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States Allowing International Doctors to Practice in the United States Without U.S. Residency Training
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Updated January 2026
Table of Contents
- The current process
- The new change
- Approved/Passed bills
○ Florida
○ Tennessee
○ Virginia
○ Wisconsin
○ Illinois
○ Iowa
○ Idaho
○ Louisiana
○ Massachusetts
○ Arkansas
○ Oklahoma
○ Indiana
○ Minnesota
○ Nevada
○ Texas
○ Rhode Island
○ North Carolina
○ Oregon - Pending Bills
○ Washington
○ New York
○ Georgia
○ South Carolina
○ Pennsylvania
○ Vermont
○ Kansas
○ Maine
○ New Jersey
○ Mississippi
○ New Hampshire
○ Michigan
○ Arizona - Failed Bills
○ North Dakota
○ Wyoming
○ Missouri
○ Kentucky
○ Maryland
○ Connecticut - Limited licensure
○ New York
○ California - Challenges
Recent changes in state laws are allowing internationally trained physicians/ international medical graduates (including every U.S. IMG) to practice without repeating residency in the U.S., following trends similar to those in Tennessee.
These changes are driven by the need to address physician shortages, especially in underserved areas. They acknowledge the training and experience of IMGs, aiming to integrate them into the U.S. healthcare system more efficiently. These new laws are intended to streamline the licensure process, reducing barriers and expanding access to quality medical care.
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What is the current process for licensure in most states for international graduates?
For state licenses, most states require you to have a few years of clinical training in an Accreditation Council for Graduate Medical Education (ACGME) accredited program.
Some states require only ONE year of minimum postgraduate training while others require 2 or 3 years of postgraduate training, extending the traditional med school timeline significantly. You can check the different requirements for each state on the FSMB website HERE.
In most cases, you also must have your ECFMG certificate for which you need to pass USMLE Step 1 and USMLE Step 2 CK.
How did the licensure application process change for international medical graduates in certain states?
The recent legislations allow international graduates to get a state license WITHOUT ANY residency/fellowship training in the United States.
Now let’s go over the details of these new legislations in the states that passed these laws:
Approved/Passed bills
Florida
What does the new bill in the state of Florida change for internationally trained physicians?
The new bill eliminates the need for residency training in the U.S. for internationally trained physicians, a game-changer for alumni of top medical schools abroad.
Bill Status
✅Approved by governor Ronald Dion DeSantis on 21st of March 2024
What are the requirements for licensure in Florida under the new bill?
- “Has an active, unencumbered license to practice medicine in a foreign country.
- Has actively practiced medicine during the entire 4-year period preceding the date of the submission of a licensure application.
- Has completed a residency or substantially similar postgraduate medical training in a country recognized by his or her licensing jurisdiction which is substantially similar to a residency program accredited by the Accreditation Council for Graduate Medical Education, as determined by the board.
- Has had his or her medical credentials evaluated by the Educational Commission for Foreign Medical Graduates (ECFMG), holds an active, valid certificate issued by that commission, and has passed the examination used by that commission. (there are some criteria where ECFMG certification might not be required).
- Has an offer for full-time employment as a physician from a health care provider/ health care facility that operates in this state.”
What are the conditions after acquiring the license?
- Must maintain his or her employment with the original employer or with another health care provider that operates in this state.
- Should be working at a location within this state, for at least 2 consecutive years after licensure.
- Such physicians must notify the board within 5 business days after any change of employer.
Source:
https://www.flsenate.gov/Session/Bill/2024/7016
https://legiscan.com/FL/text/S7016/2024
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Tennessee
You can check the details of the new pathway for licensure in Tennessee for international medical graduates in our other blog HERE.
Virginia
The new law in Virginia provides a pathway for physicians licensed in foreign countries to temporarily practice medicine in Virginia and eventually obtain full licensure after meeting specific requirements without having to repeat residency in the U.S.
Bill Status
✅Approved by the Governor Glenn Youngkin on 04/04/24. Started on July 1st 2024
What are the requirements for international physicians to acquire a provisional license in Virginia?
- “Has received a degree of doctor of medicine or its equivalent from a legally chartered medical school outside of the United States recognized by the World Health Organization, has been licensed or otherwise authorized to practice medicine in a country other than the United States, and has practiced medicine for at least five years.
- A valid certificate issued by the Educational Commission for Foreign Medical Graduates (ECFMG) or other credential evaluation service approved by the Board, provided, however, that the Board may waive such certification at its discretion where the applicant is unable to obtain the required documentation from a noncooperative country.
- Has achieved a passing score on USMLE Step 1 and Step 2 CK.
- Has entered into an agreement with a medical care facility that provides an assessment and evaluation program designed to develop, assess, and evaluate the physician’s nonclinical skills and familiarity with standards appropriate for medical practice in the Commonwealth according to criteria developed or approved by the Board.
- Will enter a full-time employment relationship with such medical care facility after the board issues a license to the applicant.
- Has satisfied any other criteria that the Board may require for issuance of a provisional license pursuant to this subsection.”
Note - This bill does not necessarily require completing residency in your home country, making it easier and more practical for the highest-paid doctors from abroad to move and transition; eligibility can also be based on a certain number of years of experience as a practicing physician
How long will the provisional license last?
A provisional license to practice medicine will be valid for a maximum of two years.
