Verifications and Documents

Q. What documents must be "ORIGINAL" (i.e., sent directly to the Board from the source)?
A. All of the following must be "ORIGINAL":

  • Verifications (state licensure, training, medical school, employment/staff membership)
  • Exam scores (USMLE, NBME, NBOME, FLEX, NBPME, etc.) 
  • ECFMG Certification Status Report
  • Federation of State Medical Boards (FSMB) Board Action Data Bank Inquiry or Federation of Podiatric Medical Board (FPMB) Board Action Data Bank Inquiry
  • The Board may require other documentation 


Q. What documents do I need to submit?  Can they be photocopies?
A. You will need to submit the following documents which may be photocopies and do not need to be notarized (written or typed responses/explanations to personal history questions, etc., should be signed and the original sent to this Board):

  • Birth Certificate - All U.S and Canadian born applicants must submit a Birth Certificate issued by a state Department of Health or Deptartment of Vital Statistics 
  • Marriage Certificate/Divorce Decree 
  • Court ordered name change 
  • Copy of passport (if there is a name discrepancy between the name on the application and birth certificate) 
  • MD Diploma 
  • American Board Certificates (if certified)
  • ​National Practitioner Data Bank (NPDB Self-Query)
    • The NPDB is sent to you, the applicant, and you must forward the entire contents of the envelope to the OMB
  • The Board may require other documentation or explanatory statements


Q. I was born in a foreign country and was not issued a birth certificate.  What do I need to submit?
A. If you are a naturalized citizen, you must:

  • Have the naturalization certificate, passport and completed Affidavit notarized
  • Submit the Affidavit and a photocopy of your passport to this Board 
  • Other options may be presented by the Board 

IMPORTANT:    It is illegal to photocopy your Naturalization Certificate and cannot be accepted by the OMB.

 

Q. Some of my documents are in a foreign language.  Are these acceptable?
A.  All documents submitted must be in English.  If your documents are in any other language you must have them translated into English and submit both the original translation and a photocopy of the document in the foreign language. 

 

Q. What if I worked/trained in a hospital/clinic that has closed?
A.
If a training or employment/staff membership location has closed, been sold, or changed names, please provide this information to the Board in writing.

  • Sold/Changed Names: Contact the location to request the required verification information.  The staff must also include details regarding sale dates, and previous and current business names.  If no information is available, they must state why (i.e., “Happy Hospital was sold to Healthy Medical Group in 5/99 and all physician records prior to 5/98 have been archived”).

  • Closed:  Contact a former director or supervisor who can provide the required information.  Or, for employment/staff if you cannot contact anyone, you may be required to have three peer physicians from the local area of the practice during that time write letters of reference on your behalf and submit them directly to this Board.    

Q. What do I do if I have had disciplinary/legal issues such as:

  • Suspension of privileges or reprimanded
  • Academic probation
  • State board action / investigation / reprimand / letter of concern / etc.
  • DUII, Drug/Alcohol, or mental/physical health issues

A. You must submit your own signed explanation (this should not be an attorney’s summary or a statement written by a second party regardless of affiliation) to include, but not be limited to, details such as dates, circumstances, and final outcome.  Additionally, you must request the information as indicated for each case below:

  • Suspension/Reprimand/Probation: Contact the facility/location involved and request that it send a statement and any documentation to include details regarding the issue directly to the OMB.
  • DUII/Arrest/Conviction:  Request the law enforcement agency send copies of the arresting officer’s report and related documents directly to the OMB.  You must also have the court send copies of all related court documents directly to the OMB.  If the agency or court no longer has the records, they must submit a statement regarding this issue.
  • Drug/Alcohol/Mental/Physical Health:  Have any treatment facility or physician involved send copies directly to this Board of your records including but not limited to your history, evaluation, treatment, current condition, and a statement regarding your ability to practice medicine.  This includes any physical health condition that has impaired your ability to practice medicine or your specialty.