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APPLICATION REQUIREMENTS & INSTRUCTIONS - MD/DO/DPM
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Article Content
- Omissions or false, misleading or deceptive information provided in applying for a license in Oregon is grounds for a $195 fine and further disciplinary action, including denial of your application.
- Complete the application yourself. Do not delegate this important task to someone else. If the information provided is incomplete or incorrect, it will delay the processing of your application and could delay the granting of a license to practice in Oregon.
- Take your time and read all online application instructions carefully. If you have questions as you complete the application, contact us to assist you.
- Documents submitted to the Board will not be returned to you. Keep copies of all materials submitted for your own reference.
- Apply for the appropriate type and status of license. See License Definitions page or contact us if you have questions.
- Complete the online application using your full, legal name as it appears on birth, marriage, naturalization, or name change documents.
- Account for all periods of time since you graduated from medical/osteopathic/podiatric school to the present date.
- Provide full details and dates, and complete names, addresses, and zip codes where requested.
- Use the Board’s Online Status Report to help you keep track of what materials the Board has received and what is still needed to complete your license application.
- Select only one person to follow the processing of your application. This can be you or a recruiting agency. This minimizes contacts to the Board and speeds the process.
- Once your application file is complete, you will be notified to log in online to complete the initial registration process and pay the required registration fees.
- Licenses are granted in batches on a weekly basis. In most cases, licenses are issued within about one week after completion of the initial registration process.
- Lists of licenses granted each week are posted on the OMB website. Details of all licenses granted are immediately available through the OMB’s licensee lookup page.
- When your license is granted, you will receive a certificate of registration with a wallet license card and a formal engrossed license.
Below are links to printable checklists of required application materials. For complete information on checklist items, see Documentation Required below.
Size of Documents: Documents submitted must be legible, no larger than 8 1/2 x 11 inches, and no smaller than 5 x 7 inches. If the original document is larger or smaller than this, please have the copy reduced or enlarged to 8 1/2 x 11 inches to show all wording, dates and signatures.
Copies of Original Documents: Do not submit original documents. Copies do not need to be notarized. Any documents submitted become a part of your file and will not be returned to you. Copies must be legible. Translations of foreign documents are required (see below).
Official Translations: If any of your documents are in a foreign language, the Board requires you to furnish a copy of the original document as well as an official, word-for-word translation. Acceptable translators are an employee of a professional translating company, a member of the American Translation Association, or a faculty member of the modern languages or linguistics department of a United States college or university. The translation must be on official letterhead and bear the translator's certification seal. Translations will not be returned to the applicant. All information appearing on the document must also appear on the translation each time it appears on the original document. This includes pre-printed information, such as the letterhead of a university, titles, etc. The translation must be attached to the copy of the document being translated.
Federation Credentials Verification Service (OPTIONAL): The Federation Credentials Verification Service (FCVS) provides a service to physicians that gathers information and verifications of core credentials to be kept on file for use by state medical boards and other organizations. The documents in the FCVS profile may be used to satisfy some of the Board’s application requirements. However, the FCVS profile is NOT REQUIRED. The information received from FCVS does not include all items required by the Board. More information is available through the Federation of State Medical Board's website at http://www.fsmb.org/fcvs.html, or call 1-888-ASK-FCVS.
Licensure by Endorsement: The Oregon Medical Board has adopted rules to allow licensure by expedited endorsement for physicians. Your application will be reviewed by Board staff to see if you qualify. For more information, see the Endorsement Information page. If you qualify for licensure by endorsement, some of the following items may not be required and Board staff may obtain or verify some of the required items for you. Once your application is submitted, paid for, and reviewed by staff, your Online Status Report will show outstanding items.
Birth Certificate: Provide a copy of official birth certificate or birth record. Hospital birth certificates are not acceptable. Your complete, legal name, including Jr., II, III, initial only, or no middle name, will be shown on your formal license, and all licensees must pursue their profession under their own name as it appears on the license. A copy of your passport, driver's license, etc., does not meet this requirement and cannot be accepted in lieu of the required birth certificate.
Name Change (due to marriage, divorce, adoption, court order): Furnish a copy of your marriage certificate, divorce decree, adoption papers, or court order.
Naturalization: It is a violation of law to copy a naturalization document. Instead, please complete the naturalization form provided by the Board with the number, date and place of naturalization. This form must be notarized and is available at www.oregon.gov/OMB/MDDO_Application/naturalization.pdf.
Photograph: Provide a close-up passport quality photograph, front view, head and shoulders (not profile) taken within 90 days preceding the filing of the application.
Diploma: Provide a copy of your diploma showing graduation from a school of medicine/osteopathy/podiatry. If the diploma is written in a foreign language, furnish an official translation attached to the copy of the diploma.
