Resources & Information

The NCMB does not assign a license number to residents. When filling out forms that request a license number, leave the space blank, or use “RTL” to indicate that you hold a resident training license.

Yes, it is recommended.

Call your Graduate Medical Education (GME) office staff, who function as agents of the North Carolina Medical Board regarding resident training licenses. The GME offices are prepared to handle all inquiries from incoming residents and can explain the application process and assist with questions concerning the online RTL application, fingerprint/criminal background check process and application supporting documents. GME offices strive to approve RTL license applications before residents’ start date.

Once your residency ends you will have access to update your practice address in your Licensure Gateway. From our homepage, click on “Change my name or home/practice address”.

Yes, unless the full license application is approved and a full license is issued BEFORE your RTL renewal date.

You will need to complete the full physician license application online.

You will need a supervising perfusionist until you are certified by the American Board of Cardiovascular Perfusion (ABCP). Without the ABCP certificate you are required to apply for a provisional perfusionist license. This license is only good for 12 months. You will be required to submit a Designation of Supervising Perfusionist form.

Once you have passed the exams for certification, contact the American Board of Cardiovascular Perfusion and have them send us verification. You will also need to submit a written request, along with the required fee to have your provisional license converted to a full license.

The licensure process for perfusionists is:

1. Application is submitted.
2. Required items are provided to the Board.
3. Once the application is complete (license verifications, databank queries, SBI report, and all other requested information has been received) the application goes through the Quality Assurance final review stage.
4. If the application or SBI report reveals negative information, the applicant may be asked to come for an interview with the Perfusionist Advisory Committee (PAC). The PAC will determine a recommendation on licensure.

No. Sleep techs are registered, not licensed, by the North Carolina Medical Board and as such have no license number. The number assigned to a polysomnographic technologist upon initial registration with the Board is a login number for use when registering each year.

Sleep techs must register annually, on or before September 1st.

Registrants must provide: 1) Their full legal name; 2) Their complete address and current telephone number; 3) Evidence that they are currently credentialed in good standing by the Board of Registered Polysomnographic Technologists (BRPT.)

No. The registration is an online process, which sleep techs will access via the Board’s website. It may be necessary for sleep techs to email, mail or fax certain information to the Board to document their credentials.

Yes. The registration fee, which is set by statute, is $50.

Under the Polysomnography Practice Act, it is a Class 1 misdemeanor to practice polysomnography without registering with the Board. Failure to register could result in criminal prosecution or a court injunction barring the unregistered sleep tech from practicing.

Registrants must attest that they are currently credentialed by the BRPT. The Board will verify the sleep tech’s credentials with the BRPT. If the Board is unable to verify if a registrant is currently credentialed by the BRPT, the sleep tech may be required to provide a copy of his or her certificate.

No. The Board is directed by statute only to maintain the registry. Complaints and investigations of violations of the Polysomnography Practice Act shall be directed to and conducted by the national Board of Registered Polysomnographic Technologists.

There will be an application specifically designated for ITPE applicants, but it will not be available until January 2026 when the law becomes effective. Please do not apply for any other application for which you do not qualify and please do not submit any materials via email to Board staff.

There are at least 11 criteria applicants must satisfy in order to qualify for an ITPE license, including:

• An offer of full-time employment from an NC hospital or a rural medical practice with an on-site NC licensed physician.
• A foreign medical license that is:
  • Active, current, and in good standing, OR
  • Active and in good standing within the past 5 years.
• 130 weeks of Medical Education from a medical school listed in the World Dictionary of Medical Schools
• Eligible to be certified by the Education Commission for Foreign Medical Graduates, which includes having the applicant’s medical school verified, passing USMLE Step 1 and 2, and completing any additional assessments as required by applicant’s selected Pathway.

• Postgraduate Training that is either:
  

  • 2 years of Graduate Medical Education approved by the applicant’s country of licensure, OR
  • Actively practiced medicine in country of licensure for at least 10 years after graduation.

