District of ColumbiaPhysician License Requirements

International Medical Graduates (IMG) Pathway

Must obtain ECFMG certification; complete USMLE Steps 1 and 2 CK; graduate from a medical school listed in the World Directory of Medical Schools

Physicians must graduate from an accredited medical school — LCME-accredited for MD programs or COCA-accredited for DO programs. International medical graduates (IMGs) must hold ECFMG certification and complete an accredited U.S. residency program to qualify for state licensure.

Passing Scores

USMLE: Pass/fail for Step 1, minimum 214 for Step 2 CK, minimum 198 for Step 3; COMLEX: Pass/fail for Level 1, minimum 400 for Levels 2-CE and 3

MD candidates must pass all three steps of the USMLE (United States Medical Licensing Examination). DO candidates may take the COMLEX-USA (Comprehensive Osteopathic Medical Licensing Examination). Some states accept either exam series. Many states also require a jurisprudence exam on state-specific medical practice laws and regulations.

All states require completion of at least one year of ACGME-accredited or AOA-approved postgraduate training (residency). Most states require completion of a full residency program for unrestricted licensure, though some allow limited licensure after PGY-1. Board certification by an ABMS or AOA specialty board may be required or provide expedited pathways.

The Interstate Medical Licensure Compact (IMLC) provides an expedited pathway for physicians to obtain licenses in multiple member states. Eligible physicians receive a Letter of Qualification (LOQ) from the IMLC Commission, which facilitates licensure in participating states without repeating full application processes.

Collaborative Requirements

Physicians practice independently; may supervise mid-level providers (PAs, NPs) per state regulations

Supervision of Mid-Level Providers

May supervise physician assistants, nurse practitioners, and other mid-level providers according to state-specific supervision ratios and requirements

Controlled Substance Details

District of Columbia requires a separate state controlled substance registration in addition to federal DEA registration

Licensed physicians have broad scope of practice including diagnosis, treatment, prescribing, and surgery. Physicians may supervise mid-level providers such as PAs and APRNs. DEA registration is required for prescribing controlled substances. Many states also require a separate state Controlled Dangerous Substance (CDS) registration.

CME Details

50 hours of AMA PRA Category 1 Credit or equivalent required per 2 years renewal cycle.

Regulatory Board

Physician licenses must be renewed on schedule with the state medical board. Continuing Medical Education (CME) requirements vary by state but typically range from 20-50 hours per renewal cycle. Some states require specific CME topics such as opioid prescribing, pain management, cultural competency, or ethics.

Reciprocity Requirements

• •Active, unrestricted medical license in another state
• •Graduation from LCME-accredited (MD) or COCA-accredited (DO) medical school, or ECFMG certification for international medical graduates
• •Completion of USMLE or COMLEX examination sequence
• •Completion of at least 1 year(s) of ACGME or AOA-accredited residency training
• •Pass criminal background check
• •IMLC expedited compact licensure pathway available for qualified physicians

The Interstate Medical Licensure Compact (IMLC) provides an expedited pathway for physicians to obtain licenses in member states. For non-IMLC states, physicians must apply for licensure by endorsement, which typically requires verification of medical education, residency training, exam scores, and current good standing in all states of licensure.