Medical License in Hawaii: Requirements, Endorsement, and Renewal

To practice medicine in Hawaii, you need a full, unrestricted license from the Hawaii Medical Board, which sits inside the Department of Commerce and Consumer Affairs (DCCA). Most applicants come in by endorsement from another state: submit proof of your medical degree, residency, exam scores, a National Practitioner Data Bank report, an AMA Profile, and an FCVS report, pay the fee, and expect roughly 45 to 60 business days for processing once the file is complete. A medical license in Hawaii runs on a two-year cycle: MD licenses expire January 31 of each even-numbered year, DO licenses expire June 30.

Who Qualifies

Every applicant must graduate from an accredited medical school and complete supervised postgraduate training before the board will consider the file. Under Hawaii Revised Statutes §453-4, graduates of an LCME-accredited (MD) or AOA-accredited (DO) program need at least one year of residency in an ACGME- or AOA-accredited program, or an equivalent Canadian program accredited by the Royal College of Physicians and Surgeons of Canada or the College of Family Physicians of Canada.¹

You also need passing scores on either the USMLE or COMLEX-USA. For U.S. and Canadian medical school graduates, Hawaii sets no time limit for finishing the exam sequence and no cap on attempts,² which is more flexible than most states.

Applying by Endorsement

The endorsement application requires your medical degree verification, residency verification, exam scores, an NPDB report, an AMA Physician Profile, and a Federation Credentials Verification Service (FCVS) report.³ Hawaii accepts the FCVS for core credential verification, so an existing FCVS profile shortens the paperwork.⁴

Fees depend on license type and where you land in the renewal cycle:

MD license, full cycle: $392, made up of a $50 non-refundable application fee, $97 license fee, $148 Compliance Resolution Fund fee, and $97 half-renewal fee. Apply in the second half of the cycle (odd-numbered year through the next even-numbered year) and the total drops to $221 because the half-renewal portion is excluded.³
DO license: $384 during the full cycle, with the same non-refundable $50 application fee.⁵

Once the board has a complete file, processing typically takes 45 to 60 business days. Missing paperwork, outstanding third-party verifications, or a case flagged for board review will stretch that. You can track status through the DCCA’s online portal.⁶

If You Trained Outside the U.S. or Canada

Foreign medical graduates go through one of two pathways.³ The first is for graduates who completed at least two years of residency in an ACGME-accredited U.S. program or an equivalent Canadian program. They must hold ECFMG certification or have completed the AMA Fifth Pathway Program, and all three USMLE steps must be passed within seven years.⁷

The second pathway is for foreign graduates who did not train in an ACGME- or Canadian-accredited program. They need three years of medical training or experience in an AMA-approved hospital and must have passed the FLEX or USMLE within the seven-year window. Note that the two-year postgraduate minimum under the first pathway is double what domestic graduates need, so plan the training timeline early.¹

The Interstate Medical Licensure Compact

Hawaii joined the Interstate Medical Licensure Compact (IMLC) in 2025 under Act 112, giving physicians already licensed in a compact state a faster route to a Hawaii license. The compact currently includes over 40 states, the District of Columbia, and Guam.⁸

To qualify, you must hold a full, unrestricted license in a compact state designated as your State of Principal License, have no disciplinary history, and meet the compact’s eligibility criteria. Your SPL verifies your credentials, and once cleared, Hawaii issues the license without a duplicate application. The compact charges a $700 processing fee, plus Hawaii’s issuance fee: $221 for an MD or $384 for a DO. All fees are non-refundable, and future renewals follow Hawaii’s standard schedule.⁸

Other License Types

The full, unrestricted license is the one most physicians pursue and the only one that allows independent practice statewide. Two narrower categories exist for specific situations.

A temporary educational license covers physicians still in residency or fellowship at an accredited Hawaii-based training program. It permits supervised practice inside the program only and does not authorize independent practice.

A limited and temporary license covers visiting physicians who need to practice in Hawaii for a short, defined period, such as a medical conference, disaster response, or delivery of specialized care. The application is streamlined and the license carries a fixed expiration date.

Renewal and Continuing Education

Every Hawaii medical license renews on a two-year cycle, but the deadline depends on license type. MD licenses expire January 31 of each even-numbered year, with the current cycle running through January 31, 2026. DO licenses expire June 30 of each even-numbered year, with the next deadline on June 30, 2026.⁹ The deadline is the same for everyone regardless of when the license was originally issued.

