The easiest state to get a medical license is rarely the cheapest one to keep. New York, the state most lists open with, charges $735 to license and $600 every two years after that, more than four times what South Carolina charges to hold the same credential. This page ranks the easy states, the hard ones, and every board behind them.
Every number below comes from the board that charges it or the commission that publishes it, and every table carries the date we checked it. Where one of our own state pages holds the figure, the link goes there.
The Easiest States to Get Medical License
Five states appear on almost every easy list: New York, Indiana, Michigan, Colorado and Ohio. What they share is a shorter verification chain, not a lower bar. None of them skips primary source verification of your degree, your training or your exam scores. Four of the five are compact members. New York is not.
1. New York
New York has no standalone medical board. The New York State Board for Medicine sits inside the State Education Department, and licenses are issued by its Office of the Professions. Discipline is somewhere else again, at the Office of Professional Medical Conduct inside the Department of Health. Two agencies, one physician.
The fee schedule is short: $135 for the application and $600 for the first registration, $735 in total. A limited permit, used while the full application is pending, costs $105. Registration then runs on a two year cycle at $600 each time, which is where New York stops being cheap.
What makes it fast is the narrower verification set. The Office of the Professions asks for medical school credentials, postgraduate training, affiliated training hospitals and examination scores. International graduates go through ECFMG certification, and many use an FCVS profile, which adds a step at the front and removes several later.
2. Indiana
The Medical Licensing Board of Indiana runs one of the cheapest files in the country: $250 to apply and $200 every two years to stay licensed. The renewal fee is written into the Indiana Administrative Code, at $200 per biennium. Our Indiana licensing guide carries the full fee list.
Indiana verifies exam scores, medical school transcripts, an NPDB report, a background check and every prior state license. A ninety day temporary permit is available to physicians already licensed in the United States, its territories or Canada, and Indiana is a compact member that can serve as a State of Principal License.
3. Michigan
Michigan splits its physicians between two boards: the Michigan Board of Medicine for MDs and the Michigan Board of Osteopathic Medicine and Surgery for DOs, both administered by the Bureau of Professional Licensing through MiPLUS. Fees are the same either way, $375 to apply and $314 every three years, as set out in our Michigan medical license guide.
The reciprocity route is the reason Michigan appears on these lists. A physician holding an active, unrestricted license in another state or a Canadian province, in good standing, can have that license verified directly to Michigan rather than rebuilding the whole file. The offsetting cost is CME: 150 hours per three year cycle, including mandated implicit bias and human trafficking training.
4. Colorado
The Colorado Medical Board sits inside the Division of Professions and Occupations rather than standing alone, and it grants no automatic reciprocity. What it does offer is a predictable clock and a compact route. Colorado is a full compact member and can serve as a State of Principal License.
The catch most applicants miss is the renewal calendar. Colorado licenses expire on a fixed date, April 30 of odd numbered years, not on an anniversary of your own, so a license issued in March can need renewing weeks later. Colorado’s renewal cycle and its new 30 hour CME requirement are covered in full on the state page.
5. Ohio
The State Medical Board of Ohio charges $305 in board fees and clears most complete applications in about 8 to 12 weeks through eLicense. Ohio also runs a reciprocal licensure path for holders of a substantially similar out of state license held in good standing for at least a year, which is open to every license type except training certificates, limited permits and special certificates.
Ohio joined the compact as the 35th member state. That number is now historical: the compact has 44 member states and two territories, and Ohio is one of the 39 states that can act as a State of Principal License. Our page on how the Ohio process runs has the step by step version.
Which boards publish the fastest processing times?
