Starting residency · HI
Starting residency in Hawaii
Hawaii requires residents to hold a training license from the Hawaii Medical Board: the Limited and temporary license for residency training. Hawaii has a graduated income tax (top rate 11% above $325,000 for 2026).
Training license
- Status
- Training license required
- Called
- Limited and temporary license for residency training (MDR for MDs, DOSR for DOs)
- Fee
- $57; renewal $45
- Renewal
- Annual, for the length of training; the board sends no renewal notice
Who applies: Resident; the program director or a hospital representative signs an attestation with the application and each renewal.
Hawaii law bars practicing medicine without a license or a limited and temporary license, with no resident exemption. The residency license limits practice to the duties of the training position, so it does not cover moonlighting. The form says to renew at least one month before the one-year term ends.
Full license: After 1 year of accredited residency for US/Canadian graduates (MD or DO); 2 years for IMGs. A full license matters if you plan to moonlight.
Source: Hawaii Medical Board
State income tax
Graduated income tax: top rate 11% above $325,000 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
Hawaii training license
Apply for your Hawaii 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
- Hawaii 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 Hawaii Medical Boardand your program before you apply.