Many states have rules regarding the number of times an applicant is allowed to take a qualifying examination such as NBME, NBOME, FLEX, or USMLE. If it took you several tries you need to pay special attention to each state’s rules which vary greatly from state to state.
States with No Examination Attempt Limit:
- Arizona
- Colorado
- Connecticut
- Florida
- Guam
- Hawaii
- Maryland
- New York
- Puerto Rico
States with Specific Examination Attempt Limits
Keep in mind, many of these states offer a waiver so you may still qualify for licensure.
- Alabama 4th attempt at USMLE Step 3 following proof of formal training after the 3rd attempt, 10 attempts at all USMLE Steps, No limit on COMLEX
- Alaska 2 attempts per USMLE Step, 2 attempts per COMLEX Level, Arkansas allows 3 attempts per step but may offer a waiver.
- Arkansas 3 attempts per USMLE Step, 3 attempts per COMLEX Level
- California has no attempt limit on steps I and II but only allows 4 attempts on step III.
- Delaware No more than 6 attempts to pass each step
- The District of Columbia 3 attempts at USMLE Step 3; After which one additional year of postgraduate training is required, No limit on COMLEX
- Georgia 3 attempts per USMLE Step, No limit on COMLEX
- Idaho Failure to pass USMLE after 2 attempts may lead to Board interview or evaluation, No limit on COMLEX
- Illinois 5 attempts at all USMLE Steps combined, 5 attempts at COMLEX Levels combined
- Indiana 3 attempts per USMLE Step,5 attempts per COMLEX Level
- Iowa 6 attempts at both USMLE Step 1 and 2, 3 attempts at USMLE Step 3, 6 attempts at both COMLEX Levels 1 and 2, 3 attempts at COMLEX Level 3, 3 years of approved postgraduate training required if outside the attempt limit.
- Kansas 3+ attempts at USMLE Step 3 or COMLEX Level 3
- Kentucky Step or Level 1-4 attempts, Step or Level 2 CK-4 attempts, Step or Level 2 CS-4 attempts, Step or Level 3-4 attempts
- Louisiana No limit at USMLE Step 1 or COMLEX Level 1, 4 attempts each at USMLE Steps 2 and 3 or COMLEX Levels 2 and 3
- Maine 3 attempts at USMLE Step 3. More than 3 attempts requires a request for a waiver.
- Maryland Unlimited attempts at each USMLE Step or COMLEX Levelttempt limit on steps I and II but only allows 6 attempts on step III.
- Massachusetts 3 attempts at USMLE Step 3 or COMLEX (See Board Regulations 243 CMR 2.02 (3)(b).)
- Michigan 3 attempts at each USMLE Step
- Minnesota 3 attempts at each USMLE Step, 4 attempts allowed if current license in another State and current certification by specialty board of ABMS, AOABPE, RCPSC, CFPC., 3 attempts at each COMLEX Level.
- Mississippi 3 attempts at each Step, No limit on COMLEX
- Missouri 3 attempts at USMLE Step 3, 3 attempts on COMLEX
- Montana If an applicant fails to pass the first attempt at USMLE Step III, the applicant may be reexamined no more than five additional times., No limit on COMLEX
- Nebraska 4 attempts+ at each USMLE Step, 4 attempts+ at each COMLEX Level
- Nevada Must pass all 3 Steps of USMLE in not more than a total of 9 attempts and must pass Step 3 in not more than a total of 3 attempts
- New Hampshire 3 attempts at each USMLE Step or COMLEX Level
- New Jersey 5 attempts at USMLE Step 3, No information available on COMLEX
- New Mexico 6 attempts per USMLE Step
- North Carolina 3 attempts per USMLE Step, 3 attempts per COMLEX Level
- North Dakota 3 attempts at each USMLE Step or COMLEX Level
- Ohio Cannot have exceeded the maximum number of attempts for any step or level established by the NBME or NBOME, as effective on the date of application for a license. The board may grant a waiver if (1) the applicant holds current specialty board certification; or (2) demonstrates that a step or level was completed within the maximum number of attempts permitted by the NBME or NBOME at the time the step or level was successfully completed, provided that the applicant did not exceed six attempts for the step or level.
- Oklahoma 3 attempts at each USMLE Step (Step 2 = CK & CS)
- Oregon 3 attempts at USMLE step 3/COMLEX level 3. 4th attempt after additional 1 year postgraduate training. Waiver of attempt requirement may be available if ABMS/AOA certified.
- Pennsylvania No more than 4 attempts at each Step or Step Component
- Rhode Island 3 attempts at each USMLE Step, 3 attempts at each COMLEX Level
- South Carolina 4 attempts per USMLE Step and COMLEX Level
- South Dakota Allowed 3 attempts, must pass on third, for the USMLE or COMLEX examination
- Tennessee If an applicant fails any step of the USMLE or FLEX examinations more than four (4) times, then the Board shall require proof of board-certification by an ABMS-recognized specialty board and proof of meeting requirements for Maintenance of Certification prior to application before consideration for licensure.
- Texas 3 attempts at each USMLE Step or COMLEX Level. (Exceptions may apply for applicants who held a Texas Physician in Training permit on or before September 1, 2005 or who have been licensed in good standing in another state for 5 years. See TMB website for more information.)
- Utah 3 attempts at each USMLE Step or COMLEX Level
- Vermont 3 attempts at USMLE Step 3
- Virgin Islands Must take SPEX (only given in May and November) and an oral exam. 2 attempts
- Virginia 4 attempts on any USMLE step with a 5th attempt considered upon petition or appeal submitted to the Board to be reviewed in accordance with Board policy in Guidance Document 85-9
- Washington 3 attempts at USMLE Step 3
- West Virginia 6 attempts per USMLE Step or Step component
- Wisconsin 3 attempts at each USMLE step/COMLEX level
- Wyoming 7 total attempts on USMLE or COMLEX in 7 years
