The Federation of State Medical Boards
(FSMB) is the organization that represents the interests of state
medical boards. In April 1999, the FSMB adopted a policy that includes
the following requirements.
- All applicants for licensure should have
satisfactorily completed a minimum of three years of postgraduate
training in an ACGME- or AOA-approved postgraduate training
program, including completion of PGY 3 level training prior
to full and unrestricted licensure (emphasis added).
Postgraduate training should include some exposure to general
- All applicants for postgraduate training shall
have satisfactorily completed Steps 1 and 2 of the USMLE or Parts
1 and 2 of the certifying examination administered by the NBOME prior
to acceptance into a postgraduate training program.
- Medical boards shall encourage medical schools to
share information with the medical boards regarding any
disciplinary actions taken against students. (emphasis added)
Currently a vast majority of state
licensing boards require one year of postgraduate training in order to
be eligible to obtain an unlimited license to practice medicine. There
is now a trend developing to increase the number of postgraduate
training years needed for an unlimited license. 1999 saw two states
introduce legislation that would raise the postgraduate training
requirement for licensure. Only one state was successful in enacting its
legislation. This now brings the total number of states that require two
or more years of postgraduate training before being eligible for an
unlimited license to seven. At recent meetings, state licensing boards
executives indicated the issue of increasing postgraduate training
requirements is being added to many of their agendas for the next year.
While a majority of students may say,
"I am going to do a residency, so this won’t impact me,"
they may not be looking at the whole picture. A couple of points to
think about: 1) Nurse practitioners and physician assistants are
practicing primary care with little or no direct on-site supervision.
These mid-level practitioners receive less education than physicians
with four years of medical school and one year of postgraduate training;
2) In postgraduate training, the physician is not allowed to
"moonlight." Moonlighting can only be done once
the physician receives an unlimited license, and 3) Many physicians
entering postgraduate training are faced with repayment of large school
All of the requirements listed are
important and need to be addressed if legislation is introduced in a
state. Contact your student or intern/resident organization and
encourage their participation. If you would like to become involved on a
personal level if legislation is introduced in your state, contact Linda
Mascheri, AOA Division of State Government Affairs, (800) 621-1773 ext.
8184 or you can e-mail her at