How can an applicant acquire a renewable restricted license?
- “Has successfully completed the participating facility’s assessment and evaluation program required.
- Passed Step 3 and will enter a full-time employment relationship with a medical facility.”
This renewable two-year restricted license will be to practice medicine in medically underserved areas in Virginia or a health professional shortage area.
Can an applicant get a full unrestricted license?
After completing at least two years of practice under a renewable two-year restricted license, an internationally trained physician can apply for a full, unrestricted medical license.
Please keep in mind that although this law passed, it is NOT in effect at this time and that it typically takes some time for the board to get regulations in place to implement the provisions in a new law.
Wisconsin
What does the new bill in the state of Wisconsin change for internationally trained physicians?
The new law provides a pathway for internationally trained physicians to practice medicine and surgery in Wisconsin without having to repeat residency in the USA.
Bill Status
✅Approved by the Governor Tony Evers on March 22, 2024.
When will the new bill in Wisconsin take effect?
This act will take effect in early 2025.
What are the requirements for international physicians to practice medicine in Wisconsin with a provisional license?
- “The applicant has an offer for full−time employment as a physician in this state from a federally qualified health center, a community health center, a hospital, an ambulatory surgical center, or any other health care facility approved by the board.
- The applicant has been granted a medical doctorate or a substantially similar degree by an international medical school.
- The applicant has completed a residency program or a postgraduate medical training program that is substantially similar to a residency program.
- The applicant has practiced as a fully licensed or otherwise authorized physician in his or her country of practice for at least 5 years after completing a residency program or a postgraduate medical training program that is substantially similar to a residency program.
- The applicant has practiced continuously as a physician in his or her country of practice for at least one out of the 5 years immediately preceding the date that the applicant submits an application for a provisional license.
- The applicant has been in good standing with the medical licensing or regulatory agency of his or her country of practice for the 5 years preceding the individual’s application and does not have any pending disciplinary action before the medical licensing or regulatory agency.
- The applicant has obtained certification by the Educational Council for Foreign Medical Graduates (ECFMG), a successor organization, or another evaluation entity approved by the board.
- The applicant has passed all steps of the United States Medical Licensing Examination (USMLE) exams.
- The applicant has or will have prior to working as a physician in this state, a federal immigration status and employment authorization that enables the applicant to work as a physician in this state.
- The applicant possesses basic fluency in the English language.
P.S.: The holder of a provisional license granted under this paragraph may practice medicine and surgery only under the supervision of a physician who is licensed to practice medicine and surgery.”
How can one acquire a permanent license in Wisconsin after a period of provisional license?
A provisional license can be converted to a permanent license after the holder practices medicine and surgery full-time in the state and maintains good standing for three consecutive years.
The website and documents will be updated to reflect this new pathway closer to the implementation date.
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Illinois
What does the new bill in the state of Illinois change for internationally trained physicians?
The new bill eliminates the need for residency training in the U.S. for internationally trained physicians.
Bill Status
✅Approved by governor J. B. Pritzker June 16 2023. This legislation takes effect Jan. 1, 2025.
What are the requirements for internationally trained doctors to get a provisional license in the state of Illinois?
- Who has been trained in a country other than the United States and whose education has been certified by the Educational Commission for Foreign Medical Graduates(ECFMG)
- Who has passed Step 1, Step 2 Clinical Knowledge, and Step 3 of the United States Medical Licensing Examination.
- Who maintains an unencumbered license from another country; and who is not licensed to practice medicine in any state or territory of the United States.
- An international medical graduate shall be eligible to apply for a limited license to practice medicine in the State of Illinois.
- Issues a two-year limited license to an international medical graduate who satisfies all of the following criteria
- Submits a fully completed application on forms provided by the Division which includes the payment of a $100 fee;
- Provides an official transcript and diploma or official transcript and certification of graduation from the medical education program granting the degree and proof of Educational Commission for Foreign Medical Graduates (ECFMG) certification; provided, however, that the Division may waive this requirement at its discretion where the applicant is unable to obtain the required documentation from a non-cooperating country;
- Provides proof of successful completion of the United States medical Licensing Examination (USMLE) Steps 1, 2, and 3. Examination scores shall be submitted directly to the Division from the testing entity.
- Submits evidence the applicant has been engaged in the active practice of medicine in their country of practice in at least 3 of the last 10 years.
- If the active practice of medicine predates the three years preceding the date of application, the applicant must show evidence of a US clinical experience including, but not limited to, a clinical observership.
- Has entered into an agreement with a sponsoring entity such as a hospital, a critical access teaching hospital, a Federally Qualified Health Center, a State facility, a community health center, or another facility approved by the Division that provides an assessment and evaluation program designed to develop, assess, and evaluate the physician’s nonclinical and clinical skills and familiarity with standards appropriate for medical practice in the State of Illinois.
- Submits to a background check process required of applicants generally.
What would the provisional period of this program consist of?
Upon the issuance of the limited license, an individual may only practice:
1) Within an approved sponsoring entity which must be either a hospital, a critical access teaching hospital, a Federally Qualified Health Center, a State facility, a community health center, or another facility approved by the Division; and
2) Under the supervision and control of an approved sponsoring entity who designates a faculty supervisor who possesses a full and unrestricted physician license that has never been disciplined in the State of Illinois.
