Starting residency · PA
Starting residency in Pennsylvania
Pennsylvania requires residents to hold a training license from the Pennsylvania State Board of Medicine: the Graduate License. Pennsylvania has a flat income tax (3.07% for 2026).
Training license
- Status
- Training license required
- Called
- Graduate License (Graduate Medical Trainee)
- Fee
- $30 for graduates of accredited schools, $85 for graduates of unaccredited schools; renewal $15
- Renewal
- Annual; valid up to 12 months and renewed each training year
Who applies: Program. The training hospital starts the application in the state's PALS system and pays the fee; the resident then completes and submits their part.
State rule bars practicing as part of a GME program without a graduate license, including short-term trainees and out-of-state rotators. Training at PGY-2 requires passing USMLE Steps 1 and 2 (or equivalent), and PGY-3 and above requires Step 3, unless the trainee holds a full license. The license covers training within the assigned hospital complex and program sites. Applicants complete an FBI fingerprint check and 3 hours of child abuse education. The board asks for early applications but publishes no lead time.
Full license: MD: after 2 years of training for graduates of accredited (US/Canadian) schools; 3 years for graduates of unaccredited schools (49 Pa. Code § 17.1, last amended April 2026). DO: after 1 year. A full license matters if you plan to moonlight.
State income tax
Flat income tax: 3.07% for 2026. Most municipalities and school districts levy a local earned income tax, totaling 1% for most residents. Philadelphia's wage tax is 3.735% for residents and 3.425% for nonresidents from July 1, 2026; Pittsburgh residents pay 3%. Most workplaces also withhold a Local Services Tax, generally capped at $52 a year.
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
Pennsylvania training license
Apply for your Pennsylvania 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.
DO residents get a temporary graduate training license from the separate State Board of Osteopathic Medicine: $140, $25 annual renewal, also started by the training hospital.
Related
- Compare RAP, IBR and Tiered Standard on a resident's income
- Pennsylvania 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 Pennsylvania State Board of Medicineand your program before you apply.