al-al-6a6116d33ad1247cd183236b: 540-X-3-.04 — Examination Requirements
Public comment closed · opened August 31, 2026.
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The proposed rule amends the examination requirements for physician licensing in Alabama, particularly by setting limits on the number of attempts an applicant can make to pass parts of the Comprehensive Osteopathic Medical Licensing Examination (COMLEX) and the United States Medical Licensing Examination (USMLE). This change aims to enhance the licensing standards for physicians in the state.
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The rule, in full
1,895 words as published, August 31, 2026. View the original →
APA-1 TRANSMITTAL SHEET FOR NOTICE OF INTENDED ACTION Control: 540 Department or Agency: Alabama Board of Medical Examiners Rule No.: 540-X-3-.04 Rule Title: Examination Requirements Intended Action Amend Would the absence of the proposed rule significantly harm or endanger the public health, welfare, or safety? Yes Is there a reasonable relationship between the state’s police Yes power and the protection of the public health, safety, or welfare? Is there another, less restrictive method of regulation available No that could adequately protect the public? Does the proposed rule have the effect of directly or indirectly increasing the costs of any goods or services involved? No To what degree?: N/A Is the increase in cost more harmful to the public than the harm that might result from the absence of the proposed rule? NA purpose of, and so they have, as their primary effect, thefor the Yes protection of the public? Does the proposed action relate to or affect in any manner any No matter of the proposed rule?is a party to concerning the subject Does the proposed rule have an economic impact? No If the proposed rule has an economic impact, the proposed rule is required to be accompanied by a fiscal note prepared in accordance with subsection (f) of Section 41-22-23, Code of Alabama 1975. Certification of Authorized Official I certify that the attached proposed rule has been proposed in full compliance with the requirements of Chapter 22, Title 41, Code of Alabama 1975, and that it conforms to all applicable filing requirements of the Administrative Procedure Division of the Legislative Services Agency. Signature of certifying officer Wi iam M. Perkins William M Perkins & F IL E D Date Thursday, August R0,E2026 ’ D AU G 20 ,202 6 A G E N C Y G IS LA T I E S V C L E APA-2 ALABAMA BOARD OF MEDICAL EXAMINERS NOTICE OF INTENDED ACTION AGENCY NAME: Alabama Board of Medical Examiners RULE NO. & TITLE: 540-X-3-.04 Examination Requirements INTENDED ACTION: Amend SUBSTANCE OF PROPOSED ACTION: The Board proposes to strengthen the licensing standards of Alabama physicians by instituting restrictions on the attempt limits on the Comprehensive Osteopathic Medical Licensing Examination (COMLEX). TIME, PLACE AND MANNER OF PRESENTING VIEWS: All interested persons may submit data, views, or arguments concerning the proposed new rule(s) and regulation(s) in writing to: Effie Hawthorne, Office of the General Counsel, Alabama State Board of Medical Examiners, Post Office Box 946, Montgomery, Alabama 36101-0946, by mail or email (publiccomment@albme.gov), until and including October 5, 2026. Persons wishing to submit data, views, or comments in person should contact Effie Hawthorne by telephone (334-242-4116) during the comment period. Copies of proposed rules may be obtained at the Board’s website: www.albme.gov. FINAL DATE FOR COMMENT AND COMPLETION OF NOTICE: Monday, October 5, 2026 CONTACT PERSON AT AGENCY: Effie Hawthorne Phone: 334-833-0171 Email: ehawthorne@albme.gov Wi iam M. Perkins William M Perkins (Signature of officer authorized to promulgate and adopt rules or his or her deputy) 540-X-3-.04 Examination Requirements. (1) Applicants for a certificate of qualification shall achieve a passing score on one of the licensure examinations listed below: (a) The United States Medical Licensing Examination (USMLE).
1. Applicants who are not dual degree candidates as
specified in subparagraph (1)(a)3. below, shall have achieved a passing score on Step 3 in not more than three administrations. These applicants shall have passed Steps 1, 2 and 3 within a seven-year period. The time period for completion of Steps 1, 2 and 3 begins when the applicant initially passes his or her first Step. The Board shall not accept scores from a re-examination of a previously passed Step of the USMLE. The seven-year period is determined on a calendar year to calendar year basis. These applicants shall not have attempted to pass Steps 1, 2 and 3 a combined total of more than ten (10) times.
3. Applicants who are dual degree candidates as defined
in these rules shall have achieved a passing score on Step 3 in not more than three administrations, and shall have completed Steps 1, 2 and 3 within a ten (10)-year period, except that the Board may approve, within its discretion and at the request of the applicant, a longer period not to exceed 15 years. The time period for completion of Steps 1, 2, and 3 begins when the applicant initially passes his or her first step. The time period for completion is determined on a calendar year to calendar year basis. The Board shall not accept scores from a re-examination of a previously passed step of the USMLE.
4. For purposes of the United States Medical Licensing
Examination, dual degree candidates are defined as the following: 3-.04-1 (i) The applicant is pursuing the M. D. or D. O. degree and the Ph.D. degree in an institution or program accredited by the LCME and a regional university accrediting body; and (ii) The applicant is a student in good standing, enrolled in the institution or program; and (iii) The Ph.D. studies are in a field of biological sciences tested in the USMLE Step 1 content, including, but not limited to anatomy, biochemistry, physiology, microbiology, pharmacology, pathology, genetics, neuroscience and molecular biology.