NPDB Self-Query: Request a Self-Query from the National Practitioner Data Bank (NPDB). The results of the Self-Query will be mailed to you, and you must forward them to the Board. The report should be current and have been completed within the past three months. Please access the NPDB website: www.npdb.hrsa.gov/.
Fingerprint Card with Identification Verification Form: Pursuant to ORS 677.265 (9), applicants must provide fingerprints in order for the Board to conduct a state and federal criminal records check. All fingerprints are processed through the Oregon State Police (OSP) and the Federal Bureau of Investigation (FBI). Fingerprints must be submitted on form FD-258, which will be mailed to applicants upon receipt of application, or can be obtained from local law enforcement offices.
Fingerprint cards must be completed properly ( example), with all of the identification information filled out according to the instructions. The applicant must sign the card in the presence of the official taking the fingerprints, who will also sign the card. In addition, the official taking the fingerprints must complete an Identification Verification form verifying the identity of the applicant at the time of printing. Fingerprint cards returned to the Board without this form will be rejected, and applicants will be required to submit new fingerprints, which will delay licensure. Applicants will be required to show picture identification (i.e., driver’s license, state issued identification card, military identification card, passport) at the time of fingerprinting.
Completed fingerprint cards are to be returned to the Oregon Medical Board along with the Identification Verification form. Do not send the fingerprint cards directly to the FBI or OSP.
The fingerprints must be of a quality meeting FBI standards, which are printed on the back of each fingerprint card. If the instructions are not followed or if the fingerprints do not meet FBI standards, the cards may be rejected by OSP or FBI. This will delay the application process. All applicants are therefore urged to complete this step of the application process early so as not to delay licensure.
Medical Practice Act and DEA Open Book Examinations: The two required open-book examinations and study materials on the Medical Practice Act (Oregon Revised Statutes Chapter 677), Oregon Administrative Rules (Chapter 847), and Practitioner's Manual explaining State and Federal DEA Laws are available at www.oregon.gov/OMB/mpadea.shtml.
Special Purpose Examination (SPEX): Physician applicants (MD/DO) are expected to take the SPEX examination if:
- Completion of postgraduate training, specialty board certification or recertification was obtained 10 or more years prior to submitting an application for Oregon licensure, or
- The applicant ceased practice for 12 or more consecutive months immediately preceding the application.
If you wish to request a waiver of the SPEX examination, you must submit a request in writing and provide documentation of continuing medical education for the past 3 years or have a letter sent directly to the Board stating that you have been granted an appointment as a professor or associate professor at an Oregon medical or osteopathic medical school.
The Board may require other documentation or explanatory statements.
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Fees charged by any other agencies to provide verification to the Board will be the responsibility of the applicant.
The following items must be:
- Fully completed with dates in month/day/year format.
- Currently dated.
- On letterhead, computer-generated form, or Board-provided form.
- Mailed in an institution envelope. Do not provide your own envelope.
- Faxed or e-mailed responses are not accepted.
Verification of Medical Education: Send the Verification of Medical Education form to the Dean/Registrar of each medical/osteopathic/podiatric school attended. The form must be completed fully, showing dates of attendance and exact date of graduation. The form must show any leaves of absence, repeated years, whether the student was accepted as a transfer student, etc. An official of the school must sign the form, and the school seal must be affixed.
Dean’s Letter: This letter is the one already in your medical school file, written by the Dean while you were a student at the school.
Federation Disciplinary Inquiry:
- Federation of State Medical Boards (FSMB): MD/DO applicants must go directly to the Federation website (www.fsmb.org/fpdc_data_inquiry.html) and submit the Board Action Databank Inquiry Form. The results are then mailed to the Board.
- Federation of Podiatric Medical Boards Podiatrists (FPMB): DPM applicants must go directly to the FPMB website (www.fpmb.org/orderreports) and submit the Disciplinary Inquiry Report Form. The results are then mailed to the Board.
Internship/Residency/Fellowship Verification: Send the Verification of Internship, Residency, Fellowship Training form to the Director of Medical Education, Residency Program Director, Chairman of the Department, or other official of all internship, residency, or fellowship hospitals. The response received must provide beginning and ending dates of training and must include an evaluation of overall performance.
ECFMG Certification Verification (International Graduates Only): Send the Request for Status Report of ECFMG Certification form to the Educational Commission for Foreign Medical Graduates (ECFMG) for verification of your status. Verification of your status by the ECFMG and the examinations leading to this certification can also be obtained at https://cvsonline2.ecfmg.org/ImgGenInfo.asp.
Fifth Pathway Program Verification (International Graduates Only): A letter is required from the Program Director, Chairman or other official of the Fifth Pathway hospital, sent directly to the Board verifying the beginning and ending dates of the Fifth Pathway and including an evaluation of overall performance.