A limited license issued under this subsection is valid for two years and may be renewed every two years.
What are the pathways to full licensure?
An individual who successfully obtains a limited license and practices under such limited license continuously until its expiration shall be eligible to apply for a two-year restricted license to practice medicine in a designated Illinois Health Professional Shortage Area in Illinois as approved by the Division.
This license is restricted in practice location only, and a restricted license holder shall be entitled to practice independently within a designated Illinois Health Professional Shortage Area. After two years of such restricted practice, the individual shall be eligible to apply for a full, unrestricted license to practice medicine.
Source: https://s3.amazonaws.com/govhawk-registers/IL_20250110.pdf
Iowa
What does the new bill in the state of Iowa change for internationally trained physicians?
The new bill is looking to remove the need for repeat residency in the US for IMGS.
Bill Status
Signed by governor on May 3rd 2024. Effective date January 1st 2025
What are the requirements for a provisional license in Iowa under the new bill?
- “Has a medical doctorate issued by an international medical program in good standing.
- Has been in good standing with the medical licensing or regulatory institution of the individual’s resident country during the immediately preceding five years and has no pending discipline before the licensing or regulatory institution.
- Has completed a residency or substantially similar postgraduate medical training in the individual’s resident country.
- Has practiced medicine and surgery or osteopathic medicine and surgery as a licensed physician for five years following the completion of a residency or substantially similar postgraduate medical training.
- Possesses basic fluency in the English language.
- Offer for employment as a physician at a health care facility in this state.
- A federal immigration status allowing the international medical graduate to practice as a physician in the United States
- ECFMG certification.
- Receive a passing score on the United States medical licensing examination (USMLE).
- Pass a background check as required by the board.
- Complete a licensure application as required by the board.
- Pay all required fees as required by the board.
How can a provisional license be converted to a full license in Iowa?
A provisional license will be converted to a full license to practice medicine and surgery or osteopathic medicine and surgery after three years, provided it has not been revoked or surrendered by the licensee.
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Idaho
What does the new bill in the state of Idaho change for internationally trained physicians?
The new bill eliminates the need for repeating residency training in the U.S. for internationally trained physicians.
Bill Status
Signed by Governor Brad Little on March 28, 2024, and takes effect January 1, 2025
What are the requirements for internationally trained doctors to get a provisional license in the state of Idaho under the new bill?
- “Submit a completed written application to the board, including proof of graduation from an international medical program, completion of postgraduate medical training, and clinical experience required pursuant to section 54-1803(12)(d), Idaho Code.
- Has practiced medicine as a physician in good standing with the regulatory institution in such individual’s home country for at least three (3) years after the completion of postgraduate medical training;
- Completed at least five hundred (500) hours of clinical experience under direct physician supervision in a clinical setting in the United States;
- Has practiced medicine within the last five (5) years or has a waiver from the board
- Possesses basic fluency in the English language as demonstrated by a passing score on the occupational English test for medicine or other equivalent exam approved by the board.
- Have an offer for employment as a physician at any sponsoring entity operating in the state of Idaho, with a supervising physician who is licensed in Idaho, in good standing with the board, board-certified, and has institutional privileges.
- Report any past or pending disciplinary issues to the board and do not have disqualifying disciplinary issues as determined by the board.
- Be eligible to obtain federal immigration status that allows the international physician to practice as a physician in the United States.
- Possess a passing score on the United States Medical Licensing Examination (USMLE) 1 and 2.
- Undergo a fingerprint-based criminal history check of the Idaho central criminal database and the federal bureau of investigation criminal history database.
- Meet the qualifications described in the section.
How can a provisional license be converted to a full license in Idaho?
At the conclusion of the three (3) year period, an international physician shall be eligible to apply for a full license if
- The international physician was employed and training for the full three (3) years;
- The supervising physician provides a letter of recommendation
- The international physician is not the subject of an active investigation by the board
- The international physician has passed the USMLE 3 or equivalent exam as approved by the board.
Louisiana
What does the new bill in the state of Louisiana change for internationally trained physicians?
The new bill eliminates the need for residency training in the U.S. for internationally trained physicians.
Bill Status
Signed by Governor on June 11, 2024, and takes effect August 1, 2024
What are the requirements for internationally trained doctors to get a provisional license in the state of Louisiana under the new bill?
- “Has been granted a medical doctorate or substantially similar degree by an international medical program of good standing
- Is in good standing with the medical licensing or regulatory institution of the individual’s licensing country
- Has completed a residency or substantially similar post-graduate medical training in the individual’s licensing country or practiced as a medical professional performing the duties of a physician in the individual’s licensing country for no less than five years.
- Is a citizen of the United States or Canada or legally entitled to live or work in the United States and possesses basic fluency in the English language
- Has submitted sufficient evidence to the board that the applicant has an offer for employment as a physician at a facility owned or operated by a hospital licensed in this state.
Note - This bill does not necessarily require completing residency in your home country; eligibility can also be based on a certain number of years of experience as a practicing physician
How can a provisional license be converted to a full license in Louisiana?
At the conclusion of the two (2) year period, an international physician shall be eligible to apply for a full license.
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Massachusetts
What does the new bill in the state of Massachusetts change for internationally trained physicians?
The new bill eliminates the need for residency training in the U.S. for internationally trained physicians.
