For example, you may retake a passed Step to comply with the time limit imposed by a medical licensing authority for the completion of all Steps or a requirement imposed by another authority recognized by the USMLE program for this purpose. If you pass a Step, you are not allowed to retake it, except to comply with certain state board requirements which have been previously approved by USMLE governance. Students pursuing a dual degree are advised to check the state-specific requirements for licensure listed by the FSMB.

Students who pursue both degrees should understand that while many states' regulations provide specific exceptions to the seven-year rule for dual-degree candidates, others do not. These explanations will vary and each licensing jurisdiction will need to decide on its own which explanation justifies an exception. A candidate seeking an exception to the seven-year rule should be required to present a verifiable and rational explanation for the fact that he or she was unable to meet the seven-year limit.The PhD should reflect an area of study which ensures the candidate a continuous involvement with medicine and/or issues related, or applicable to, medicine.The candidate has obtained both degrees from an institution or program accredited by the LCME and a regional university accrediting body.For this reason, the USMLE program recommends to licensing jurisdictions that they consider allowing exceptions to the seven-year limit for MD/PhD candidates who meet the following requirements: The USMLE program recognizes that the recommended seven-year time limit may pose problems for medical licensure for some candidates with a combined degree (i.e., MD/PhD).

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