Employment Verification(s): Send the Verification of Practice, Employment, Staff Membership form to the Director or other official of each hospital, clinic, facility, location, medical group, agency, etc., where you were employed, practiced, held staff privileges, and/or completed any and all locum tenens assignments in the past five (5) years. This form, or a letter sent directly to the Board, must include beginning and ending dates of association as well as an evaluation of overall performance. Verifications of employment/practice from where you are currently employed or practicing that are dated more than three months prior to the receipt of your application by the Board must be re-submitted with a current verification. Only employment verifications for the past five (5) years are required unless you are advised otherwise by the Board.
License Verification(s): Send the Verification of Licensure form to an official of the board in each state, province, or country where you are licensed, even if you have never practiced there or even if your license has lapsed there. This form or a letter must show license number, date issued, grades if applicable, disciplinary actions (past and present), and current status. Do not request a verification of licensure of a temporary license issued for the completion of a training program unless informed otherwise by the Board.
Official Exam Grade Transcript(s): Your licensing examination scores must be sent from source. The following are provided for your convenience.
If you took a licensing exam through another state board, request exam transcripts from that state board. You may use the Verification of Licensure and Certification of State Board Written Examination Grades form to request this.
The Board may require other documentation or explanatory statements.
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If you answer "YES" to any personal history question, please furnish details and request source documents as indicated below. Failure to provide all details will delay the processing of your file.
Personal History Questions: CATEGORY I
Question 1 |
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Applicant |
Provide full details to include date of licensure, license number, type of license, and current status of the license. |
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Licensing Board |
Provide verification of licensure to include license number, date issued, and current status. |
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Question 2 |
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Applicant |
Provide full details to include state/province, type of examination failed, dates and grades (if known) for each failure. |
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Examination Agency |
The report of examination grades will verify any failed attempts. |
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Question 3 |
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Applicant |
Provide full details to include state/province, reasons/circumstances and any disciplinary action. |
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Licensing Board |
Provide full details and include copies of any legal documents. |
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Questions 4, and 5 |
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Applicant |
Provide states, dates and reasons/circumstances. |
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Licensing Board |
Provide full details and include copies of any legal documents. |
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Question 6 |
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Applicant |
Provide full details including dates and reasons/circumstances, and provide a copy of documents, reports and correspondence. |
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State Narcotic Office/Drug Enforcement Administration (DEA) |
Provide full details and include copies of any legal documents. |
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Question 7 |
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Applicant |
Provide full details of the arrest, the dates, places, and disposition of the case. |
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Police Department/ Court |
Provide a Certified Copy (with court seal affixed) of the original charge, the judgment, the sentence and/or the dismissal order or other such documents which reflect the disposition of the matter. |
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Question 8 |
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Applicant |
Provide full details to include the agency conducting the investigation as well as the reasons for the criminal, civil, or licensing investigation. Provide a copy of documents, reports and correspondence. |
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Investigating Agency |
Provide full details concerning reasons for the investigation. |
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Question 9 |
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Applicant |
Provide full details to include details of the case, where/when incident occurred, disposition of the case, judgment, etc. Please indicate if the case is still pending. Provide a copy of the documents, reports and correspondence. |
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Investigating Agency |
Provide full details concerning reasons for the investigation. |
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Question 10 |
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Applicant |
Provide full details to include the agency/party with which the settlement was entered as well as the reasons for and conditions of the settlement. Provide a copy of the documents, reports and correspondence. |
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Agency/Party |
In some cases information is needed in addition to the applicant's explanation. (see above) |
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Question 11 |
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Applicant |
Provide full details to include name of patient, where/when incident occurred, disposition of the case, judgment, etc. Please indicate if the case is still pending. Provide a copy of the documents, reports and correspondence. |
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Malpractice Carrier/Court |
In some cases information is needed in addition to the applicant's explanation. (see above) |
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Question 12 |
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Applicant |
Provide the length of time you did not practice medicine or ceased the practice of your specialty and the reason why, as well as your activities, (medical or non-medical) for that period of time. |
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Hospital/School/Training Program |
In most cases, the applicant’s explanation is all that is needed concerning an affirmative response to question 12. However, in some cases the applicant will be asked to request information be sent directly from other sources to the Board. |
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Question 13 |
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Applicant |
Provide name of the medical/osteopathic/podiatric school, training program, dates and reasons/circumstances. |
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School/
