Medical Industry: Licensing & Certification
Those who set afoot on the career path to become a physician generally know what licenses and certifications stand between them and their goal of practicing medicine. Hours of undergraduate studies, medical school and residency ensure no one embarks on the lengthy venture without a healthy dose of regulatory understanding.
Still, for those starting or already running a private practice, knowing career advancement credentials for other positions could help in terms of staffing, employee advancement and bolstering the prestige of an operation.
Likewise, for those working in a specialized position at a private practice, licensing and certification can lead to more money, greater opportunities and promotion.
In the United States, all physicians must be licensed to practice, which is controlled by each individual state, pursuant to its state Medical or Osteopathic Board.
A candidate must first graduate from an accredited medical school with an MD (Doctor of Medicine) or DO (Doctor of Osteopathic Medicine) degree.
US students studying at a foreign medical school and foreign medical students looking to be licensed in the US must receive accreditation through the Educational Commission for Foreign Medical Graduates (ECFMG).
Next, the student must complete three to seven or more years
of graduate medical education through an accredited residency
program, with the number of years depending on the medical
All states require that first-time applicants for licensure successfully pass the three- part United States Medical Licensing Examination (USMLE), which is administered by the National Board of Medical Examiners and the Federation of State Medical Boards. Step 1 assesses knowledge of necessary scientific principles; Step 2 assesses clinical knowledge and skills; and Step 3 assesses application of all of the above knowledge and skills to the unsupervised practice of medicine. The first two steps are often taken during the medical school education or graduate education/residency period. The third step is taken after deciding on what state board you are applying for. Most states require all three steps of the USMLE to be taken within 7 years.
Once these prerequisites are met, the candidate can submit proof to the applicable state licensing board, along with any other documentation required by the licensing state, including personal information and disciplinary information, if any.
Since the licensure process can be a lengthy one and requirements vary by state, it is important that the candidate contact the applicable state medical board as soon as practicable so as to verify the requirements and the time it may take to get licensed. The Federation of State Medical Boards maintains a directory with links to all of the State Medical and Osteopathic Boards
Board Certification for Physicians
After the physician has received his or her State Medical or Osteopathic license, a voluntary application for Board Certification can be made. The Board Certified physician demonstrates expertise in a particular specialty of medicine, beyond the basic competency required to be licensed. Most certifications must be renewed after 10 years. The primary member organizations offering Board Certification are the American Board of Medical Specialties, the American Board of Physician Specialties, and the American Osteopathic Association.
Licensing and Certification for Other Medical Professionals
Licensing for Nurses
Nurses, like physicians, must be licensed to practice. This is governed by State Boards of Nursing, who set the licensing prerequisites. The National Council of State Boards of Nursing (NCSBN) provides links to all the state boards with their contact information. Most state boards require licensing candidates to pass certain education and examination components. A nurse may be licensed as a Licensed Practical Nurse (LPN), also called a Licensed Vocational Nurse (LVN), or a Registered Nurse (RN).
To be licensed as an LPN, the candidate must complete post-high school educational courses on basic nursing care, and pass the National Council Licensure Examination for (NCLEX-PN), which is administered by the NCSBN. Licensure as an RN involves additional education, including graduation from a state approved nursing school, and passing the NCLEX-RN examination. Unlike physicians, nurses can receive a multistate license through the Nurse Licensure Compact (NLC), which some states have joined.
Certification for Nurses
Like doctors, registered nurses can specialize in the many areas of the medical field. In fact, advancement in nursing often entails pursuing certification in one of more than 200 specialties and subspecialties. While not required by law, holding a specialty certification offers another advantage. According to the American Nurses Credentialing Center, nurses who hold a specialty certification earn thousands more than their non-certified counterparts.
The ANCC is the largest nurse credentialing organization in the United States. Prior to registering to take a certification exam, candidates must show that they hold active registered nurse licenses, have suitable education and possess experience in the specialty field. Certifications last for five years, after which nurses must fulfill a certain number of continuing education credits plus have at least 1,000 hours of nursing practice in the area of concentration or retake and pass the exam to receive a renewal.
