Eligibility for Licensure

Pathways to Physician Licensure in North Dakota

Eligibility Requirements of all Applicants:

Before we get to the various pathway for licensure, every applicant needs to:

EXAMS: Pass all steps of approved medical licensing examinations within 3 attempts (exceptions apply). Approved licensing examinations include:
- For MDs: USMLE, FLEX, NBME, LMCC
- For DOs: NBOME or COMLEX
FIT TO PRACTICE: Be physically, mentally, and professionally capable of practicing medicine
HISTORY: Hold a history free of any finding by the Board, any other state medical licensure board, or any court of competent jurisdiction, of the commission of any act that would constitute grounds for disciplinary action under North Dakota Century Code section 43-17-31
CURRENT PRACTICE: If you have not practiced clinically within the two years preceding the application, you will need to provide a re-entry to practice plan and interview before the board OR request an administrative license in which you cannot practice in a clinical setting.

Note: An applicant may be called to interview before the board before a license is issued based on the applicant’s history.

Pathway 1: US & Canadian Medical School Graduates

Education Required:

You must have an MD or DO degree from an LCME, CACMS, or COCA accredited medical or osteopathic school in the US or Canada

Training Required:

Complete 1 year of postgraduate training (residency) in the US or Canada accredited by the ACGME or RCPSC

Note: applicants graduating from a Canadian medical school accredited by CACMS after June 30, 2025, must also obtain ECFMG certification.

Pathway 2: International Medical School Graduates

Education Required:

You must have an MD degree (or equivalent) from a medical school outside the US and Canada approved by the Board with ECFMG certification
Note: Graduates of international osteopathic schools are NOT eligible

Training Required:

Complete 2 years of postgraduate training (residency) in the US or Canada accredited by the ACGME or RCPSC

Special Exception: If you've completed at least 1 year of US/Canadian ACGME accredited residency training but not 30 months total, you might still qualify if you can prove you have other professional experience and training that is substantially equivalent to 18 months residency training AND you meet one of these:

Board certified by a specialty board recognized by the US American Board of Medical Specialty or Canada’s Royal College of Physicians and Surgeons, OR
Passed the SPEX examination from the Federation of State Medical Boards

Additional Requirements:

Hold a certificate from the Educational Council for Foreign Medical Graduates (ECFMG) except for graduates of medical schools in the United Kingdom, Australia, and New Zealand.
Demonstrate working ability in English

Pathway 3: Uniquely Qualified License

Who is this for?

Applicants who don't meet all technical requirements for licensure but will bring a unique contribution not readily available to the State.

The Big Picture: The board can grant a license if you're "uniquely qualified" through your experience or will make a unique contribution to medicine that isn't readily available to North Dakota citizens. You will need to fill out a petition for this license and interview before the Board at its next available meeting. Note that this license is granted at the Board’s discretion upon review of the following considerations.

What the Board Considers:

Unique qualifications – how are you uniquely qualified for licensure?
Specialty area – what to you practice that is otherwise not readily available in North Dakota?
Board certification - Are you certified in a specialty?
Practice history - How long and what type of medical practice have you had?
Training & research - What's your postgraduate training and research experience?
Other state licenses - Are you licensed elsewhere?
Disciplinary record - Any disciplinary actions or adverse actions from medical facilities?
Malpractice history - Any malpractice judgments or settlements?
Exam scores - Results from USMLE, SPEX, or other licensing exams
Other relevant factors - Anything else that shows your qualifications

Pathway 4: Interstate Medical Licensure Compact

Who is this for?

Physicians already licensed in another state who want to practice in multiple states through a streamlined compact agreement.

Education Required:

MD or DO degree from a school accredited by:
- Liaison Committee on Medical Education (LCME);
- Commission on Osteopathic College Accreditation (COCA); OR
- Listed in the International Medical Education Directory

Exam Requirements:

Passed all parts of USMLE or COMLEX-USA within 3 attempts each (or equivalent predecessor exams)

Training Required:

Completed graduate medical education (residency) approved by:
- Accreditation Council for Graduate Medical Education (ACGME), OR
- American Osteopathic Association (AOA)

Board Certification:

Hold specialty certification or time-unlimited specialty certificate from:
- American Board of Medical Specialties (ABMS), OR
- American Osteopathic Association's Bureau of Osteopathic Specialists

License Requirements:

Must have a full, unrestricted license from a member board state.

Clean Record Required:

No criminal convictions or deferred adjudications for any offense by a court of competent jurisdiction
Never had a medical license disciplined in any jurisdiction (except for non-payment of fees)
Never had a controlled substance license or permit suspended or revoked
Not currently under investigation by any licensing agency or law enforcement

Key Advantage: This pathway allows physicians with strong credentials and clean records to obtain licenses in multiple compact member states more easily than applying individually to each state. To obtain licensure through this pathway, please fill out an application through the Interstate Medical Licensure Compact – https://imlcc.com. For more information - see the Board's webpage on IMLC licensure.

Key Differences Between Pathways

Pathway 1 (US/Canadian): 1 year postgraduate training required
Pathway 2 (International): 2 years postgraduate training required (with possible exceptions)
Pathway 3 (Uniquely Qualified): Standard requirements may be waived if you are uniquely qualified and will bring practice not readily available in the state.
Pathway 4 (Interstate Compact): License issued through the Interstate Medical Licensure Compact.

Abbreviations:

ABMS: American Board of Medical Specialties
ACGME: Accreditation Council for Graduate Medical Education
AOA: American Osteopathic Association
CACMS: Committee on Accreditation of Canadian Medical Schools
COCA: Commission on Osteopathic College Accreditation
COMLEX: Comprehensive Osteopathic Medical Licensing Examination
ECFMG: Educational Commission for Foreign Medical Graduates Examination
FLEX: Federation Licensing Examination
LCME: Liaison Committee on Medical Education
LMCC: Licentiate of the Medical Council of Canada
NBME: National Board of Medical Examiners
NBOME: National Board of Osteopathic Medical Examiners
RCPSC: Royal College of Physicians and Surgeons in Canada
USMLE: United States medical licensing examination