Bill Status
Signed by Governor on November 20, 2024, and takes effect November 20, 2024
What are the requirements for internationally trained doctors to get a provisional license in the state of Massachusetts under the new bill?
- Has a degree of doctor of medicine or its equivalent from a legally chartered medical school outside the United States and recognized by the World Health Organization
- Who has been licensed or otherwise authorized to practice medicine in a country other than the United States and who has practiced medicine for at least 1 year.
- Has a valid certificate issued by the commission or other credential evaluation service approved by the board; provided, however, that the board may waive such certification if the applicant is unable to obtain the required documentation from a noncooperating country
- Has achieved a passing score on Step 1 and Step 2-Clinical Knowledge of the Licensing Exam.
- Has entered into an agreement with the participating healthcare facility providing that the facility shall develop, assess and evaluate the applicant’s familiarity with nonclinical skills and standards appropriate for medical practice in the commonwealth according to assessment and evaluation criteria developed or approved by the board
- Shall enter a full-time full employment relationship with the participating facility after the board issues a limited license to practice medicine to the applicant
- Has satisfied other criteria that may be developed by the board to implement this subsection
Note – This bill does not necessarily require completing residency in your home country; eligibility can also be based on a certain number of years of experience as a practicing physician
The provisional license is valid for 1 year only, after which the applicant needs to apply for a restricted license.
Criteria for a restricted license:
- Successful completion of the participating facility’s assessment and evaluation program
- A passing score on Step 3 of the Licensing Exam
- Any additional prerequisites that the board may require, may apply for a renewable 2-year restricted license to practice medicine only in a physician shortage area; provided, however, that a 2-year restricted license shall not be renewed more than once; and provided further, that any additional prerequisites for eligibility shall not include post-graduate clinical training and that the restricted license shall authorize the holder to practice independently in a primary care specialty, psychiatry or other specialty as may be approved by the board
How can a restricted license be converted to a full license in Massachusetts?
After 2 years of restricted practice, the internationally-trained physician may apply for a full, unrestricted license to practice medicine
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Arkansas
What does the new bill in the state of Arkansas change for internationally trained physicians?
It removes the requirement of repeating residency in the U.S. for foreign physicians.
Bill Status
Filed on April 1, 2025 and Passed on April 22, 2025
What are the requirements for internationally trained doctors to get a provisional license in the state of Arkansas?
- The provisional license authorizes practicing medicine only within the clinical programs approved by the sponsoring physician who is licensed by the Arkansas State Medical Board.
- He or she has been offered full-time employment as a physician from a healthcare provider that operates in a medically underserved population in this state.
- Hold an active, unencumbered license to practice medicine in a foreign country;
- Have actively practiced medicine during the four-year period preceding the date of an application under this section;
- Have the Educational Commission for Foreign Medical Graduates evaluate his or her medical credentials.
- Hold an active, valid certificate issued by the Educational Commission for Foreign Medical Graduates.
- Pass the examination used by the Educational Commission for Foreign Medical Graduates.
- An applicant who is licensed under this section shall:
(A) Maintain his or her employment with the original healthcare provider that operates in this state for at least three (3) consecutive years after licensure;
(B) Notify the Arkansas State Medical Board within five (5) business days after any change of employer;
(C) Appear personally before the Arkansas State Medical Board together with the sponsoring physician who is licensed by the Arkansas State Medical Board; and
(D) Present to the Arkansas State Medical Board information as to what area or department in which he or she will be practicing medicine and who will be his or her sponsoring physician.
How can a provisional license be converted to a full license?
- The Arkansas State Medical Board shall issue each provisional license under this section for a period of one year.
- At the end of one year, the provisional license issued shall lapse, and if the physician desires to continue the practice of medicine under the provisional license, the physician shall:
(i) Submit completed renewal forms to the Arkansas State Medical Board providing information as requested by the Arkansas State Medical Board;
(ii) Pay a renewal fee as established by the Arkansas State Medical Board; and
(iii) If requested, appear in person before the Arkansas State Medical Board, together with the sponsoring physician. - At the end of the second year of practice with a provisional license under this section, the physician is eligible for an active, unrestricted license to practice medicine in this state after review and approval of the Arkansas State Medical Board.
Oklahoma
What does the new bill in the state of Oklahoma change for internationally trained physicians?
The new bill eliminates the need for residency training in the U.S. for internationally trained physicians.
Bill Status
Introduced on February 3rd, 2025. And approved by the Governor.
What are the requirements for internationally trained doctors to get a provisional license in the state of Oklahoma under the new bill?
- Graduated from a medical school which meets the requirements of Educational Commission for Foreign Medical Graduates (ECFMG)
- Paid any application fee as set by the Board
- Verification of successful completion of a three-year post-graduate training program in the graduate’s licensing country, OR verification that the applicant otherwise practiced as a medical professional performing the duties of a physician for at least three (3) of the last five (5) years outside the United States verified by the employer or health care provider.
- Submit sufficient evidence that the applicant is an international medical school graduate and has an offer for employment as a physician at a health care provider that operates in this state and has a post-graduate training program accredited by the Accreditation Council for Graduate Medical Education (ACGME) in place
- Shall only provide medical services at a health care provider that has in place post-graduate training programs accredited by the Accreditation Council for Graduate Medical Education (ACGME)
- Shall be supervised by the chair of the department within the applicant’s intended practice during the term of the limited license.
