Starting residency · WA
Starting residency in Washington
In Washington, whether a resident needs a training license depends on the program or the applicant. Washington has no state income tax on wages.
Training license
- Status
- Depends on the program or applicant
- Called
- Physician and Surgeon Residency License (a limited license; the fee table lists it as Postgraduate Limited License)
- Apply
- No apply-by date published; the commission's FAQ gives an average processing time of about four weeks.
- Fee
- $411; renewal $411 (each includes $86 in state surcharges)
- Renewal
- Annual, matched to the program year
Who applies: Resident, online; the program director signs the appointment form recommending the resident.
State law exempts residents in Washington training programs from licensure and says the commission may issue a residency license. The commission tells incoming residents to apply unless their program director says otherwise, so whether a resident must hold one depends on the program; many programs require it before training starts. The license covers residency duties only and does not allow moonlighting.
Full license: MD: after 2 years of ACGME training, for US/Canadian graduates and IMGs. DO: after 1 year. A full license matters if you plan to moonlight.
Source: Washington Medical Commission
State income tax
No state income tax on wages.
Source: dor.wa.gov
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
Washington training license
Ask your program whether Washington requires a training license for you, then apply early if it does.
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 apply through the Department of Health to the Board of Osteopathic Medicine and Surgery, which issues a postgraduate limited license ($371 application, $351 annual renewal); state law also exempts DO trainees in board-approved programs. Washington does not tax wages. It taxes long-term capital gains at 7%, and 9.9% on gains above $1 million. A separate 9.9% income tax aimed at incomes above $1 million (ESSB 6346, 2026) is set to start with 2028 income.
Related
- Compare RAP, IBR and Tiered Standard on a resident's income
- Washington 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 Washington Medical Commissionand your program before you apply.