INSTRUCTIONS FOR APPLYING FOR STEP 3 AND



INSTRUCTIONS FOR APPLYING FOR STEP 3 AND

PERMANENT LICENSURE IN ILLINOIS

FOR GRADUATES OF U.S. AND INTERNATIONAL

MEDICAL SCHOOLS

Applying for USMLE Step 3 in Illinois requires the submission of three (3) separate applications:

1. 4-Page State of Illinois Permanent License Application

2. 3-Page USMLE Step 3 application

3. 2-Page EBHAR for trainees with M.D. degree to request all USMLE test scores.

D.O.’s request their scores from NBOME.

Each of these applications may be completed online or on paper. See links featured in appropriate section for each application.

Guidelines:

State of Illinois Permanent License Application

You may print out and complete State of Illinois licensure 4-page application with BLACK ink only.

OR this form may be completed in its entirety online at .

1. Application Transmittal

Physician form which MUST be sent as the cover sheet with the application and documents.

2. 4-Page Application Form

On page 1:

#1 Professional Name = PHYSICIAN/SURGEON

#2 Professional Code = 036

#3 License Method =

“EXAMINATION”

#4 Application Fees = $102.00 (check payable to Continental Testing Services)

On page 3, Part IV:

Original State of Licensure = Illinois

Profession Name: Physician

License Number: You may look up your temporary license number and the date of issuance on the Illinois Department of Financial and Professional Regulation website at

License Status: Active

On page 3, Part V:

Be sure to list all attempts of USMLE exams, National Boards, Osteopathic Boards, or FLEX taken including failures.

Required Support Documents for applicants submitting either written or online application.

3. Copy of original medical school diploma.

4. Original, official transcripts from undergraduate education AND from medical school with school seal affixed

(original English translation, if applicable). Your original documents will be returned after processing. You must

also provide a photocopy of the documents.

5. VE-PC Form

You must account for the entire time period since medical school graduation including any

unemployment/vacations. Any gap in time will delay the processing of your application! Start with

CURRENT position.

6. TN-MED Form

Proof of 24 months, at a minimum, of satisfactory completion of clinical training in an approved training facility within the U.S. or Canada. This form cannot be signed any earlier then 15 days before the completion of the 24 months. An Institutional SEAL must be affixed. If requesting from an institution other than Loyola, and a seal is not available, the signature MUST be notarized, and letter on the program/institutional letterhead stating no seal exists attached.

7. CT Form – Certification of Licensure

The CT form is to be completed ONLY IF you have ever held/hold a permanent license in any state or country. Complete the top half of the form and send it to each appropriate licensing agency. The document must be completed by the jurisdiction of original licensure and the jurisdiction where you have most recently been practicing. This applies to individuals licensed in a U.S. jurisdiction or foreign country or province. Please direct the licensing entity to return the completed form directly to you so that it is included with your application packet. This can be faxed TO the agency, but an original with seal must be mailed back.

NOTE: Some states charge for this service. Call to verify so you may include payment with your request to expedite process

8. Name change documentation if applicable (e.g., copy of marriage license).

USMLE Step 3 application

Guidelines:

Print 3-page application and complete in BLACK ink. This form may be completed online at (). If you do choose to do the application online, you will still need to print Page 3, affix your photo and have your photograph and signature notarized.

1. Licensing Authority

Board code for Illinois:

Licensing Authority: Illinois

2. Fee

$705.00

3. Name

Please indicate any name changes and provide a copy of the legal document verifying the change.

4. Date of Birth

5. Social Security, National Identifier number if assigned by a country outside the US.

Country Code:

US: 099

For other countries, please refer to instructions

6. Gender

7. Citizenship upon entering Medical School

US: 099

For other countries, please click .

Proof of Examination

Applicants who are M.D.s, request the appropriate Board(s) or Council to forward an official transcript of your pass/fail examination history of USMLE, FLEX, National Boards, and/or LMCC directly to

Continental Testing Services

Medical Licensing Unit

P. O. Box 100

LaGrange IL 60525

Phone (708-354-9911)

For USMLE:

D.O.s should request their transcripts from the NBOME at the following link. .

You will receive your Step 3 scores first from USMLE then Continental Testing Services shortly thereafter. Please refer to Instructions. For applicants who have taken Step 3 in Illinois (Passed Step 3 Illinois) for instructions as to procedure for completion of your permanent license application once Step 3 has been passed.

Permanent licenses are issued in the name of the applicant and are mailed directly to the

applicant's home address as indicated on the application.

You must provide GME with a copy of your license when you receive it. It may be brought directly to the office or faxed to the GME office at 708-216-9033. You may not begin your program until the GME office has a copy of your license. Duration of current permanent licenses is on a 3-year cycle. All issued now will expire July 31, 2008 regardless of the application date.

Worthwhile Noting:

State Controlled Substances Registration Application

While you are in training you may continue use the institution’s DEA number. However, if you wish to apply for your own Federal DEA number, you will first need to complete this form. () The Illinois State Controlled Substances License is required in order to be eligible to apply for a Federal DEA number, or for you to use your current Federal DEA number in Illinois.

✓ Please complete both pages of the application

✓ List Loyola University Medical Center as your business address

o 2160 S. First

o Maywood, IL 60153

✓ Circle all drug schedule options

✓ Attach appropriate fee, a separate $5 check payable to IDFPR

✓ Submit to Continental Testing Services along with the rest of your application packet

Your Controlled Substance license will be delivered to the Loyola GME office. Once you receive your Controlled Substances License, you may apply for your Federal DEA on their website: deadiversion.drugreg/reg_apps/onlineforms.html.

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