Massachusetts Medical License Requirements and Fees: Exams and Training

To meet the Massachusetts medical license requirements for a full license, you need a degree from an accredited medical school, a passing score on either the USMLE or the COMLEX-USA, at least three years of accredited postgraduate training, and a $600 application fee paid to the Board of Registration in Medicine. International graduates have extra steps, and anyone who plans to prescribe controlled substances needs a separate federal registration on top of the state license.

Medical School and Degree

You need a medical degree from a school accredited by the Liaison Committee on Medical Education (LCME), or a doctor of osteopathy degree from a program accredited by the American Osteopathic Association (AOA).¹

International medical graduates must hold a degree the Board considers substantially equivalent to an LCME- or AOA-accredited program. That means at least two academic years of basic science study and two academic years of clinical study covering core disciplines, including internal medicine, surgery, pediatrics, obstetrics and gynecology, psychiatry, and public health.¹

International graduates also need a valid Educational Commission for Foreign Medical Graduates (ECFMG) certificate as of the date of licensure. Fifth Pathway program graduates are exempt from the ECFMG requirement.¹

Licensing Examination

Every applicant must pass either the United States Medical Licensing Examination (USMLE) or the Comprehensive Osteopathic Medical Licensing Examination (COMLEX-USA). If you’re an international graduate asking the Board to waive the substantial equivalency requirement for your education, you need to have completed all three steps of the USMLE or all three levels of COMLEX within a seven-year window.¹

Postgraduate Training

Massachusetts requires at least three years of postgraduate medical training in a program accredited by the Accreditation Council for Graduate Medical Education (ACGME), the AOA, or an accredited Canadian program. The three-year rule took effect January 1, 2014, so older guides that still mention a two-year requirement are out of date.¹

Many applicants use the Federation Credentials Verification Service (FCVS) to compile and verify the records the Board needs. The FCVS pulls together medical school transcripts, postgraduate training in ACGME- or AOA-accredited programs, USMLE and COMLEX scores, ECFMG certification where applicable, and licensure history including any disciplinary actions.²

The Application, Fees, and Insurance

The initial full license application fee is $600, and it’s nonrefundable.³ Beyond paying the fee and documenting your education and training, you must demonstrate good moral character. Once licensed, you must carry malpractice insurance for the entire life of the license.⁴

If you already hold a license in another state the Board considers equivalent to Massachusetts, or if you hold specialty board certification recognized by the American Medical Association or the AOA, the Board may grant a license without examination.⁵

Choosing the Right License Type

The full license is what lets you practice independently. A few other categories exist, and applying for the wrong one is a common mistake.

A limited license is for physicians enrolled in postgraduate training at Massachusetts healthcare facilities. All training must happen in an ACGME-accredited program, an AOA-approved program, or a subspecialty clinical fellowship at a facility that runs an approved program in the parent specialty.⁶ The initial fee is $100, it’s valid for one academic year, must be renewed each training year, and can be used for up to seven years of clinical training.⁷

A temporary license is narrow and short-term. It is not a placeholder while your full application is pending, and it cannot be used for residency or fellowship training. There are four kinds, each costing $250: a temporary faculty license for teaching at a medical school affiliated with a hospital; a locum tenens license for substituting for another physician for up to three months; a temporary CME license for attending a Massachusetts medical education course; and a short-term faculty license for a 30-day affiliated faculty appointment.⁸

An administrative license, also $600, is for physicians whose work is administrative or academic. It does not authorize diagnosing or treating patients, prescribing controlled substances, delegating medical acts, or issuing opinions on medical necessity.⁴

DEA Registration If You’ll Prescribe

Your Massachusetts license by itself does not let you prescribe controlled substances. For that you need a federal Drug Enforcement Administration registration, obtained by filing DEA Form 224 online or by mail. The application asks for tax identification information, personal details, state licensing data, and background questions about controlled substances. The DEA will not issue a registration to a physician whose state license has been revoked or rescinded.⁹

DEA registration renews every three years, with no grace period. If it lapses, you cannot prescribe, dispense, or administer controlled substances until it is reinstated, and you must notify the DEA whenever your address changes. Prescribing controlled substances to treat opioid addiction requires a separate registration using Form 363.⁹

Keeping the License Active

Full, administrative, and volunteer licenses renew every two years, and the renewal fee is $600.¹⁰ Renewal requires continuing medical education credits, including at least ten credits in risk management.¹¹

Full licensees renewing must also show proficiency in electronic health records, which includes computerized physician order entry and e-prescribing. Three EHR credits can count toward the ten risk management credits.¹¹

Physicians who prescribe controlled substances must complete CME on effective pain management, risks of opioid abuse and addiction, identifying patients at risk for substance use disorders, and proper counseling on medication storage and disposal, once per licensing cycle.

Miss the renewal deadline and you cannot practice medicine in Massachusetts in any fashion or capacity until the Board revives your license. The lapsed license renewal fee is $700, a $100 penalty on top of the standard renewal cost.¹²

Telemedicine and Out-of-State Physicians

A physician must be licensed in the state where the patient is located. If you’re out of state and want to provide telehealth services to patients in Massachusetts, you need a Massachusetts license. Limited exceptions exist for physician-to-physician consultations, prospective patient screening, episodic follow-up care, follow-up after travel, and clinical trials.

The Interstate Medical Licensure Compact (IMLC) offers a streamlined route to multi-state licensure in member states, but Massachusetts has not enacted the compact. As of 2026, compact legislation has only been introduced in the state legislature.¹³ Until Massachusetts joins, out-of-state physicians apply through the Board’s standard process, with the option of licensure without examination for those already licensed in a state with equivalent standards.⁵

1
Legal Information Institute. 243 CMR 2.03 – Initial License for Graduates of International Medical Schools
2
Federation of State Medical Boards. Credentials Verification Process
3
Mass.gov. Physician Licensing Fees and Eligibility Requirements
4
Mass.gov. General Physician Licensing Questions
5
Mass.gov. Massachusetts General Laws c.112 Section 2 – Registration of Physicians
6
Mass.gov. Apply for My Physician Limited License
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Mass.gov. Specific Limited Licensing Questions
8
Mass.gov. Board of Registration in Medicine – Apply for My Physician Temporary License
9
Emergency Medicine Residents’ Association. How Do I Get My DEA Registration?
10
Mass.gov. Board of Registration in Medicine – Schedule of Fees
11
Legal Information Institute. 243 CMR 2.06 – License Renewals
12
Mass.gov. Renew My Lapsed Physician Full License
13
Interstate Medical Licensure Compact. Interstate Medical Licensure Compact