- Shall have a command of the English language that is satisfactory to the State Board of Medical Licensure and Supervision, by the Educational Commission for Foreign Medical Graduates (ECFMG).
- Foreign applicants and international medical school graduates shall provide satisfactory evidence of having met the requirements for permanent residence or temporary nonimmigrant status as set forth by the United States Immigration and Naturalization Service.
How can a provisional license be converted to a full license in Oklahoma?
Three (3) years after the first date the limited licensee begins to practice medicine at a health care provider in this state, the Board may grant a full and unrestricted license to practice medicine to a limited licensee who:
- Is in good standing without disciplinary actions or investigations pending from his or her limited licensure period
- Provides documentation of a passing score for USMLE Step 1, 2 CK, and 3.
Note – This bill does not necessarily require completing residency in your home country; eligibility can also be based on a certain number of years of experience as a practicing physician
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Indiana
The new law provides a pathway for internationally trained physicians to practice medicine and surgery in Indiana without having to repeat residency in the USA.
Bill Status
Introduced on January 21st, 2025. If enacted Will take effect on July 1st, 2025.
What are the requirements for internationally trained doctors to get a provisional license in the state of Indiana?
- The individual applies in a form and manner required by the board
- The individual pays a fee of one hundred dollars ($100)
- The individual holds a medical doctorate or substantially similar degree issued by an international medical program in good standing
- The individual holds a certificate issued by the Educational Commission on Foreign Medical Graduates
- Is in good standing with the medical licensing or regulatory institution of the individual’s resident country and has no pending discipline before the licensing or regulatory institution
- Completed a residency program or other similar postgraduate medical or clinical training that, as determined by the board, is substantially similar to a residency program accredited by the Accreditation Council for Graduate Medical Education
- Practiced medicine as a licensed physician in a full-time capacity for at least five (5) years out of the preceding six (6) years
- Achieved a passing score on steps one (1) through three (3) of the United States Medical Licensing Examination
- Is proficient in the English language
- The individual has a written offer of employment as a physician at a health care facility in an underserved area and the written offer includes the following:
(A) A statement that the health care facility formally agrees to sponsor the individual.
(B) A requirement that the individual must work in collaboration with a supervising physician through a written collaborative agreement that specifies:
(i) the responsibilities and scope of the individual’s practice; and
(ii) the manner in which the individual must consult, cooperate, and coordinate with the supervising physician.
(C) A statement that:
(i) the governing board of the health care facility; or
(ii) if the health care facility has no governing body, the chief executive; has, after consulting with the medical staff of the health care facility, granted privileges to the individual - The board may not issue a limited license under this section to an individual who does not possess a federal immigration status allowing the individual to practice as a physician in the United States.
How can a provisional license be converted to a full license in Indiana?
A limited license under this section expires biennially and may be renewed for not more than six (6) cumulative years.
The board may convert a limited license under this section that is in good standing to an unlimited license after five (5) years.
The board may require a comprehensive evaluation by an independent organization of an individual to determine the individual’s competencyinthe specialtybefore issuing anunlimited medical license to the individual.
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Minnesota
What does the new bill in the state of Minnesota change for internationally trained physicians?
The new bill eliminates the need for residency training in the U.S. for internationally trained physicians.
Bill Status
Introduced on June 9, 2025 and Passed on June 14, 2025
What are the requirements for internationally trained doctors to get a temporary license in the state of Minnesota under the new bill?
- The applicant shall present evidence satisfactory to the board that the applicant is a graduate of a medical or osteopathic school approved by the board as equivalent to accredited United States or Canadian schools based upon its faculty, curriculum, facilities, accreditation, or other relevant data.
- The applicant shall present evidence satisfactory to the board that the applicant has been awarded a certificate by the Educational Council for Foreign Medical Graduates, and the applicant has a working ability in the English language sufficient to communicate with patients and physicians and to engage in the practice of medicine.
- The applicant must not be under license suspension or revocation by the licensing board of the state or jurisdiction in which the conduct that caused the suspension or revocation occurred.
- The applicant pursuant to a license or other authorization to practice, has practiced medicine, for at least 60 months in the previous 12 years outside of the United States outside of the United States. A limited license under this subdivision is valid for one 24-month period and is not renewable or eligible for reapplication.
- Submit sufficient evidence of an offer to practice within the context of a collaborative agreement within a hospital or clinical setting where the limited license holder and physicians work together to provide patient care
- Passed steps or levels one and two of the USMLE or the COMLEX-USA with passing scores as recommended by the USMLE program or National Board of Osteopathic Medical Examiners within three attempts.
- Provides services in a designated rural area or underserved urban community
- Submits two letters of recommendation in support of a limited license, which must include one letter from a physician with whom the applicant previously worked and one letter from an administrator of the hospital or clinical setting in which the applicant previously worked. The letters of recommendation must attest to the applicant’s good medical standing. The board may accept alternative forms of proof that demonstrate good medical standing where there are extenuating circumstances that prevent an applicant from providing letters.
- A limited license holder must submit to the board, every six months or upon request, a statement certifying whether the person is still employed as a physician in this state and whether the person has been subjected to professional discipline as a result of the person’s practice.