Training Program |
Provide full details concerning the circumstances, results, and copies of any legal documents. |
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Question 14 |
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Applicant |
Provide full details to include the name of the hospital, clinic, surgical center, dates, and reasons/circumstances. |
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Hospital/ Employment |
Provide full details including dates, circumstances, results, and copies of any legal documents. |
Personal History Questions - CATEGORY II
Question 1 |
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Applicant |
Provide full details and dates regarding treatment received for the condition. If any medications were prescribed, furnish the names, dosages and the dates the medications were taken. Include the names and addresses of the treating psychiatrist, psychologist, social worker, clinical therapist, or counselor and dates of treatment, or therapy. Request the person providing treatment send directly to the Board complete details of treatment or counseling including dates, diagnosis (if any), treatment and prognosis. |
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Source |
Provide a full report to include Family History/Physical; Individual Assessment and Evaluation; Psychiatric Evaluation; Psychosocial Assessment; Discharge Summary and Discharge Plan for Continued Care or the equivalent. Letters/reports to be sent directly to this Board. |
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Question 2 |
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Applicant |
Provide full details and dates regarding this treatment. If any medications were prescribed, furnish the names dosages and the dates the medications were taken. Include the names and addresses of the treating psychiatrist, psychologist, social worker, clinical therapist, or counselor and dates of treatment or therapy. Request the person providing treatment send directly to the Board complete details of treatment or counseling including dates, diagnosis (if any), treatment and prognosis. |
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Source |
Treatment provider to furnish complete details of treatment or counseling Including dates, diagnosis (if any), treatment and prognosis. Request the Appropriate official at the hospital send directly to the Board a full report to include Family History/Physical; Individual Assessment and Evaluation; Psychiatric Evaluation; Psychosocial Assessment; Discharge Summary and Discharge Plan for Continued Care or the equivalent. Letters/reports need to be sent directly to this Board. |
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Question 3 |
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Applicant |
If you received treatment for this dependency, provide full details and dates regarding this treatment. Include the names and addresses of the treating psychiatrist, psychologist, social worker, clinical therapist, or counselor and dates of treatment or therapy. Request the person providing treatment send directly to the Board complete details of treatment or counseling including dates, diagnosis (if any), treatment and prognosis. |
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Source |
Treatment provider to furnish complete details of treatment or counseling Including dates, diagnosis (if any), treatment, and prognosis. Request the appropriate official at the hospital send directly to the Board a full report to include Family History/Physical; Individual Assessment and Evaluation; Psychiatric Evaluation; Psychosocial Assessment; Discharge Summary and Discharge Plan for Continued Care or the Equivalent. Letters/reports to be sent directly to this Board. |
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Question 4 |
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Applicant |
Provide full details and dates regarding this treatment and/or hospitalization. Include the names and addresses of the treating psychiatrist, psychologist, social worker, clinical therapist, or counselor and dates of treatment or therapy. Request the person providing treatment send directly to the Board complete details of treatment or counseling including dates, diagnosis (if any), treatment and prognosis. If you have been arrested for a DUII or DWI, request for the arresting officer's report and court documents to be sent directly to this Board. |
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Source |
Provide a full report to include Family History/Physical; Individual Assessment and Evaluation; Psychiatric Evaluation; Psychosocial Assessment; Discharge Summary and Discharge Plan for Continued Care or the equivalent. Police Department/Court to provide a Certified Copy (with court seal affixed) of the original charge, the judgment, the sentence and/or the dismissal order or other such documents which reflect the disposition of the matter. Letters/reports to be sent directly to this Board. |
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Question 5 |
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Applicant |
If you received treatment related to this chemical substance screening test, provide full details and dates regarding treatment. Include names and addresses of the treating psychiatrist, psychologist, social worker, clinical therapist or counselor and dates of treatment or therapy. Request the person providing treatment send directly to the Board complete details of treatment or counseling including dates, diagnosis (if any), treatment and prognosis. |
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Source |
Furnish complete details of treatment or counseling including dates, Diagnosis (if any), treatment and prognosis. Hospital report is also needed to include Family History, Physical, Individual Assessment and Evaluation, Psychiatric Evaluation, Psychosocial Assessment, Discharge Summary and Discharge Plan for Continued Care or the equivalent. Letters/reports to be sent directly to this Board. |
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Question 6 |
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Applicant |
Provide full details and dates to include the name and location of the diversion program, regulatory board, healthcare program or facility, and/or court, and reasons for and results of entering the program. |
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Source |
Furnish treatment records and any court/legal documents directly to the Board. |
The Board may require other documentation or explanatory statements. |
- Fees are set by law and administrative rule. No exceptions are made to the current fees.
- Read eligibility requirements carefully. Once fees are submitted, they will not be refunded, credited, transferred or prorated.
- The application processing fee is required before the Board begins the processing of your application. Once received, the application and fee are valid for a period of one year from the date received. If licensure is not obtained within that one-year period, a new application and processing fee must be submitted as if filing for the first time. The applicant is expected to meet current requirements.
- The application fee does not include the registration fees, which must be paid prior to issuing a license.
Current fees for licensure can be found here.
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