Starting residency · KY

Starting residency in Kentucky

In Kentucky, whether a resident needs a training license depends on the program or the applicant. Kentucky has a flat income tax (3.5% for 2026).

Checked 2026-10-21

Training license

Status
Depends on the program or applicant
Called
From PGY-2: Residency Training License (R) or Institutional Practice Limited License (IP)
Apply
Board says the process takes about 6 to 8 weeks (30 to 60 more days with adverse history); training verification is not accepted before April 1.
Fee
$75; renewal $65
Renewal
Annual (academic year July 1 to June 30)

Who applies: Resident, online; the Kentucky program director must submit an R Form recommendation.

First-year residents are exempt from licensure (KRS 311.560). After one year of training, residents need an IP license (Steps 1 and 2 passed) or an R license (all steps passed) and may not start PGY-2 until it is issued. The R license allows moonlighting at sites the program director designates and a DEA registration; the IP license limits practice to the program. The statute also says first-year trainees shall register with the board at no cost, but the board's pages describe no such registration.

Full license: After 2 years of accredited training plus a licensing exam, for all graduates (MD or DO, US or IMG). A full license matters if you plan to moonlight.

Source: Kentucky Board of Medical Licensure

State income tax

Flat income tax: 3.5% for 2026. Many cities and counties levy occupational license taxes on wages, mainly where the work is done. Louisville Metro charges 2.2% for residents and 1.45% for nonresidents; Lexington-Fayette charges 2.25%, and Fayette County schools levy a separate tax.

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.

    1. Mid-March

      Match Day

      You learn where you'll train. Your program sends its residency (GME) agreement and onboarding steps.

      What a residency agreement covers →

    2. March–April

      Kentucky training license

      Ask your program whether Kentucky requires a training license for you, then apply early if it does.

      Board requirements →

    3. April–June

      Credentialing and onboarding

      Hospital credentialing, health screening, payroll and benefits forms, and a DEA registration if your program requires one.

      The physician's guide to credentialing →

    4. 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.

    5. 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.

      Compare RAP, IBR and Tiered Standard →

    6. 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.

      How RAP works →

    One board licenses MDs and DOs.

    Related

    General information, checked on the date above. Board requirements and fees change; confirm with the Kentucky Board of Medical Licensureand your program before you apply.