Starting residency · TX
Starting residency in Texas
Texas requires residents to hold a training license from the Texas Medical Board: the Physician-in-Training (PIT) permit. Texas has no state income tax on wages.
Training license
- Status
- Training license required
- Called
- Physician-in-Training (PIT) permit
- Apply
- Board rule 22 TAC 161.55: apply at least 60 and no more than 120 days before the program starts. The board suggests allowing 90 to 120 days for processing.
- Fee
- $200 for the length of the residency; a $7 surcharge may be added
- Renewal
- None; valid for the length of the training program
Who applies: Resident, online, after the GME office or program coordinator supplies a TMB ID number; the program must certify the applicant before the permit is issued.
Texas law requires residents to register with the board, and residents without a full Texas license hold a PIT permit. The permit covers supervised practice within the program only: outside moonlighting is not allowed, though moonlighting within the program's scope is. Changing programs requires a new application. Out-of-state residents rotating in Texas also need a permit.
Full license: After 1 year of ACGME or AOA training for US/Canadian graduates (MD or DO); 2 years for IMGs, with additional IMG conditions. A full license matters if you plan to moonlight.
Source: Texas Medical Board
State income tax
No state income tax on wages.
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
Texas training license
Apply for your Texas 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.
Related
- Compare RAP, IBR and Tiered Standard on a resident's income
- Texas 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 Texas Medical Boardand your program before you apply.