If speed is the only question, compare the processing times that boards publish or are held to by statute. Michigan and Oklahoma sit at the short end, at four to eight weeks for a complete file. North Carolina and New Jersey sit at the long end, at close to three months, and both offer a compact route that is far quicker.
| State | Published processing time | What the clock measures |
|---|---|---|
| Michigan | 4 to 6 weeks | Complete file |
| Oklahoma | 6 to 8 weeks | Complete file |
| Texas | About 51 days | From licensing status, once an analyst is assigned |
| Ohio | 8 to 12 weeks | Complete application |
| Virginia | 8 to 12 weeks | Complete application |
| Colorado | 60 to 90 days | Complete file |
| Louisiana | 60 to 90 days | Complete file |
| North Carolina | 83 days | Board average for traditional applications, most recent 90 day period |
| New Jersey | About 3 months | Board average, from receipt of the application |
From the licensing desk: the states that feel easy are the ones that ask for fewer third party confirmations, because every verification is a piece of paper someone else has to send. In the applications we process, the delay is almost never the board. It is a residency program that takes six weeks to return a training form, or a hospital that no longer keeps privileging records that old.
Cost per year reorders the easy list completely
Application fees are the wrong way to compare medical license cost by state. A license is a subscription, and the number that matters is the renewal fee divided by the length of the renewal cycle. Run that across the states where we hold verified board figures and New York, the state at the top of most easy lists, turns out to be one of the most expensive to keep.
| State | Application fee | Renewal | Cost per year |
|---|---|---|---|
| South Carolina | $500 | $140 every 2 years | $70 |
| Indiana | $250 | $200 every 2 years | $100 |
| Michigan | $375 | $314 every 3 years | $105 |
| Georgia | $500 | $230 every 2 years | $115 |
| Virginia | $302 | $337 every 2 years | $169 |
| Pennsylvania | $35 | $360 every 2 years | $180 |
| Oklahoma | $500 | $200 every year | $200 |
| New Jersey | $325, plus a $225 endorsement fee | $290 per year, billed by two year cycle | $290 |
| New York | $735 (includes first registration) | $600 every 2 years | $300 |
| Louisiana | $382 | $332 every year | $332 |
| North Carolina | $550 | $350 every year | $350 |
Three comparisons are worth holding on to. Pennsylvania charges $35 to apply and $360 to renew, so the state that looks cheapest on day one costs $80 a year more than Indiana to keep. North Carolina moved to the top of this table on October 1, 2026, when its annual renewal rose from $250 to $350. And Texas, which sits on the hard list below, takes $895 at submission, more than three times the Indiana application and more than twenty times the Pennsylvania one.
Cost check: board fees are not the whole bill. Budget for fingerprinting and a criminal background check, primary source verification, an FCVS profile where the board wants one, courier fees for anything that still moves on paper, and a jurisprudence exam fee in the states that run one.
Hardest States to Get Medical License
Five states are consistently the slowest and the most document hungry: Massachusetts, Texas, New Jersey, Nevada and California. Two of them sit outside the Interstate Medical Licensure Compact, which removes the fastest route into the state. Two of them run separate osteopathic boards, so the answer changes depending on whether you are an MD or a DO.
1. Massachusetts
The Massachusetts Board of Registration in Medicine wants the verification documents collected and submitted together rather than trickling in, which turns one slow third party into a stalled file. Applicants also carry a detailed malpractice claim history from every past carrier.
The state layers on requirements no other board asks for in the same combination: a supervisory form, a notarized certificate of moral and professional character, opioid and pain management training, electronic health record proficiency, child abuse recognition, domestic and sexual violence education, and MassHealth enrollment. Massachusetts is also not a compact member, so there is no expedited route in.
2. Texas
The Texas medical license costs $895 at submission, the highest application fee among the states on this page. The Texas Medical Board verifies graduation, examination history and professional character, and it requires fingerprints plus a Texas specific jurisprudence exam that no amount of experience elsewhere waives.
State law sets an average processing target of 51 days once the application moves from pre licensure into licensing and an analyst is assigned. The friction is in the communication model rather than the rules: correspondence runs through the online system and email, replies can take days, and there is no direct line to the analyst handling your file.
3. New Jersey
The New Jersey State Board of Medical Examiners sits under the Division of Consumer Affairs and asks for one of the longest evidence lists in the country: medical education verification and transcripts, the full examination record, every postgraduate year verified separately, employment history, personal references, a background check, and both AMA and NPDB profiles. The Board puts its own average at three months from receipt of the application, and the bill at $325 to apply, a one time $225 endorsement fee and $290 for each year of registration.