• Additional Competency Examination. In addition to the examinations required for ECFMG eligibility, the applicant must also provide successful passage of one of the following examinations:
  

  • Examinations currently accepted by state law and board rules, including USMLE Step 3
  • Examinations accepted for licensure in other countries that are members of IAMRA and the exam must be comparable to the USMLE and tests for ability to practice medicine, medical knowledge, skills and understanding of clinical science essential to patient care, communication and interpersonal skills, and interactive testing component.
  • Board Certification from American Board of Medical Specialties (AMBS), American Osteopathic Association (AOA), or Royal College of Physicians and Surgeons of Canada (RCPS).
  • Comprehensive Assessment demonstrating clinical competence by a program approved by the Board.
  • The Board may waive the additional exam requirements but must require the applicant to successfully pass the SPEX or PLAS within one year. The Board will not issue a waiver for the additional examination unless all other requirements of the license have been met.
• No disciplinary history and no pending investigations in any jurisdiction.
• No criminal history. A criminal background check will be required from the applicant’s country of licensure.
• Practice experience. Applicants have to have practiced medicine for at least five years.
• Communication. Applicants must be proficient in English.
• Immigration Status. Applicants must be authorized to work in the United States.
• Social Security Number. Applicants must have a social security number that must be verified by the Social Security Administration.

There will also be an application fee of $400. Applications will not be processed until the application fee is submitted.

Proof of any of the above credentials must be primary source verified, meaning documentation must be received from the originating source. The Board will not accept credentialing documents directly from an applicant.

You must have either (1) a current and active license in good standing to practice medicine in a foreign country, or (2) had an active license in good standing to practice medicine within five years immediately preceding the submission of your application.

Applicants must have completed 130 weeks of medical education at a medical school that is listed in the World Dictionary of Medical Schools. The applicant must also be eligible for Educational Commission for Foreign Medical Graduates (ECFMG) certification, meaning the school must be recognized by the ECFMG and the applicant must pass the USMLE Step 1 and Step 2 along with any additional assessment requirements under a selected ECFMG pathway.

No, you do not have to be ECFMG certified, but you must have completed all the steps to be eligible for ECFMG certification. This includes having your medical school verified by the ECFMG, passing both USMLE Step 1 and Step 2, as well as any additional assessments required under your selected Pathway within the time frame set by the ECFMG.

Please visit: https://www.ecfmg.org/certification-pathways/pathway-schools.html

Please visit: https://www.ecfmg.org/.

You must have attended the medical school at the time designated by the ECFMG.

Yes, to be ECFMG eligible you must pass USMLE Step 1 and Step 2 as well as any assessments required by your ECFMG Pathway.

There are two options. You must either have completed two years of postgraduate training in a graduate medical education program approved by your country of licensure OR have actively practiced medicine in your country of licensure for at least 10 years.

The requirement to be ECFMG eligible will require the applicant to successfully pass USMLE Step 1 and Step 2, along with any assessment required to complete an ECFMG pathway. In addition, the applicant must also successfully pass one of the following exams:

Examinations currently accepted under G.S. 90-10.1, which includes successful passage of all USMLE steps, including USMLE Step 3.
• Examinations accepted for licensure in other countries that are members of IAMRA and the exam must be comparable to the USMLE and tests for ability to practice medicine, medical knowledge, skills and understanding of clinical science essential to patient care, communication and interpersonal skills, and interactive testing component.
• Board Certification from American Board of Medical Specialties (AMBS), American Osteopathic Association (AOA), or Royal College of Physicians and Surgeons of Canada (RCPS).
• Comprehensive Assessment demonstrating clinical competence by a program approved by the Board.
• The Board may waive the exam requirements but must require the applicant to successfully pass the SPEX or PLAS within one year. The Board will not issue a waiver of the additional examination requirement unless all other requirements of the license have been met.

Applicants must have practiced medicine for at least five years in their country of licensure.

The Board cannot assist you in securing an offer of full-time employment. You should search for any available job opportunities at NC licensed hospitals or rural medical practices and follow the employer’s process for applying.

There are two options. ITPEs must have an offer letter of full-time employment from either (1) a hospital located and licensed in North Carolina, OR (2) a medical practice in a rural area where there will be a NC licensed physician on-site.

The hospital must be located and licensed in North Carolina. Click here for a list of hospitals licensed in North Carolina

No. The hospital must be located and licensed in North Carolina. Click here for a list of hospitals licensed in North Carolina

The medical practice must be located in a North Carolina rural medical practice with a population of less than 500 people per square mile, where a fully licensed NC physician is physically practicing on-site. Click here to see a list of rural counties in North Carolina with less than 500 people per square mile.

The IMLC licensure pathway was implement in in North Carolina in January 2026.

No. The IMLC does not automatically grant you authority to practice in other states. The IMLC is an expedited pathway to licensure in all participating Compact member states. You are still required to apply for licenses in other states, which you may do if you are eligible by applying through the IMLC Commission website.

