NOTHING to do with eligiblity for licenure), you MUST complete your residency, regardless of whether or not you obtained your permenent license. Specialty boards do NOT care one way or the other WHEN you got your license. They have nothing to do with ANY licensing authority (and vis versa). They only care that you completed your residency training. Some specialty boards will even allow you to take the final board exam, AND BOARD CERTIFIY you without you even having a permenent license.

P

[JMT]

You can take the step 3 in the following states without first doing residency:
Arkansas
California
Connecticut
Florida
Lousiana
Maryland
Nebraska
New York
South Dakota
Texas
Utah
Washington
West Virginia

Obtained this information from my first aid 2006 book. Thought this might help.