- The board must not grant a license under this section unless the applicant possesses federal immigration status that allows the applicant to practice as a physician in the United States.
- An employer of a limited license holder must pay the limited license holder at least an amount equivalent to a medical resident in a comparable field. The employer must carry medical malpractice insurance covering a limited license holder for the duration of the employment.
How can a provisional license be converted to a full license in Minnesota?
The board may issue a full and unrestricted license to practice medicine to a person who holds a limited license and who has:
- Held the limited license for two years and is in good standing to practice medicine in this state
- Practiced for a minimum of 1,692 hours per year for each of the previous two years
- Submitted a letter of recommendation in support of a full and unrestricted license from any physician who participated in the collaborative agreement.
- Passed steps or levels one, two, and three of the USMLE or COMLEX-USA with passing scores as recommended by the USMLE program or National Board of Osteopathic Medical Examiners within three attempts
- Completed 20 hours of continuing medical education
Nevada
What does the new bill in the state of Nevada change for internationally trained physicians?
The new bill eliminates the need for residency training in the U.S. for internationally trained physicians.
Bill Status
Introduced on February 3 2025 and approved by the Governor May 30 2025.
Requirements
The Board may issue a limited license to practice medicine to an applicant who:
(a) Holds or has held a valid and unrestricted license to practice medicine issued by a foreign country other than Canada and has completed a residency program or other program of postgraduate training in that foreign country or performed the duties of a physician in that foreign country within the 5 years immediately preceding the date on which the application is submitted or within such other time period as the Board deems acceptable;
(b) Meets the requirements prescribed by the Board with respect to proficiency in the English language
(c) Is of good moral character and reputation;
(d) Is in good standing with the foreign regulatory body that issued the license or, if the applicant is no longer licensed by the foreign regulatory body, was in good standing with the regulatory body at the time in which the license of the applicant expired or was otherwise deactivated at the request of the applicant.
(e) Is a graduate of a foreign medical school whose curriculum is judged to be acceptable by the Board;
(f) Has passed all steps of the United States Medical Licensing Examination.
(g) The Board may require an applicant who has not performed the duties of a physician for a continuous period of 24 months immediately preceding the date on which the applicant submits the application to complete an examination prescribed by the Board similar to the Step 2 clinical skills exam of the United States Medical Licensing Examination to evaluate the clinical skills of the applicant to practice medicine.
The Board may upon licensure of the applicant, require the applicant to provide to the Board notification of an offer for employment as a physician:
(1) At a federally-qualified health center;
(2) From the State or a political subdivision thereof, which may include, without limitation, a county hospital, a health district, a medical school within the Nevada System of Higher Education or a facility operated by a division of the Department of Health and Human Services;
(3) At a nonprofit facility which provides mental or behavioral health services or primary care services; or
(4) From a physician group practice located in a medically underserved area of this State
The holder of a limited license issued pursuant to this section:
(a) Shall file with the Board for approval a written practice agreement between the limited licensee and each physician supervising him or her.
(b) Except if authorized in emergency or life threatening situations by the regulations adopted, shall not practice medicine except under the supervision and control of a physician who holds an active unrestricted license to practice medicine in this State, practices in the same or a substantially similar specialty as the limited licensee and has practiced in that same or similar specialty for at least 2 years
How can a provisional license be converted to a full license?
The Board may issue an unrestricted license to practice medicine upon the submission of an application by the holder of a limited license issued pursuant to this section who:
(a) Has completed at least 2 years of practice as a full-time physician under the limited license;
(b) Is in good standing in this State; and
(c) Has received a written recommendation from each physician currently supervising the holder of a limited license
- The Board shall not issue a license to practice medicine to an applicant who has been licensed to practice any type of medicine in another jurisdiction and whose license was revoked for gross medical negligence by that jurisdiction.
- The Board may revoke the license of any person licensed to practice medicine in this State if it determines that the person had a license to practice any type of medicine in another jurisdiction which was revoked for gross medical negligence by that jurisdiction.
Note – This bill does not necessarily require completing residency in your home country; eligibility can also be based on a certain number of years of experience as a practicing physician
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Texas
What does the new bill in the state of Texas change for internationally trained physicians?
The new bill eliminates the need for residency training in the U.S. for internationally trained physicians.
Bill Status
Signed by the Governor June 20, 2025
Requirements
The board shall issue an initial provisional license to practice medicine to an applicant who:
(1) Has been granted a degree of doctor of medicine or a substantially similar degree by a program of medical education that meets eligibility requirements for the applicant to apply for certification by the Educational Commission for Foreign Medical Graduates;
(2) Has been licensed in good standing to practice medicine in another country and is not the subject of any pending disciplinary action before the licensing body;
(3) Has completed a residency or a substantially similar postgraduate medical training required by the applicant ’s country of licensure;
(4) Passes the Texas medical jurisprudence examination;
(5) Has proficiency in the English language;
(6) Is authorized under federal law to work in the United States;
(7) Has been offered employment in this state as a physician by a person who provides health care services in the normal course of business in a facility-based or group practice setting, including a health system, hospital, hospital-based facility, freestanding emergency facility, or urgent care clinic;
(8) Has passed the first and second steps of the United States Medical Licensing Examination (USMLE) or its successor within three attempts; and
(9) Meets any other requirement the board prescribes by rule.
