In most countries, only persons with a medical license bestowed either by a specified government-approved professional association or a government agency are authorized to practice medicine. Licenses are not granted automatically to all people with medical degrees. A medical school graduate must receive a license to practice medicine before he or she can be called a physician in a legal sense, a process that usually entails testing or examinations by a medical board. The medical license is the documentation of authority to practice medicine within a certain locality. In the United States, medical licenses are usually granted by each individual state.