Massachusetts physician licensing.

What the file involves.

A typical Massachusetts file, for an MD licensed in one other state with one malpractice carrier in the last 10 years, moves between 12 parties and 10 core document types, or 11 parties when one physician writes both your evaluation and your character reference. A DO file adds NBOME, for 13, and international graduates add ECFMG through FCVS. FCVS carries your school, training, exam, and NPDB verifications; the board asks separately for everything else, and two of the documents need a U.S. notary.

• The Board of Registration in MedicineReceives the application and fee, runs a name-based criminal record check, reviews the file, and issues the license; its Licensing Committee takes files that raise questions.
• FSMB’s FCVSAssembles your profile for the board: exam scores, verified education and training, and the NPDB report.
• Your medical schoolVerifies your attendance and graduation to FCVS.
• Each residency or fellowship programVerifies your training to FCVS: every US, Puerto Rico, or Canadian program, completed or not.
• NBOME (DO files)Sends your COMLEX-USA transcript to FCVS.
• The NPDBReports on you through FSMB, which requests the report as the board’s agent, with no separate step for you.
• Every board that has issued you a full licenseVerifies each active or inactive full license in the US, Puerto Rico, or Canada.
• A supervising physicianEvaluates at least a year of your current clinical work; locum tenens physicians need evaluations from their facilities covering the last two years.
• A physician character referenceAttests to your moral and professional character: a US-licensed physician, not a relative, who has known you at least a year, and who may also be your evaluator.
• The AMA or the AOASends your physician profile to the board: the AMA’s for MDs, either one for DOs.
• Each malpractice carrier of the last 10 yearsReports your claims history to the board.
• MassHealthTakes the enrollment application state law requires of every licensee, at least as a non-billing ordering and referring provider, to get and keep the license.
• A domestic and sexual violence course providerCertifies the DPH-approved training you must finish before you apply.

Postgraduate training

Two years of ACGME, AOA, or accredited Canadian training for graduates of US and Canadian schools. The board may accept one year if you hold a current, active, unrestricted full license in another state, show continuous clinical activity, and are certified by an ABMS or AOA board.

Exams

USMLE Steps 1 to 3 or COMLEX-USA Levels 1 to 3, all passed within seven years of your first passed step unless the board grants a waiver, as it can for joint-degree applicants up to ten years. Each Step or Level must be passed within four attempts, with no waiver, and three failed attempts at Step 3 or Level 3 mean another year of accredited training before a fourth, unless waived.

International graduates

ECFMG certification valid on the date of licensure and a medical education the board finds substantially equivalent; more than three months of clerkships away from your school’s primary teaching hospital needs a waiver unless you graduated from one of five schools the board names. The board’s rule, its fees page, and an interim policy state the training years for international graduates differently.

Time out of practice

After 24 or more consecutive months out of practice, you must show current clinical competency, for example with 100 hours of practice-relevant CME beyond the licensure requirements, SPEX or COMVEX, or board certification or recertification within the prior 24 months. Otherwise expect a reentry plan of 1 to 12 months, usually with a non-disciplinary restricted license.

Conditions of the license

Every applicant applies to enroll in MassHealth, at least as a non-billing ordering and referring provider, and agrees not to balance-bill Medicare patients. Physicians who give direct or indirect patient care in Massachusetts also carry malpractice coverage of at least $100,000 per claim and $300,000 a year.

Training required to apply

Child abuse and neglect reporting training and domestic and sexual violence training, both before the application goes in. Initial applicants also need 2 credits on implicit bias, 3 on opioids and pain management if they prescribe controlled substances, and proof of proficiency with electronic health records.