Starting residency · DC
Starting residency in District of Columbia
District of Columbia requires residents to hold a training license from the District of Columbia Board of Medicine (DC Health): the Medical Training License. District of Columbia has a graduated income tax (top rate 10.75% above $1,000,000 for 2026).
Training license
- Status
- Training license required
- Called
- Medical Training License (MTL)
- Apply
- Regulation: submit no later than 90 days before starting clinical training in DC. The board's page says to apply before the onsite start date.
- Fee
- $150 (includes a $50 background check); renewal $105
- Renewal
- First license up to 13 months, later licenses up to 3 years (rule effective September 11, 2026); renewals are filed March 1 to May 31
Who applies: Resident, online with DC Health; the GME office acts as liaison and the program director submits attestations.
DC Health requires every resident and fellow training in DC hospitals to hold an MTL unless they hold a full DC license. The MTL covers practice only in the program it was issued for. Residents from programs outside DC rotating in DC for up to 120 days use a separate Medical Training Registration. Applicants need USMLE Steps 1 and 2 (or COMLEX Levels 1 and 2) passed, and every application and renewal includes a background check. The board's web page lists a $50 renewal fee; its March 2026 FAQ and 2026 renewal notice say $105.
Full license: After 1 year of ACGME or AOA residency for US graduates (MD or DO); 3 years for IMGs (Canadian graduates from July 1, 2025 count as IMGs). A full license matters if you plan to moonlight.
State income tax
Graduated income tax: top rate 10.75% above $1,000,000 for 2026.
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
District of Columbia training license
Apply for your District of Columbia training license as soon as your program sends instructions. Applications often need school records and background checks that take weeks.
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.
One board licenses MDs and DOs.
Related
- Compare RAP, IBR and Tiered Standard on a resident's income
- District of Columbia 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 District of Columbia Board of Medicine (DC Health)and your program before you apply.