Role of state medical licensure in assessing physician competence

Granting of a state medical license is seen by many as a government's endorsement of a practitioner’s competence. However, in most states, the requirements for licensure are fairly minimal and largely consist of evidence the practitioner actually went to medical school and engaged in at least some postgraduate clinical training. The ongoing maintenance of state medical licensure typically has limited requirements as well. Most states require physicians to undertake some amount of continuing medical education (CME), but the number of required credits varies and compliance is usually on an honor system.

In addition to a medical degree, most states require at least a one-year postgraduate internship to hold a medical license, and many require at least two or three years of residency. However, the growing shortage of physicians in many locales is driving some states to lessen these requirements.

Problems with licensure should always raise a concern about competency. Most states will have websites where actions against a license can be found, including restrictions or suspensions. If a physician is licensed in an unusual number of states, an explanation should be sought. Keep in mind that most state medical board have little skill in competency assessment and frequently overreact or underreact to incidents that raise questions about a practitioner’s ability.