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Life After Residency

The transition from being a resident physician to practicing medicine on your own is stress-filled and often traumatic. Systematically meeting the requirements will help you manage the challenges ahead.

Requirements that take time and attention need to be fulfilled. These include:

  • Licensure in the state where you plan to pracitce,
  • Registration with agencies that monitor medication prescribing,
  • Privileges at hospitals, surgicenters or other sites where you will be providing health care, 
  • Learning about the community you will be joining, both professionally and personally.

State Licensure

Even doctors need to get a pass.

And in the medical world, the equivalent of a pass is a medical license.If you want to practice medicine, then you will need a license to do it. Physician licensing is state-specific.

You can’t get a license unless you have graduated from an osteopathic medical school and successfully completed a minimum of six months of a residency (and then you qualify only in the Virgin Islands). For many states, the minimum requirement to get a license is one year, in others it is two years of residency after graduation from DO school.

The Federation of State Medical Licensure Boards provides state-specific requirements for licensure, including contact information. 

Some states have a DO board that grants licenses and others have a licensure board that handles both DOs and MDs.

It takes some time too. Most states require three months to complete the paperwork for initial licensure.  If there are any issues, or difficulty in obtaining documents, it can take six months.

Can I get a license without an osteopathic internship?

There are five states (Florida, Michigan, Oklahoma, Pennsylvania, and West Virginia) that require osteopathic physicians to show that they have the broad-based training of a generalist before they will be granted a license.  This can be demonstrated by the completion of an Osteopathic Internship, and in some states a transitional year, or the equivalent which includes a month of intern-level training in medicine, surgery, ob/gyn, and pediatrics. 

CME and the Newly Licensed Physician

As soon as you get a license, you have to think about how you are going to keep it through Continuing Medical Education. State requirements are typically 50 hours or fewer each year, with the requirements for continuing medical education being less than the requirements to maintain board certification.

DEA Certification

Before practicing medicine as a solo practitioner, you must be issued a certificate to prescribe controlled substances by the U.S. Department of Justice’s Drug Enforcement Administration. Certificates are issued for practice in specific locations, so you must first obtain a license to practice in a given state. 



Learn more about the process of obtaining a DEA Certificate.

Some states may also require a special license or certificate for prescribing controlled substances. This is something about which you will learn more during your post-graduate medical education.

Certification Boards

Licensure, board certification, state examinations or ...

Where do I take the test to see which tests I have to take?

It's good that doctors have proven themselves to be good at taking tests, because you will continue to have testing experiences after graduation from medical school and through your life of practice.

The issue of ‘board exams’ can be confusing, so let’s look at some definitions and examples. 

  • Licensure board exams are taken to obtain a license and are designed to protect the public. Standards include those items that a physician must meet to safely practice medicine.
  • Certification board exams signify additional training and specialization. Board exams test additional training and achievement,

Specialty Board Exams

Upon completion of residency, you will be considered “board-eligible,” meaning that you have fulfilled the requirements for specialty board certification, but have not yet taken the required exam.

The osteopathic profession and the allopathic profession each has its own set of specialty colleges and administers its own specialty certification board exams.

  • Osteopathic physicians who have completed an allopathic residency program may be eligible to take the allopathic certification exams. 
  • Osteopathic physicians who have completed allopathic residency programs may be eligible to take the osteopathic board specialty exams. 

Check with the AOA and the specialty college to learn which requirements exist for this option. Some osteopathic physicians who have completed allopathic residency programs elect to take BOTH the osteopathic and allopathic specialty board certification exams.

Go back and check-out Managing the Maze (ppt) for additional information.  (Note: Before viewing Managing the Maze, you must choose 'read only' on the first screen that appears.)



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