Applicants with any criminal record add another layer, including a personal explanation, police reports, reference letters and court documents. One thing has changed in New Jersey’s favor: it is now a compact member state, so a physician already licensed elsewhere in the compact has a route that skips most of that list. Our New Jersey licensing page has the fee breakdown and the renewal rules.
4. Nevada
Nevada runs two physician boards. The Nevada State Board of Medical Examiners licenses MDs from Reno, and the Nevada State Board of Osteopathic Medicine licenses DOs from Henderson. They are separate agencies with separate applications, separate fees and separate lookups, and choosing the wrong one costs weeks.
The application itself is exhaustive by design: full credential documentation, extensive background checks, veteran status, and verification of every previous license and practice location. Nevada also writes supervision duties into administrative code rather than leaving them to the practice, which matters for anyone bringing a PA into a new Nevada practice.
5. California
California licensing requirements are the strictest in the country on training. The Medical Board of California requires 36 months of board approved postgraduate training from every applicant, whether the medical school was domestic or international, and 24 of those months must be consecutive in the same program.
Residents in California programs hold a Postgraduate Training License while they train, and after 36 months they have 90 days to convert it to a Physician’s and Surgeon’s Certificate to keep practicing. DOs are licensed by a different agency again, the Osteopathic Medical Board of California. And California remains outside the compact, so none of this can be shortened by holding a license somewhere else.
Common mistake: treating compact membership as compact eligibility. Membership means the state issues licenses through the compact. Eligibility means a member board will vouch for you, and only 39 states plus the District of Columbia and Guam can do that. Hawaii and Vermont issue compact licenses but cannot be the state your application starts from.
Medical licenses by state: all 52 boards and their compact status
There is no national medical license. Fifty states plus the District of Columbia and Puerto Rico each license independently, and the board that does it is not always called a medical board. Washington has a medical commission, Kansas has a board of healing arts, Missouri has a board of registration for the healing arts, and New York has no medical board at all.
The Interstate Medical Licensure Compact Commission reports 44 member states plus two United States territories, 59 licensing boards, 145,733 Letters of Qualification and 246,359 licenses issued as of October 31, 2026. Arkansas went live in October 2026, which leaves Alaska, New Mexico and Rhode Island still implementing. The compact is an agreement among sovereign states, not a federal program.
| Jurisdiction | Licensing board | Official site | Compact status |
|---|---|---|---|
| Alabama | Alabama Board of Medical Examiners | albme.gov | Member, SPL |
| Alaska | Alaska State Medical Board | commerce.alaska.gov | Passed, in process |
| Arizona | Arizona Medical Board | azmd.gov | Member, SPL |
| Arkansas | Arkansas State Medical Board | armedicalboard.org | Member, SPL |
| California | Medical Board of California | mbc.ca.gov | Not a member |
| Colorado | Colorado Medical Board | dpo.colorado.gov | Member, SPL |
| Connecticut | Connecticut Medical Examining Board | portal.ct.gov | Member, SPL |
| Delaware | Delaware Board of Medical Licensure and Discipline | dpr.delaware.gov | Member, SPL |
| District of Columbia | District of Columbia Board of Medicine | dchealth.dc.gov | Member, SPL |
| Florida | Florida Board of Medicine | flboardofmedicine.gov | Member, SPL |
| Georgia | Georgia Composite Medical Board | medicalboard.georgia.gov | Member, SPL |
| Hawaii | Hawaii Medical Board | cca.hawaii.gov | Member, issues only |