Unless the applicant is a citizen of the United States or has been issued a visa to legally work in the United States, the board may not issue a provisional license to an applicant who is a citizen of a country:
(1) Identified by the United States Director of National Intelligence as a country that poses a risk to the national security of the United States in the most recent Annual Threat Assessment of the U.S. Intelligence Community ; or
(2) Identified as a country subject to prohibitions in the International Traffic in Arms Regulations (22 C.F.R. Part 126.1).
The holder of a provisional may practice only in
(1) A facility-based or group practice setting with an Accreditation Council for Graduate Medical Education residency program; or an American Osteopathic Association residency program;
(2) An Accreditation Council for Graduate Medical Education-affiliated setting; or
(3) An American Osteopathic Association-affiliated setting.
A provisional license expires on the second anniversary of the date the provisional license was issued.
On application, the board shall renew a provisional license to practice medicine if the applicant Has passed the first and second steps of the United States Medical Licensing Examination (USMLE) or its successor within three attempts; and holds a valid certificate issued by the Educational Commission for Foreign Medical Graduates.
The holder of a renewed provisional license may practice only in a rural community or medically underserved area or health professional shortage area, as designated by the United States Department of Health and Human Services, that has a current shortage of physicians, unlike graduates from the best medical universities in America, who often favor more urban areas;
How can a provisional license be converted to a full license?
The board on application shall issue a license under this subtitle to the holder of a provisional license if the provisional license holder satisfies the examination requirements.
An applicant must pass each part of the following examinations
(1) The Medical Council of Canada Examination (LMCC) or its successor;
(2) The National Board of Osteopathic Medical Examiners (NBOME) examination or its successor;
(3) The National Board of Medical Examiners (NBME) examination or its successor;
(4) The Federation Licensing Examination (FLEX) after May 1985;
(5) The United States Medical Licensing Examination (USMLE) or its successor;
The board may not issue a license to an applicant who is subject to board investigation or discipline for conduct that occurred while holding the provisional license; or has been convicted of, is on deferred adjudication community supervision or deferred disposition for, or is under active investigation for the commission of A felony or a misdemeanor involving moral turpitude.
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Rhode Island
What does the new bill in the state of Rhode Island change for internationally trained physicians?
The new bill eliminates the need for residency training in the U.S. for internationally trained physicians.
Bill Status
Introduced on January 22, 2025. and Signed by the Governor June 23, 2025.
What are the requirements for internationally trained doctors to get a temporary license in the state of Rhode Island under the new bill?
- A physician who has received a degree of doctor of medicine or its equivalent from a medical school located outside the United States with recognized accreditation status from ECFMG
- Has completed the required years of training in a residency program accredited by ACGME-I or in a residency program in a country whose GME accrediting agency has been recognized by the WFME, or programs accredited by another accreditation authority approved by the board
- Who has been licensed or otherwise authorized to practice medicine in a country other than the United States for at least three (3) years with an unrestricted medical license
- Has a valid certificate issued by the Educational Commission for Foreign Medical Graduates; provided, however, that the board may waive such certification at its discretion where the applicant is unable to obtain the required documentation from a non-cooperating country;
- Has achieved a passing score on both of Steps 1 and 2 (clinical knowledge) of the United States Medical Licensing Examination within three (3) attempts for each step;
- Has entered into an agreement with the participating healthcare facility i.e (a federally-qualified health center, community health center, hospital, or other healthcare facility that provides a board-approved assessment, training and evaluation program designed to develop, assess, train and evaluate an internationally-trained physician’s clinical and non-clinical skills, including training in identified clinical and non-clinical gaps identified by the physician(s) in the facility) providing that the facility shall assess, train and evaluate the applicant’s clinical and nonclinical skills to ensure standards appropriate for medical practice in Rhode Island, according to the assessment and evaluation criteria developed or approved by the board;
- Will enter a full-time employment relationship with that participating healthcare facility after the board issues a limited international physician license pursuant to this subsection
- Has satisfied other criteria that the board may require for issuance of a limited international physician license pursuant to this section
The one-year limited international physician license may be renewed twice, for a total three (3) year term of limited international physician registration for physicians in primary care specialties and may be renewed for the total number of years required for ACGME-accredited residency training in other specialties, at the discretion of the board
How can a restricted license be converted to a full license in Rhode Island?
To be eligible to apply for a full medical license to practice medicine in Rhode Island, an internationally-trained physician shall provide the board with proof of the following:
- Successful completion of the participating healthcare facility’s assessment, training and evaluation program, with an attestation from the facility that the physician is competent to practice their specialty independently;
- A passing score on Step 3 of the USMLE within three (3) attempts; and
- The license shall authorize the holder to practice independently in a primary care specialty, psychiatry, or other specialty approved by the board
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North Carolina
What does the new bill in the state of North Carolina change for internationally trained physicians?
The new bill eliminates the need for residency training in the U.S. for internationally trained physicians.
Bill Status
Introduced on February 6, 2025 and approved by the Governor July 1st, 2025.
Requirements
The Board may issue an “internationally-trained physician employee license” to practice medicine and surgery to a physician when the Board has received satisfactory verification of all of the following requirements:
(1) The applicant has been offered employment as a physician in a full-time capacity at a hospital that is located in North Carolina and licensed by the State of North Carolina or a medical practice located in a rural county with a population of less than 500 people per square mile, in North Carolina, where a physician fully licensed by the State under this Chapter is physically practicing on-site at the rural medical practice
(2) The applicant has a current and active license in good standing to practice medicine in a foreign country or had that type of license expire no more than five years prior to submission of an application to the Board.
