Graduating from medical school is a huge accomplishment on the path to becoming a licensed physician. However, you may be wondering if you can actually call yourself a doctor as soon as you receive your diploma.

The short answer is no—you must complete additional training before you are legally and professionally considered a doctor.

In this comprehensive guide, we will explain the key requirements and steps involved in transitioning from a medical school graduate to a practicing physician. We will cover residency training, medical licensing exams, and the credentials you need to begin working with patients.

By the end, you’ll understand exactly when and why you are considered a full-fledged doctor.

You Must Complete Residency Training After Medical School

Definition of a medical residency

A medical residency refers to a stage of graduate medical training in which a physician practices medicine under the supervision of fully licensed doctors. Residency programs allow newly graduated doctors, known as residents, to develop skills in a specific medical specialty.

Residencies typically last 3-7 years depending on the chosen specialty.

Length of residency programs

The length of residency programs varies by medical specialty:

  • Internal medicine: 3 years
  • General surgery: 5 years
  • Pediatrics: 3 years
  • OB/GYN: 4 years
  • Emergency medicine: 3-4 years

Within each specialty, there may be subspecialty programs that require 1-3 additional years of training beyond the base residency. For example, a neurology residency may last 4 years beyond the 3-year internal medicine residency.

Specialty-specific training

Residency programs provide rigorous, hands-on training within a specific medical specialty. Residents work under attending physicians and are supervised as they:

  • Diagnose and treat patients in clinics and hospitals
  • Interpret diagnostic tests and imaging studies
  • Perform medical procedures relevant to their specialty
  • Manage patient care teams and coordinate care

This immersive experience allows residents to develop clinical skills and expertise within their chosen specialty.

Transition from student to professional

Residency training marks the transition from medical school to autonomous medical practice. As residents progress through their training:

  • Their knowledge base expands greatly.
  • They gain proficiency in clinical skills.
  • They take on increasing responsibility for patient care.
  • They develop leadership abilities by directing teams.

By the end of residency, physicians have the knowledge, skills, and experience needed for unsupervised practice in their specialty.

Passing Licensing Exams is Required for Unrestricted Practice

USMLE Step 1, Step 2 CK, Step 2 CS

After graduating from medical school, aspiring physicians in the United States are required to pass the United States Medical Licensing Examination (USMLE) administered by the National Board of Medical Examiners (NBME) and the Federation of State Medical Boards (FSMB).

The USMLE is a three-step examination that assesses an examinee’s understanding of and ability to apply concepts and principles that are important in health and disease. Passing all steps is required to obtain an unrestricted license to practice medicine.

COMLEX Level 1, Level 2 CE, Level 2 PE (DO students)

Graduates from osteopathic medical schools in the United States take the Comprehensive Osteopathic Medical Licensing Examination (COMLEX) administered by the National Board of Osteopathic Medical Examiners (NBOME).

Like the USMLE, the COMLEX is a three-level licensing examination that tests osteopathic medical knowledge and clinical skills that are considered essential for osteopathic generalist physicians to practice medicine without supervision.

Obtaining your medical license

After completing medical school and passing the required licensing examinations, physicians apply for a medical license in the state where they wish to practice medicine. The medical board of the state reviews the application and issues a medical license if all requirements are met.

Having a full, unrestricted medical license is required for a physician to practice medicine without supervision. According to a 2021 report, over 1 million physicians in the United States held active medical licenses.

Difference between a license and board certification

There is an important distinction between having a medical license and being board certified:

  • A medical license legally allows physicians to practice medicine independently in a particular state.
  • Board certification is an additional qualification physicians can pursue to demonstrate specialty expertise in a particular field like surgery, pediatrics, etc. It is not required for medical licensure.

Professional Titles Indicate Doctor Status

Using the term ‘doctor’ vs physician

There is often confusion around when medical school graduates can start calling themselves “doctor.” While students earn a medical degree (MD) upon graduation from medical school, they are not licensed physicians yet and have not completed residency training.

Using the term “physician” is reserved for those who have completed medical training and obtained full medical licensure. However, the title of “doctor” can be used once the MD degree is conferred.

It’s important to note the distinction between addressing someone conversationally as “doctor” versus using “physician” professionally. Anyone who holds a doctoral degree, including an MD, has earned the right to the title of “doctor.”

However, only licensed physicians can diagnose conditions, prescribe medication, and otherwise practice medicine independently.

Titles before and after residency completion

Before completing residency training, medical school graduates enter a training phase called “residency” where they gain hands-on clinical experience under supervision. At this stage, they are referred to as “residents” or “doctors” but not formally “physicians” or “attendings.”

After finishing residency, MDs are considered fully licensed physicians and can be referred to as “doctors” or “physicians” interchangeably. Many choose to adopt the title “attending physician” at this stage to indicate they are leading in a clinical environment versus training as a resident.

When to adopt the title ‘Attending Physician’

The title “Attending Physician” designates a doctor who has finished residency and has primary responsibility for a patient’s care in a clinical setting. It reflects that they are now the lead, licensed physician overseeing healthcare teams, rather than still training as a resident.

Typically this title is adopted upon completion of residency when beginning formal practice. However, some choose to indicate their attending role even when still finishing advanced specialty fellowships that follow residency.

Using “attending physician” denotes being the decision-maker responsible for patient care on a clinical service.

You Must Complete 1+ Years of Residency to Practice Medicine

Cannot prescribe medications or treat patients independently

After finishing 4 years of medical school and obtaining an M.D. or D.O. degree, graduates are not yet able to practice medicine independently. They must complete additional supervised training called a medical residency which typically lasts 3-7 years depending on the specialty.

Without completing residency training and obtaining a medical license, medical school graduates cannot legally prescribe medications, perform medical procedures, or treat patients on their own. They require supervision from fully licensed physicians.

Supervision required until fully licensed

During residency, new M.D.s and D.O.s are called resident physicians or residents. They work under the supervision of attending physicians who are fully licensed and provide oversight of the care residents provide to patients.

Residents may perform examinations, order medications or tests, develop treatment plans, and assist in surgeries or procedures, but the attending physician remains ultimately responsible for the patient’s care until the resident becomes fully licensed.

Exceptions: research, teaching, medical writing

There are a few exceptions where medical school graduates can work independently without a medical license, such as in research, academics, or medical writing. However, they still cannot treat real patients or prescribe medications without completing residency.

Moonlighting as a resident physician

Some residents choose to take on extra paid shifts at hospitals, clinics, or other healthcare facilities known as moonlighting. However, they must obtain a limited medical license and still work under physician supervision when moonlighting outside their primary residency program.


Although you earn a medical degree at the end of med school, there are still several years of rigorous training and exams required before achieving full physician status. It takes dedication and hard work to complete residency, pass all licensing exams, and meet experience requirements.

The journey doesn’t end there—most doctors continue with fellowship training to subspecialize. But ultimately, being able to call yourself ‘doctor’ and work independently is an exciting milestone marking the culmination of over a decade of medical education and training.

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