Generally, you are required to hold a license in any state where your patient is located at the time of care.

No. The IMLC is a streamlined process for obtaining licenses in other Compact states and participation is completely voluntary.

Please visit the IMLC Commission website for a map of current participating states.

A Letter of Qualification (LOQ) is issued by the state in which you currently hold a medical license and states that you are eligible to apply for licensure with any Compact member state. North Carolina licensed physicians wanting to use North Carolina as their SPL to apply to other Compact member states will need to request a LOQ from North Carolina. An LOQ is valid for 365 days from the date of issuance.

A Letter of Qualification (LOQ) issued by the physician’s state of principal license is valid for 365 days from the date of issuance.

An SPL is the Compact member state where a physician holds a full and unrestricted medical license. If you hold a full and unrestricted medical license in North Carolina, North Carolina may serve as your SPL as long as you meet at least one of the following:

• The physician’s primary residence is in North Carolina
• At least 25% of the physician’s practice of medicine occurs in North Carolina
• The physician’s employer is located in North Carolina
• North Carolina is the physician’s state of residence for U.S. Federal income tax purposes

• You must go to the IMLC Commission website, confirm you are eligible, and start the application process for a Letter of Qualification (LOQ) by selecting apply. During the application process, you will select North Carolina as your SPL, complete the application form, and pay the non-refundable $700 fee.
• The IMLC Commission will forward your LOQ request to NCMB, which will send you instructions on how to submit your fingerprints for a national criminal background check as well as the additional documentation that is required to verify North Carolina as your state of principal licensure. You will be required to remit $38 to NCMB to cover the cost of the criminal background check. You must complete the fingerprinting process within 60 days of submitting your request or your application will expire.
• NCMB will review your application, including your criminal background check and SPL documentation, to verify your eligibility. If you qualify, you will be an issued an LOQ.
• Once you receive your LOQ, you will go to the IMLC Commission website to begin the process of applying for licenses in other states, which will include paying additional state fees for a license. You have 365 days from the date of issuance of the LOQ to apply for licenses in other Compact states.
• During this process, you should monitor your email, including your spam/junk folders, for communications from both the IMLC Commission and NCMB, as well as from any other medical board in states where you apply for licensure. Failure to timely respond to any email communications may cause unnecessary delays.

On your application submitted through the IMLC Commission website you select the reasons that North Carolina is your state of principal license (SPL), which may include:

• The physician’s primary residence is in the Compact member state
• At least 25% of the physician’s practice of medicine occurs in the Compact member state
• The physician’s employer is located in the Compact member state
• The Compact member state is the physician’s state of residence for U.S. Federal income tax purposes

You must submit supporting documentation for all the reasons you have selected on the application provided through the IMLC Commission website. Examples of supporting documentation include:

• Primary residence: North Carolina issued identification card, such as driver’s license or identification card issued by the NC Division of Motor Vehicles; utility bill in your name for a residence located in North Carolina; or lease or mortgage documents for a residence located in North Carolina.
• 25% of practice occurring in North Carolina: a verification form completed and submitted by your employer; or attestation form along with a log listing the locations of all your patients within the past year.
• Employer located in North Carolina: a verification form completed and submitted by your employer.
• For NC as state of residence for US federal tax purposes: a copy of your federal income tax return.

According to the IMLC, physicians must first be able to declare a State of Principal License (SPL) and always maintain their SPL status throughout their application process. In addition to designating an SPL, a physician must:

• Have graduated from an accredited medical school, or a school listed in the International Medical Education Directory or its equivalent such as the World Directory of Medical Schools
• Have successfully completed ACGME- or AOA-accredited graduate medical education
• Passed each component of the USMLE, COMLEX-USA, or equivalent in no more than three attempts for each component (Please note that passing the Canadian Licentiate of the Medical Council of Canada, or the LMCC, DOES NOT meet this requirement)
• Hold a current specialty certification or time-unlimited certification by an ABMS or AOABOS board
• Not have any history of disciplinary actions toward their medical license
• Not have any criminal history
• Not have any history of controlled substance actions toward their medical license
• Not currently be under investigation

At all times, you are obligated to follow the laws of the state in which you are practicing medicine, which is determined by the patient’s location at the time of care.

In addition to your eligibility for licensure and your supporting credentials, any investigative, litigation or compliance materials, including complaints may be shared between Compact member states.

