Starting residency · AL
Starting residency in Alabama
In Alabama, whether a resident needs a training license depends on the program or the applicant. Alabama has a graduated income tax (top rate 5% above $3,000 for 2026).
Training license
- Status
- Depends on the program or applicant
- Called
- Limited License (resident or fellow)
- Fee
- $175 certificate of qualification plus $75 license issuance; annual renewal $15 plus $300
- Renewal
- Annual
Who applies: Resident applies personally; the dean, chief medical officer or program director certifies the training by letter.
Alabama law does not require residents to hold a license. The board says individual programs require either a limited or a full license, so the need depends on the program. A resident who is serving an approved one-year residency can qualify, so PGY-1 residents are eligible. The limited license restricts practice to the residency or fellowship program, so moonlighting is not allowed, and it does not convert to a full license. IMGs also need ECFMG certification, unless their school is primarily English-speaking. Since July 1, 2025, the board treats Canadian graduates as IMGs.
Full license: After 1 year of ACGME, AOA or Canadian training for US graduates (MD or DO); 2 years for graduates of non-accredited schools, which since July 1, 2025 include Canadian schools. A full license matters if you plan to moonlight.
State income tax
Graduated income tax: top rate 5% above $3,000 for 2026. Some cities, including Birmingham and Gadsden, withhold occupational taxes from the wages of people who work there.
Source: taxfoundation.org
Match Day to your first loan payment
Assumes you enroll in RAP or IBR when the grace period ends, recertify once a year, and file each tax return by April. Your servicer's dates govern.
Mid-March
Match Day
You learn where you'll train. Your program sends its residency (GME) agreement and onboarding steps.
March–April
Alabama training license
Ask your program whether Alabama requires a training license for you, then apply early if it does.
April–June
Credentialing and onboarding
Hospital credentialing, health screening, payroll and benefits forms, and a DEA registration if your program requires one.
Late June–July 1
Move and start
Intern orientation usually starts in the last week of June. When the first paycheck arrives depends on the hospital's payroll schedule, so budget for a few weeks of moving costs without one.
About 6 months after graduation
Federal loan grace period ends
Payments start 6 months after you leave school. Choose a plan before then, or request residency forbearance, during which interest accrues and months don't count toward PSLF.
First year of payments
Payments use last year's income
RAP and IBR use the adjusted gross income on your most recent tax return, which for most new residents is a student year. Payments rise after you recertify with a resident's income.
The Board of Medical Examiners issues a certificate of qualification and the Medical Licensure Commission then issues the license; both cover MDs and DOs.
Related
- Compare RAP, IBR and Tiered Standard on a resident's income
- Alabama physician non-compete law, for when you sign your first attending contract
- All states
General information, checked on the date above. Board requirements and fees change; confirm with the Alabama Board of Medical Examinersand your program before you apply.