All state boards of nursing and the U.S. military recognize ANCC's certification programs, which include Acute Care Nurse Practitioner, Adult Health Clinical Nurse Specialist, Adult Nurse Practitioner, Adult Psychiatric and Mental Health Clinical Nurse Specialist, Adult Psychiatric and Mental Health Nurse Practitioner, Ambulatory Care Nurse, Cardiac Vascular Nurse, Case Management Nurse, Child/Adolescent Psychiatric and Mental Health Clinical Nurse Specialist, Diabetes Management, Advanced, Family Nurse Practitioner, Family Psychiatric and Mental Health Nurse Practitioner, Gerontological Clinical Nurse Specialist, Gerontological Nurse, Gerontological Nurse Practitioner, Informatics Nurse, Medical-Surgical Nurse, Nurse Executive, Nurse Executive, Advanced Nursing Professional Development, Pain Management, Pediatric Clinical Nurse Specialist, Pediatric Nurse, Pediatric Nurse Practitioner, Psychiatric and Mental Health Nurse, Public/Community Heath Clinical Nurse Specialist.
Critical Care Credential
Association of Critical Care Nurses (AACN) offers a
credentialing program targeting professionals in this area of
nursing. To receive the critical care certification, nurses must
meet certain requirements before being allowed to take the
qualifying exam. The organization allows nurses without
four-year degrees to earn the certification for adult, neonatal
and pediatric critical care. For nurses with master's degrees
and national acute care nurse practitioners, the AACN also
offers a clinical specialist credential (CCNS). Credentials from
this organization must be renewed after three years.
Licensing and Certification for Physician Assistants
Physician Assistants (PAs) practice medicine under the supervision of Physicians. They are licensed by State Boards. All States require that a PA applicant graduate from an accredited PA program, and pass the Physician Assistant National Certifying Examination before licensure. Once a student passes the exam, they become certified as a "Physician Assistant - Certified" (PA-C). The National Commission on Certification of Physician Assistants (NCCPA) administers the exam and their Website contains complete information on the certification process.
PAs must complete 100 hours of CME every two years in order to maintain their certification, and must take a recertification exam every six years. The American Academy of Physician Assistants (AAPA) offers a wide range of CME choices, including webcasts and home study programs.
Most doctors are well acquainted with the details surrounding board certification and re-certification for their particular specialties. That said, every discipline in these professions requires meeting certain continuing education requirements, which vary from state to state and discipline to discipline.
While practitioners may take advantage of credit-earning activities through their specific professional organizations - such as the American Academy of Dermatology or the American Board of Family Medicine - plenty of opportunities also are available through the American Medical Association. The following sections address some of the best options for increasing professional expertise.
Most State Medical and Osteopathic Boards require mandatory Continuing Medical Education (CME) for renewal of physician licenses. The American Medical Association has designed most of its CME curriculum to dovetail nicely with state requirements and its member physicians' hectic schedules. Combining online classes with live events, courses cover a broad range of professional interests.
- Online CME programs: These programs are
available on the Internet, or by CD-DVD and offer a range
of perspectives on clinical topics, as well as ethical
issues and patient-doctor communication. Courses on
immunization, pain management and health care disparities
also comprise the curriculum.
CME print materials: The AMA provides CME print materials across many subject areas, including health literacy, risk assessment of certain heredity cancers, road maps for clinical practice and more.
Live Events: Professional development and clinical practice constitute the focus of these meetings, which can be accessed in person at a conference or seminar, or by Webinar. Finances, practice management and disaster training l are among the subjects.
- Journal CME: Physicians can earn CME credits by reading
timely, peer-reviewed articles in the JAMA &
Archives Journals, and then passing a short online quiz
on the relevant subject.
- Direct Credit: Doctors can also earn credit directly
from the American Medical Association by preparing live CME
programs, publishing articles, completing board
certification or recertification and other relevant
activities. Participation in residency or fellowship
programs also counts toward one credit per year, provided
the position was completed within the last three
- UEMS/EACCME Credit: The American Medical Association shares an agreement of mutual recognition of CME credits with the European Union of Medical Specialties (UEMS). As such, the AMA will convert CME credit certified by the European Accreditation Council for Continuing Medical Education (EACCME) to AMA CME credits.
Most Boards of Nursing require continuing education for
license renewal. Additionally, continuing education also enables
nurses to advance their careers.
At ANA Nurse CE, The American Nurses Association offers continuing education programs, with discounts available to association members. Courses are offered online with self study and graded test taking.
The American Nurses Credentialing Center not only accredits CE programs, but also offers many of their own, through their Continuing Nurses Education programs. These include seminars and webinars, conferences, study groups, workshops, publications, and online courses.
Physician Assistants (PAs) are required to have 100 hours of Continuing Medical Education (CME) every two years in order to maintain their certification. The American Academy of Physician Assistants (AAPA) offers a wide range of CME choices, including webcasts and home study programs.