Starting residency · WV
Starting residency in West Virginia
West Virginia requires residents to hold a training license from the West Virginia Board of Medicine: the Educational Permit. West Virginia has a graduated income tax (top rate 4.58% above $60,000 for 2026).
Training license
- Status
- Training license required
- Called
- Educational Permit
- Apply
- Board recommends applying at least three weeks before the training start date; training cannot begin while the application is pending.
- Fee
- $100
- Renewal
- Annual; permits expire June 30
Who applies: Resident completes Section A of a paper application; the program director or a board-authorized designee completes Section B and mails the original to the board.
State law bars taking part in graduate medical training without a West Virginia license or educational permit, and this applies to residents who hold a full license elsewhere. The permit is limited to the training program, is not transferable between programs, and does not allow moonlighting. Before prescribing controlled substances, holders complete 3 hours of board-approved CME on prescribing and drug diversion. Values are from the board's 2026 application cycle.
Full license: MD: after 1 year of approved GME for US/Canadian graduates; IMGs after 2 years, or 1 year plus ABMS board certification. DO: after 1 year. A full license matters if you plan to moonlight.
Source: West Virginia Board of Medicine
State income tax
Graduated income tax: top rate 4.58% above $60,000 for 2026. Some cities charge a weekly city service fee, withheld from the pay of everyone who works there: Huntington $5 a week and Wheeling $2 a week. Charleston also charges one.
Source: tax.wv.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
West Virginia training license
Apply for your West Virginia 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 an educational permit from the separate West Virginia Board of Osteopathic Medicine: online application, $100 plus a 2.25% processing fee, expiring June 30 each year. SB 392 (signed March 31, 2026) cut each rate by about 5% retroactive to January 1, 2026; the Tax Foundation's February 2026 table shows the earlier 4.82% top rate.
Related
- Compare RAP, IBR and Tiered Standard on a resident's income
- West Virginia 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 West Virginia Board of Medicineand your program before you apply.