Disciplinary actions taken by any Compact member state may affect the your licenses in other states. If North Carolina is designated as your SPL and your license is suspended, revoked, or any other similar status, all other licenses you hold within the Compact will automatically be placed on the same or similar status. Other disciplinary actions may trigger investigations or similar reciprocal actions.

The IMLC licensure pathway was implement in in North Carolina in January 2026.

No. The IMLC does not automatically grant you authority to practice in other states. The IMLC is an expedited pathway to licensure in all participating Compact member states. You are still required to apply for a license in North Carolina before you seeing patient located in North Carolina at the time of care, which you may do if you are eligible by applying through the IMLC Commission website.

Generally, a license is required in the state where the patient is located at the time of care.

You may still be able to apply for a license through a traditional pathway available on NCMB’s website. Before you begin the traditional application process, you should review the application checklist to ensure you qualify.

No. You must apply for reactivation or reinstatement through the NCMB website. Reactivation is available if your NC license lapsed within the last year, unless your inactivation occurred while under investigation or as the result of a disciplinary action. Reinstatement is available if your NC medical lapsed more than a year ago or you inactivated due to an investigation or disciplinary action. These applications are available on NCMB’s website.

• In order to apply for a NC medical license through the IMLC, you must first visit the IMLC Commission website and obtain a Letter of Qualification (LOQ) from your state of principal licensure. Your LOQ must have been issued within the past 365 days in order to apply for a NC license.
• Once you receive your LOQ from your SPL, you must visit the IMLC Commission website and submit your application for licensure by selecting North Carolina and pay the non-refundable $400 fee. The IMLC will transfer your application to the NC Medical Board for review.
• Once your license is issued, you need to submit supplemental information to the Board within 30 days. This supplemental information is required under North Carolina law and failure to submit the required information may result in an investigation and possible disciplinary action. Under the Compact, investigative and disciplinary information may be shared with other Compact member states where you hold a license.
• You should monitor your email, including any spam/junk folders, for any communications from the IMLC Commission, your state of principal license, or the North Carolina Medical Board. Failure to timely respond to any communications may cause unnecessary delays.

A physician’s SPL is the Compact member state where a physician holds a full and unrestricted medical license and meets one of the following criteria:

• The physician’s primary residence is in the Compact member state
• At least 25% of the physician’s practice of medicine occurs in the Compact member state
• The physician’s employer is located in the Compact member state
• The Compact member state is the physician’s state of residence for U.S. Federal Income Tax purposes

A Letter of Qualification (LOQ) is issued by the state in which you currently hold a medical license and states that you are eligible to apply for licensure with any Compact member state. Physicians wishing to obtain a license in North Carolina will need an LOQ from their state of principal license (SPL). An LOQ is only valid for 365 days from the date of issuance.

A Letter of Qualification (LOQ) issued by the physician’s state of principal license is valid for 365 days from the date of issuance.

According to the IMLC, physicians must first be able to declare a State of Principal License (SPL) and always maintain their SPL status throughout their application process. In addition to designating an SPL, a physician must:

• Have graduated from an accredited medical school, or a school listed in the International Medical Education Directory or its equivalent such as the World Directory of Medical Schools
• Have successfully completed ACGME- or AOA-accredited graduate medical education
• Passed each component of the USMLE, COMLEX-USA, or equivalent in no more than three attempts for each component (Please note that passing the Canadian Licentiate of the Medical Council of Canada, or the LMCC, DOES NOT meet this requirement)
• Hold a current specialty certification or time-unlimited certification by an ABMS or AOABOS board
• Not have any history of disciplinary actions toward their medical license
• Not have any criminal history
• Not have any history of controlled substance actions toward their medical license
• Not currently be under investigation

All North Carolina licenses are issued by North Carolina. The IMLC Commission does not issue a nationally recognized medical license for physicians.

At all times, you are obligated to follow the laws of the state in which you are practicing medicine, which is determined by the patient’s location at the time of care. This means when your patient is located in North Carolina, you are obligated to follow all North Carolina laws when practicing medicine in North Carolina. Please visit NCMB’s website for Professional Resources, Laws, Rules, and Position Statements.

In addition to your eligibility for licensure and your supporting credentials, any investigative, litigation or compliance materials, including complaints may be shared between Compact member states.

