Starting residency · NC
Starting residency in North Carolina
North Carolina requires residents to hold a training license from the North Carolina Medical Board: the Resident's Training License. North Carolina has a flat income tax (3.99% for 2026).
Training license
- Status
- Training license required
- Called
- Resident's Training License (RTL)
- Apply
- No deadline published; the board says GME offices' document collection can take up to a month.
- Fee
- $125 plus $38 for fingerprints; renewal $150 (raised by S.L. 2026-41, effective October 1, 2026; the board's own fee page still showed $100 and $125 in October 2026)
- Renewal
- Annual, before the resident's birthday
Who applies: Resident, online; the GME office collects documents and finalizes the application.
State law requires a license to practice medicine and has no resident exemption; the RTL is the limited license for GME. Practice is confined to the training program under the program director's supervision, so the RTL does not cover outside practice. It becomes inactive when the holder leaves the program. The board's renewal page still lists a $125 renewal fee.
Full license: After 1 year of approved GME for graduates of LCME, CACMS or AOA schools; 2 years for IMGs (plus ECFMG certification). Current specialty board certification is an alternative. A full license matters if you plan to moonlight.
Source: North Carolina Medical Board
State income tax
Flat income tax: 3.99% 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
North Carolina training license
Apply for your North Carolina 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
- North Carolina 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 North Carolina Medical Boardand your program before you apply.