| Idaho | Idaho Board of Medicine | dopl.idaho.gov | Member, SPL |
| Illinois | Illinois State Medical Board (IDFPR) | idfpr.illinois.gov | Member, SPL |
| Indiana | Medical Licensing Board of Indiana | in.gov/pla | Member, SPL |
| Iowa | Iowa Board of Medicine | medicalboard.iowa.gov | Member, SPL |
| Kansas | Kansas State Board of Healing Arts | ksbha.ks.gov | Member, SPL |
| Kentucky | Kentucky Board of Medical Licensure | kbml.ky.gov | Member, SPL |
| Louisiana | Louisiana State Board of Medical Examiners | lsbme.la.gov | Member, SPL |
| Maine | Maine Board of Licensure in Medicine | maine.gov/md | Member, SPL |
| Maryland | Maryland Board of Physicians | mbp.state.md.us | Member, SPL |
| Massachusetts | Board of Registration in Medicine | mass.gov | Not a member |
| Michigan | Michigan Board of Medicine | michigan.gov/lara | Member, SPL |
| Minnesota | Minnesota Board of Medical Practice | mn.gov/boards/medical-practice | Member, SPL |
| Mississippi | Mississippi State Board of Medical Licensure | msbml.ms.gov | Member, SPL |
| Missouri | Missouri Board of Registration for the Healing Arts | pr.mo.gov | Member, SPL |
| Montana | Montana Board of Medical Examiners | boards.bsd.dli.mt.gov | Member, SPL |
| Nebraska | Nebraska Board of Medicine and Surgery | dhhs.ne.gov | Member, SPL |
| Nevada | Nevada State Board of Medical Examiners | medboard.nv.gov | Member, SPL |
| New Hampshire | New Hampshire Board of Medicine | oplc.nh.gov | Member, SPL |
| New Jersey | New Jersey State Board of Medical Examiners | njconsumeraffairs.gov | Member, SPL |
| New Mexico | New Mexico Medical Board | nmmb.state.nm.us | Passed, in process |
| New York | New York State Board for Medicine (NYSED) | op.nysed.gov | Not a member, legislation introduced |
| North Carolina | North Carolina Medical Board | ncmedboard.org | Member, SPL |
| North Dakota | North Dakota Board of Medicine | ndbom.org | Member, SPL |
| Ohio | State Medical Board of Ohio | med.ohio.gov | Member, SPL |
| Oklahoma | Oklahoma Board of Medical Licensure and Supervision | okmedicalboard.org | Member, SPL |
| Oregon | Oregon Medical Board | oregon.gov/omb | Not a member |
| Pennsylvania | Pennsylvania State Board of Medicine | dos.pa.gov | Member, SPL |
| Puerto Rico | Puerto Rico Board of Medical Licensure and Discipline | salud.pr.gov | Not a member |
| Rhode Island | Rhode Island Board of Medical Licensure and Discipline | health.ri.gov | Passed, in process |
| South Carolina | South Carolina Board of Medical Examiners | llr.sc.gov | Not a member |
| South Dakota | South Dakota Board of Medical and Osteopathic Examiners | sdbmoe.gov | Member, SPL |
| Tennessee | Tennessee Board of Medical Examiners | tn.gov/health | Member, SPL |
| Texas | Texas Medical Board | tmb.texas.gov | Member, SPL |
| Utah | Utah Medical Licensing Board | commerce.utah.gov/dopl | Member, SPL |
| Vermont | Vermont Board of Medical Practice | healthvermont.gov | Member, issues only |
| Virginia | Virginia Board of Medicine | dhp.virginia.gov | Not a member |
| Washington | Washington Medical Commission | wmc.wa.gov | Member, SPL |
| West Virginia | West Virginia Board of Medicine | wvbom.wv.gov | Member, SPL |
| Wisconsin | Wisconsin Medical Examining Board | dsps.wi.gov | Member, SPL |
| Wyoming | Wyoming Board of Medicine | wyomedboard.wyo.gov | Member, SPL |
Twelve states license DOs through a separate osteopathic board rather than the medical board: Arizona, California, Florida, Maine, Michigan, Nevada, Oklahoma, Pennsylvania, Tennessee, Vermont, Washington and West Virginia. Alabama adds its own wrinkle, where the Board of Medical Examiners handles the application and the Medical Licensure Commission issues the license. A verification search that comes back empty is often a search of the wrong board.
Worth knowing: the Commission’s only official website is imlcc.com, and it has published a notice saying it is not affiliated with the similarly named .org domain, which is not a licensing site at all. Check the address bar before entering anything.