Disciplinary actions taken by any Compact member state may affect your licenses in other states. If your license with your designated SPL is suspended, revoked, or any other similar status, all other licenses you hold within the Compact, including your North Carolina license, will automatically be placed on the same or similar status. Other disciplinary actions may trigger investigations or similar reciprocal actions.

A team-based setting or team-based practice must be either:

• A medical practice that meets all of the following:
• The majority of the practice is owned collectively by one or more licensed physicians.
• An owner who (1) is an NC licensed physician and (2) has consistent and meaningful participation in the design and implementation of health services to patients.
• The physician and team-based physician assistant that provide services at the medical practice must work in the same clinical practice area.
• A hospital, clinic, nursing home, or other health facility with active credentialing and quality programs where physicians have consistent and meaningful participation in the design and implementation of health services to patients.

• No. Team-based practice is only available to physician assistants that meet all of the following:
• More than 4,000 hours of clinical practice experience as a physician assistant AND more than 1,000 hours of clinical practice experience within the specific medical specialty of practice with a physician in that specialty.
• Practices at a team-based setting or team-based practice.
• Physician assistants, who are not eligible for team-based practice, must practice in accordance with all current NCMB rules pertaining to supervision.

Yes.

No. Team-based practice is not mandatory and whether you can be hired as a team-based physician assistant is up to your employer. If team-based practice is not adopted, then you must follow all current NCMB rules pertaining to supervision.

• PAs who are registered as team-based practice PAs do not need to file an intent to practice or have a supervisory arrangement with a physician. However, team-based practice physician assistants must work in team-based settings alongside licensed physicians who have consistent and meaningful participation in the practice. Physician assistants are required to consult, collaborate and refer with physicians as determined by the team.
• In addition, team-based practice physician assistants are limited to practicing in their registered team-based setting and designated area of practice. If their employment or area of practice changes, they must either file an intent to practice or register with the NCMB if the setting qualifies as a team-based practice.
• While NC laws and rules do not require team-based physician assistants to have supervising physicians, the law does not restrict or limit an employer’s ability impose additional requirements on employees, including supervision. Whether a physician assistant is hired or promoted as a team-based physician assistant is up to the employer. When employers choose not to participate in team-based practice, all physician assistants must comply with current supervision requirements under NCMB rules.
• Physician assistants, who are not eligible for team-based practice, must practice in accordance with all current NCMB rules pertaining to supervision.

• Physician assistants working in perioperative settings will need to be supervised by a physician as determined by NCMB rules. More details will be available in the Spring.
• Physician assistants cannot provide final interpretations of diagnostic imaging. However, they may provide final interpretations of x-rays if they have a supervising physician as determined by NCMB rules. More details will be available in the Spring.
• All physician assistants who compound must be supervised by an NC licensed physician and are subject to traditional supervision rules, including filing an intent to practice, having supervisory arrangements, and quality improvement meetings.

Yes. Employers are free to impose any additional requirements on their employees, including quality improvement meetings.

Yes. Any PA who is eligible for team-based practice and working in an appropriate team-based setting is required to submit proof to the NCMB of team-based practice qualifications. Physician assistants cannot commence practice as a team-based practice until they receive authorization from the NCMB. The process is still being developed. More details will be available in the Spring. Until a physician assistant is registered as a team-based physician assistant with the NCMB, all supervision requirements under NCMB’s current rules must be satisfied.

PAs will be able to apply for team-based practice status either after the NCMB adopts rules or June 30, 2026, whichever takes place first. Until then, all supervision requirements under NCMB’s current rules must be satisfied.

PAs that do not qualify for team-based practice are subject to traditional NCMB rules requiring the PA to complete an intent to practice listing a NC licensed supervising physician, having a supervisory arrangement that includes the PA’s prescriptive authority, and meeting with the supervising physician for the purposes of quality improvement.

No. Team-based practice only applies to team-based settings where a majority of the practice is owned by licensed physicians. A physician owner must have consistent and meaningful participation in the design and implementation of health services to patients in order to qualify. These practices are subject to the current NCMB rules pertaining to supervision.

No. A team-based setting or team-based practice does not include medical practices that specialize in pain management. Physician assistants working in practices that specialize in pain management must follow all rules pertaining to supervision, including maintaining a supervisory arrangement with a supervising physician and having quality improvement meetings. Physician assistants must consult with their supervising physician prior to prescribing targeted controlled substances if the therapeutic use of the targeted controlled substance will or is expected to exceed a period of 30 days.