Michigan and New York licensing records do not show Abdul el Sayed ever holding a physician’s license in either state, renewing questions about how he has described himself as he runs for the U.S. Senate. Last month, he introduced himself at a Detroit debate as “a physician and epidemiologist,” even as state records show no license that would allow him to practice medicine.

The issue is not new. During his 2018 gubernatorial campaign, a report found that he publicly identified as a doctor despite not holding a Michigan medical license, and Michigan law bars people from representing themselves in a way that would lead others to believe they are licensed to practice medicine if they are not. His campaign at the time said he had earned the title “doctor” “twice over,” but it did not directly answer why he had also referred to himself as a physician.

El Sayed’s own descriptions of his medical background have sometimes leaned on training rather than practice. In a 2022 podcast interview, he said his direct patient-care experience amounted to a four-week sub-internship at a small Manhattan hospital near the end of medical school. He joked that his role was to be “the worst doctor on the team” and called it “cosplaying a doctor.”

That history sits alongside real medical and public health credentials. El Sayed earned an M.D. from Columbia University’s College of Physicians and Surgeons and later completed a doctorate in public health at Oxford University. He also taught epidemiology at Columbia before returning to Michigan, where he led Detroit’s health department as executive director and health officer.

Supporters have long pointed to that academic path as the reason he is comfortable using the physician label, while critics say the title can imply a license he does not have. Republicans seized on the issue after the 2018 report, including NRSC Regional press secretary Samantha Cantrell, who mocked him in a social media post that called him “cosplaying as an Egyptian citizen and licensed physician.”

El Sayed is now in a tightly contested three-way Democratic primary against Rep. Haley Stevens and state Sen. Mallory McMorrow, and the licensing question lands at a moment when every detail of a candidate’s biography is under the microscope. The records are clear: he has an M.D. and a doctorate, but no physician’s license in Michigan or New York, and his use of the title is likely to remain part of the campaign fight as voters decide whether his credentials are enough without it.