Residency required for a full Missouri license
U.S. & Canadian graduates
That is the shortest minimum in the country, shared with 29 other jurisdictions.
International medical graduates
30 jurisdictions have a shorter minimum, and 20 others set the same one.
Missouri requires at least 1 year of accredited postgraduate training (ACGME or AOA) for graduates of U.S. and Canadian medical schools before a full, unrestricted license. Missouri requires at least 3 years of accredited postgraduate training (ACGME or AOA) for international medical graduates (IMGs) before a full, unrestricted license. A full license is not the same as finishing residency: specialty board certification through ABMS member boards or the ABPS, and most attending jobs, still require a completed ACGME-accredited program.
International medical graduates in Missouri
As of September 29, 2026, Missouri has no operative alternative licensure pathway for internationally trained physicians, so IMGs follow the standard route: ECFMG certification, the residency Match, 3 years of accredited training, and USMLE Step 3. Nearby states with an alternative pathway: Iowa, Illinois, Kentucky, Tennessee, Arkansas, Oklahoma, Nebraska.
See ECFMG certification and J-1 waivers and Conrad 30 for the steps before residency.
Physician demand in Missouri
Missouri has 298.1 active physicians per 100,000 residents, ranking 35 of 50 where 1 has the fewest physicians per capita. The state median is 272.0. Supply is above the median, so competition for jobs in metro areas can be stronger, though rural areas may still be short.
Physician jobs and salary in Missouri
Average physician pay
Ranks 14 of 51, above the median state average of $268,510.
Federal data count 475 primary-care physicians needed to remove every primary-care shortage designation in Missouri, where 21.5% of the need is currently met (HRSA via KFF, December 31, 2025). Shortage areas qualify for National Health Service Corps loan repayment and, for IMGs, Conrad 30 J-1 waiver positions. Search openings on HRSA's Health Workforce Connector or through 3RNet.
How to apply for a Missouri medical license
- Complete the training minimum above and pass USMLE Steps 1–3 (or COMLEX Levels 1–3).
- Build a credentials file with the FSMB Federation Credentials Verification Service (FCVS), which many boards accept or require.
- Submit the Missouri application with transcripts, exam scores, training verification from your program director and fingerprints for a background check.
- If you'll practice in several states, check whether the Interstate Medical Licensure Compact can speed up extra licenses.
- Once licensed, register for a DEA number and any state controlled-substance registration.
Current forms, fees and processing times are on the Missouri Board of Registration for the Healing Arts website.
Missouri medical license FAQ
How many years of residency do you need for a medical license in Missouri?
Missouri requires at least 1 year of accredited postgraduate training (ACGME or AOA) for graduates of U.S. and Canadian medical schools before a full, unrestricted license. Missouri requires at least 3 years of accredited postgraduate training (ACGME or AOA) for international medical graduates (IMGs) before a full, unrestricted license.
Can international medical graduates get licensed in Missouri?
Yes, through the standard route: ECFMG certification, an accredited U.S. or Canadian residency, 3 years of postgraduate training, and passing USMLE Step 3. Missouri had no operative alternative pathway for internationally trained physicians as of September 29, 2026.
Is there a shortage of doctors in Missouri?
Missouri has 298.1 active physicians per 100,000 residents, ranking 35 of 50 (1 = fewest physicians per capita). That is above the state median of 272.0.
How much do physicians make in Missouri?
The average annual wage for physicians in Missouri was $300,040 in BLS May 2023 OEWS data. Pay varies widely by specialty and setting.
Which exams do I need for a Missouri medical license?
MD graduates and IMGs need USMLE Step 1, Step 2 CK and Step 3; DO graduates may use COMLEX-USA Levels 1–3. Like most boards, Missouri may limit the number of attempts and the time allowed to pass all Steps, so confirm the current rule with the board.
Compare nearby states
Figures are for allopathic (MD) boards from FSMB tables and enacted legislation, re-checked monthly. Osteopathic boards may differ, and waivers exist. Confirm every requirement with the Missouri medical board before making training or job decisions.