Renewal fees are $402 for MDs and $312 for DOs.⁹ Missing the deadline causes automatic forfeiture. The license can be restored, but practicing on an expired license is treated as practicing without one.

Each cycle also requires 40 hours of continuing medical education. All 40 hours must be AMA PRA Category 1 credits, AOA Category 1A credits, or their equivalent, and the CME must align with your area of practice. Keep documentation in case of audit.¹⁰ Hawaii does not currently require CME on specific topics such as opioid prescribing or ethics, though the board can add topic requirements by administrative rule.

If you want to stop practicing but keep the license on file, you can move it to inactive status at renewal. A physician on inactive status is treated as unlicensed and cannot practice; reactivation requires a form, documentation, and applicable fees, and the board may require proof of continuing education before restoring the license.¹¹

Prescribing Controlled Substances

The medical license alone does not let you prescribe controlled substances. You need three additional registrations: federal DEA registration, state controlled substance registration through the Narcotics Enforcement Division (NED), and enrollment in the Hawaii Prescription Drug Monitoring Program (PDMP).

DEA registration costs $888 for three years and must be in place before you prescribe, dispense, or administer any controlled substance.¹² Hawaii law separately requires NED registration for every practitioner who prescribes or dispenses controlled substances, with a separate registration for each practice location. Missing a renewal or bouncing a payment causes automatic forfeiture.¹³

Since July 2018, prescribers must query the PDMP before writing a Schedule II through IV prescription. You can delegate the query to authorized staff, but each delegate needs their own account and dual approval from both you and the PDMP administrator.¹⁴

Practicing by Telehealth

Any physician treating a patient located in Hawaii by telehealth needs a Hawaii medical license. Under HRS §453-1.3(f), you cannot use telemedicine to establish a new physician-patient relationship with a Hawaii patient unless you are licensed here; once the relationship exists, ongoing telehealth care and consultation with out-of-state providers are permitted.¹

There is a narrow exception for consultation. A physician licensed elsewhere may consult by telehealth with a Hawaii-licensed physician, provided the out-of-state physician does not open an office in Hawaii, does not independently treat Hawaii patients, and the Hawaii-licensed physician retains control of the patient’s care. Ordinary phone calls, faxes, and plain email do not count as telehealth under Hawaii law.

If Your Application Is Denied

If the board denies your application, you have 60 days from the date of denial to request a contested case hearing under the Hawaii Administrative Procedure Act, HRS Chapter 91.¹⁵ Miss that window and you lose the right to challenge the decision administratively.

At the hearing you can present evidence, call witnesses, and cross-examine the board’s witnesses. An administrative law judge issues a recommended decision, which the board then reviews before making a final determination. If the final decision goes against you, you can seek judicial review by filing in the circuit court within 30 days of receiving the board’s certified final order.¹⁶ The court reviews whether the board’s decision was arbitrary, capricious, or in violation of your statutory or constitutional rights. The same framework governs appeals of disciplinary orders.

1
Hawaii.gov. Hawaii Revised Statutes Chapter 453 – Medicine and Surgery
2
FSMB. State Specific Requirements for Initial Medical Licensure
3
State of Hawaii DCCA PVL. Physician MD License by Endorsement Requirements and Instructions
4
FSMB. Participating State Medical Boards for Physicians
5
State of Hawaii DCCA PVL. Osteopathic Physician and Surgeon License by Endorsement Requirements and Instructions
6
DCCA Hawaii. Check the Status of Your Application
7
State of Hawaii DCCA PVL. Requirements and Instructions for Limited and Temporary License for Physicians
8
Interstate Medical Licensure Compact. Application Cost
9
DCCA Hawaii. Hawaii Medical Board
10
DCCA Hawaii. Physician – Government Continuing Education Requirement
11
DCCA Hawaii. Inactivate License During Renewal or Reactivate Your License
12
Federal Register. Registration and Reregistration Fees for Controlled Substance and List I Chemical Registrants
13
Justia. Hawaii Revised Statutes Title 19 Chapter 329 Section 329-32 – Registration Requirements
14
Hawaii Department of Public Safety, Narcotics Enforcement Division. Hawaii PDMP Frequently Asked Questions
15
Justia. Hawaii Revised Statutes Section 91-13.1 – Administrative Review of Denial or Refusal to Issue License or Certificate of Registration
16
Hawaii.gov. Hawaii Revised Statutes Chapter 91 – Administrative Procedure