5. If an applicant fails to achieve a passing score on
Step 3 in three administrations, the Board may approve one additional attempt to pass Step 3 after demonstration by the applicant of additional education, experience, or training acceptable to the Board. (b) The Comprehensive Osteopathic Medical Licensing Examination or its predecessor examination administered by the National Board of Osteopathic Medical Examiners .
1. Applicants who are not dual degree candidates as
specified in subparagraph (1)(b)3. below, shall have achieved a passing score on Level 3 in not more than three administrations. These applicants shall have passed Levels 1, 2 and 3 within a seven-year period. The time period for completion of Levels 1, 2 and 3 begins when the applicant initially passes his or her first Level. The Board shall not accept scores from a re-examination of a previously passed Level of the COMLEX. The seven- year period is determined on a calendar year to calendar year basis. These applicants shall not have attempted to pass Levels 1, 2 and 3 a combined total of more than ten (10) times.
2. Applicants who are not dual degree candidates as
specified in subparagraph (1)(b)3. below and who are currently board certified by one or more of the specialty boards recognized by the American Board of Medical Specialties or the American Osteopathic Association shall not be required to pass Levels 1, 2 and 3 within the seven-year period specified in subparagraph (1)(b)1. above; however, these applicants shall be limited to a combined total of ten (10) attempts to pass Levels 1, 2 and 3 as set forth in subparagraph (1)(b)1. 3-.04-2
3. Applicants who are dual degree candidates as defined
in these rules shall have achieved a passing score on Level 3 in not more than three administrations, and shall have completed Levels 1, 2 and 3 within a ten (10)-year period, except that the Board may approve, within its discretion and at the request of the applicant, a longer period not to exceed 15 years. The time period for completion of Levels 1, 2, and 3 begins when the applicant initially passes his or her first level. The time period for completion is determined on a calendar year to calendar year basis. The Board shall not accept scores from a re-examination of a previously passed level of the COMLEX.
4. If an applicant fails to achieve a passing score on
Level 3 in three administrations, the Board may approve one additional attempt to pass Level 3 after demonstration by the applicant of additional education, experience, or training acceptable to the Board. (c) The Licentiate of the Medical Council of Canada Examination. (d) If the examination was completed before January 1, 2000, applicants, by endorsement, who are licensed in another state, the District of Columbia, a territory of the United States, or a province of Canada are eligible for licensure upon proof of a passing score on one of the following examinations:
2. The National Board of Medical Examiners Examination.
(e) The Board has established that the successful completion of certain combinations of the Federation Licensing Examination, National Board of Medical Examiners Examination and/or United States Medical Licensing Examinations, which are listed herein, are acceptable through January 1, 2000, in satisfaction of the examination requirement for a certificate of qualification. Those combinations and the passing score for each examination component are as follows:
1. NBME Part 1 (passing score=75) or USMLE Step 1
(passing score=75); plus NBME Part 11 (passing score=75) or USMLE Step 2 (passing score=75); plus NBME Part III (passing score=75) or USMLE Step 3 (passing score=75); or
3. NBME Part 1 (passing score=75 or USMLE Step 1 (passing
score=75); plus NBME Part 11 (passing score=75) or USMLE Step 2 (passing score=75); plus FLEX Component 2 (passing score=75). (f) Documentation submitted through the Federation Credentials Verification Service (FCVS) may be accepted to demonstrate compliance with the requirements of this rule. (g) For purposes of the United States Medical Licensing Examination and the Comprehensive Osteopathic Medical Licensing Examination or its predecessor examination administered by the National Board of Osteopathic Medical Examiners, dual degree candidates are defined as the following:
1. The applicant is pursuing the M. D. or D. O. degree
and the Ph.D. degree in an institution or program accredited by the LCME and a regional university accrediting body; and
3. The Ph.D. studies are in a field of biological
sciences tested in the USMLE Step 1/COMLEX Level 1 content, including, but not limited to anatomy, biochemistry, physiology, microbiology, pharmacology, pathology, genetics, neuroscience and molecular biology. Author: Alabama Board of Medical Examiners Statutory Authority: Code of Ala. 1975, §34-24-53; Act No. 93-148. History: Filed May 20, 1993 for publication. See also Notice of Intended Action dated May 20, 1993 repealing existing Chapter 3. Amended: July 21, 1993; effective August 25, 1993. Amended: Filed August 21, 1997; effective September 25, 1997. Amended: Filed November 20, 1997; effective December 25, 1997. Amended: Filed July 26, 1999; effective August 30, 1999. Amended: Filed March 22, 2002; effective April 26, 2002. Amended: Filed October 17, 2002; effective November 21, 2002. Amended: Filed March 21, 2003; effective April 25, 2003. Amended: Filed December 17, 2005; effective January 21, 2005. Amended: Filed September 23, 2005; effective October 28, 2005. Amended: Filed October 15, 2008; effective November 19, 2008. Amended: Filed October 22, 2009; effective November 26, 2009. Amended: Published December 30, 2021; effective February 13, 2022. Amended: Published ______; effective ______. 3-.04-4
Rulemaking docket
We haven’t pulled this rulemaking’s full docket yet. View docket 540-X-3-.04 on Regulations.gov →
Documents
- Full text (state register) · August 31, 2026
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