PA rules change the answer for anyone building a team
An easy state for a physician is not automatically an easy state for the practice. Chart co-signature is the clearest example: some states put a percentage and a deadline in statute, some ban mandatory co-signature outright, and some leave it entirely to the practice agreement. The spread is wider than most relocation checklists suggest.
| State | What the rule requires | Authority |
|---|---|---|
| Arkansas | 100% co-signature for the first 120 days, then 10% | State medical board policy |
| California | Countersign and date a minimum 5% sample within 30 days | 16 CCR 1399.545 |
| Florida | A physician may not be required to review and co-sign PA charts | Fla. Stat. 458.347(3) |
| Hawaii | Physician personally reviews every patient record within seven days | HAR 16-85-49 |
| Indiana | Encounters reviewed within 10 business days, 10% of records in the first prescribing year | Ind. Code 25-27.5-6-1 |
| Kansas | All records within seven days for the first 30 days, periodic review after | KAR 100-28a-10 |
| Massachusetts | Schedule II prescriptions reviewed within 96 hours | 263 CMR 5.06(3) |
| Michigan | No countersignature required on orders written under a practice agreement | MCL 333.17049(2) |
| Mississippi | Monthly review of 10% of charts or 20 charts, whichever is fewer | Miss. Admin. Code 30-26-2615-1.7 |
| Missouri | 10% of services, and 20% of controlled substance cases | 20 CSR 2150-7.135(7) |
| Nevada | Supervising physician reviews and initials selected charts | NAC 630.370 |
| Washington | No statewide percentage; the collaboration agreement sets oversight | ESHB 2041 (2024) |
| No provision at all | Maine, Maryland, Minnesota, Nebraska, New Mexico, North Carolina, North Dakota | Statute and administrative code |
Washington is the state that changed most recently. Under ESHB 2041, in force since 2025, the Washington Medical Commission no longer collects PA practice agreements. The physician, the PA or the employer completes a collaboration agreement before the PA sees patients, keeps it at the primary practice location, and produces it if the Commission asks. The threshold that separates supervision from collaboration is 4,000 hours of postgraduate clinical practice or 2,000 hours in the chosen specialty.
Deadline watch: a Washington PA still working under a pre 2025 practice agreement must move to a collaboration agreement no later than the next license renewal. Nothing prompts this. The agreement simply has to exist and be produceable on request, and our PA licensing team sees it discovered during credentialing rather than before.
What to Expect When Applying for a Medical License in the US
Every state asks the same four questions in a different order: where you trained, what you scored, what you have done since, and whether anything in your record needs explaining. Graduating from medical school, finishing postgraduate training and passing the full examination sequence are the floor everywhere. The variation sits in how much of it a third party has to confirm.
Medical Education Requirements for Physicians
An unrestricted license needs at least one year of postgraduate training in every jurisdiction, and the Federation of State Medical Boards, the national non-profit representing the state medical and osteopathic boards, notes that some states require two or three. California sits at the top of that range with 36 months for every applicant.
You also need the examination sequence: all three steps of the USMLE, the program co-sponsored by FSMB and the National Board of Medical Examiners, or COMLEX-USA for osteopathic physicians. Attempt limits and time windows are set state by state, and they are the requirement most likely to end an application outright.
Postgraduate Medical Training Requirements
Residency is usually the first formal contact between a physician and a state board, because most boards issue a training permit or a limited license for the residency years. California’s Postgraduate Training License is the strictest version, required of every resident in a board approved program in the state.
More than a dozen jurisdictions also gate progress through residency itself, requiring a physician to finish the examination sequence and hold a full license before entering PGY-2 or PGY-3. If you are moving states mid training, that rule decides your timeline more than any processing average does.
Evaluating Fitness to Practice Medicine
Boards verify credentials at source, query the FSMB disciplinary data bank and the National Practitioner Data Bank, run a criminal background check, and look for gaps and inconsistencies in what you filed. Some boards will ask for an interview. A self query of your own NPDB record before you apply is the cheapest way to find a surprise while you still have time to explain it.
One point of confusion is worth clearing. A medical license lets you practice medicine generally. Physicians are not licensed by specialty in the United States, so board certification, while it often decides hospital privileges, is a separate credential from the license itself.
Quick reference
| Where the national picture stands | Current |
|---|---|
| Licensing jurisdictions in the United States | 52 (50 states, DC, Puerto Rico) |
| Compact member states | 44, plus DC and Guam |
| States that can serve as State of Principal License | 39, plus DC and Guam |
| Member states that issue compact licenses only | 2 (Hawaii, Vermont) |
| Legislation passed, implementation in process | 3 (Alaska, New Mexico, Rhode Island) |
| States outside the compact | 6 (California, Massachusetts, New York, Oregon, South Carolina, Virginia) |
| Licensing boards inside the compact | 59 |
| Letters of Qualification issued to date | 145,733 |
| Compact licenses issued to date | 246,359 |
| States running a separate osteopathic board | 12 |
| Cheapest carrying cost in our verified set | South Carolina, $70 per year |
| Most expensive carrying cost in our verified set | North Carolina, $350 per year |
| Highest application fee on this page | Texas, $895 |
Frequently asked questions
What is the easiest state to get a medical license?
There is no single easiest state to get a medical license. New York, Indiana, Michigan, Colorado and Ohio appear on most lists because they ask for fewer third party verifications. If you already hold a license in a compact member state, the compact route is usually easier than any of them.
What is the fastest medical license to get?
The compact route, if you already hold a full license in a member state. Your State of Principal License issues a Letter of Qualification, then member boards issue on top of it. North Carolina, for example, averaged 83 days on traditional applications in its most recent 90 day period, against about nine days through the compact in the Board’s June 2026 figures.
Which states have the cheapest medical licensure fees?
Compare cost per year rather than the application fee. In the states where we hold verified board figures, South Carolina is cheapest to keep at $70 a year, followed by Indiana at $100 and Michigan at $105. Pennsylvania is cheapest to enter at $35.
Is there medical license reciprocity between states?
Not in the strict sense. States grant licenses by endorsement, which recognizes your credentials but still runs an application. The Interstate Medical Licensure Compact is the closest thing to reciprocity, and it covers 44 member states plus the District of Columbia and Guam.
Which states are in the Interstate Medical Licensure Compact?
Forty four states plus DC and Guam. Thirty nine of those states can act as your State of Principal License. Hawaii and Vermont issue compact licenses only. Alaska, New Mexico and Rhode Island have passed the law and are implementing it.
Which states are the most PA friendly?
States that let experienced PAs practice without a required physician agreement, including Arizona, Maine, Minnesota, Montana, New Hampshire and North Dakota. Several of them also have no chart co-signature provision in statute at all, which removes a recurring administrative cost from the practice.
Do doctors have to be licensed in each state?
Yes. There is no national medical license, so a physician needs a license from every state where the patients are, and in most cases that includes telemedicine. The Interstate Medical Licensure Compact speeds up additional licenses in member states, but each one is still a separate state license.
The Bottom Line
Pick the state on the two numbers that actually bind you: how many third parties have to confirm something before the board can act, and what the license costs per year once you hold it. If you are already licensed in a compact member state, check your State of Principal License status first, because that one fact removes more weeks than any ranking on this page.
How We Make the Medical Licensing Process Easier
Knowing how a board works is useful. Tracking 52 of them while running a practice is not realistic, and for physicians working locum tenens or by telemedicine it is the whole job. Our team files the application and chases every verification on your behalf, in any state, and keeps the renewal calendar so a fixed expiry date like Colorado’s does not arrive unannounced. Start with our physician licensing service and we will tell you what your file needs.
Our team handles physician license applications end to end across all 50 states: board forms, primary source verification, FCVS profiles and compact filings, all checked before the file reaches the board. We work with MDs, DOs, PAs and nurses.
This article provides general guidance only. Licensing requirements, fees and CME rules change frequently and vary by state. Always verify current requirements with the official state board listed in the table above before submitting an application. Each table carries the date its figures were checked.
Written by Medicallicensing Team · Reviewed by David Ivaniuk, CEO Medicallicensing · Last updated: November 13, 2026 · Last fact-checked: September 8, 2026; fee, processing time and compact data rechecked November 13, 2026