(3) The applicant previously completed 130 weeks of medical education at a medical school listed in the World Dictionary of Medical Schools and is eligible to be certified by the Educational Commission for Foreign Medical Graduates and meets one of the following requirements:
a. The applicant has completed two years of postgraduate training in a graduate medical education program approved by the applicant’s country of licensure.
b. The applicant has actively practiced medicine in the applicant’s country of licensure for at least 10 years after graduation.
(4) The applicant has demonstrated competency to practice medicine in one of the following ways:
a. Successfully passing each part of NBME examination or its successor, USMLE or its successor or FLEX or its successor
b. Successfully passing each part of a nationally recognized standard medical licensing examination from a country that is a member of the International Association of Medical Regulatory Authorities that meets all of the following requirements- Tests for the ability to practice medicine. Tests for medical knowledge, skills, and understanding of clinical science essential for providing patient care, including general practice, cardiology, internal medicine, gastroenterology, hematology, nephrology, neurology, pediatrics, psychiatry, pulmonology, obstetrics and gynecology, radiology, rheumatology, urology, and surgery. Tests for communication and interpersonal skills. and also Includes an interactive testing component. The examining body must provide verification in English directly to the Board that the applicant has passed an examination meeting the aforementioned requirements.
c. Receiving specialty board certification as approved by any of the following:
- The American Board of Medical Specialties.
- The Bureau of Osteopathic Specialists of the American Osteopathic Association.
- The Royal College of Physicians and Surgeons of Canada.
- Any other specialty board recognized pursuant to rules adopted by the Board.
d. Submitting to a comprehensive assessment demonstrating clinical competence by a program approved by the Board.
Alternatively, the Board may waive the requirements of this subdivision and issue a temporary license and require the applicant to successfully pass the Special Purpose Examination (SPEX) or Post-Licensure Assessment Systems within one year.
(5) The applicant has not had a license revoked, suspended, restricted, denied, or otherwise acted against in any jurisdiction and is the subject of no pending investigations.
(6) The applicant does not have any convictions in any court involving moral turpitude, or the violation of a law involving the practice of medicine, or a conviction of a law substantially equivalent to a felony. The applicant shall submit to, and the Board must receive, a background screening from the country in which they are licensed.
(7) The applicant has practiced medicine for at least five years.
(8) The applicant is proficient in English
(9) The applicant is legally authorized to work in the United States. An applicant may apply for an internationally-trained physician employee license before receiving federal work authorization but may not begin employment with the North Carolina hospital or rural medical practice until receiving legal work authorization from the relevant federal agency.
(10) The applicant submits an application fee.
(I) The holder of the internationally-trained physician employee license shall not practice medicine or surgery outside the confines of the North Carolina hospital or rural medical practice, or its affiliate. A person who violates this subsection shall be guilty of a Class 3 misdemeanor and, upon conviction, shall be fined not more than five hundred dollars ($500.00) for each offense. The Board, at its discretion, may revoke the special license after due notice is given to the holder of the certified physician employee license.
(II) An internationally-trained physician employee license shall become inactive at the time its holder does one or more of the following: (1) Ceases to be employed in a full-time capacity by a North Carolina hospital or medical practice meeting the criteria set forth. (2) Ceases to be employed at a medical practice located in a rural county or practices if a physician licensed by the State under this Chapter is not physically practicing on-site at the medical practice. (3) Obtains any other license to practice medicine issued by the Board. The Board shall retain jurisdiction over the holder of the inactive license.
How can a provisional license be converted to a full license?
A physician with an internationally-trained physician employee license shall be eligible to apply for a full license to practice medicine in North Carolina after four years of active practice in North Carolina. The Board shall grant a full license if the applicant has no disciplinary actions by any state, federal, or foreign regulatory agency, no pending investigations by any state, federal, or foreign regulatory agency, no misdemeanor convictions in the two years preceding their application for a full license, no felony convictions, no pending misdemeanor or felony charges, and no adverse actions affecting their privileges or ability to practice. For purposes of this section, “misdemeanor” shall not include traffic violations.
Note – This bill does not necessarily require completing residency in your home country; eligibility can also be based on a certain number of years of experience as a practicing physician
Oregon
What does the new bill in the state of Oregon change for internationally trained physicians?
The new bill eliminates the need for repeating residency training in the U.S. for internationally trained physicians.
Bill Status
Introduced on January 13th, 2025. Signed by the Governor July 31, 2025.
What are the requirements for internationally trained doctors to get a temporary license in the state of Oregon under the new bill?
To be considered for a provisional license under this section, an internationally trained physician must have:
- Graduated from a school of medicine with a degree substantially similar to a degree of Doctor of Medicine or Doctor of Osteopathic Medicine, as determined by the board
- Completed a training program that is substantially similar to an approved training program, as determined by the board
- Completed a training program that is substantially similar to an approved training program, as determined by the board
- Practiced medicine in another country or jurisdiction for at least three years
- An offer of employment at a clinical facility located in this state that will provide supervision and assessment of the applicant in accordance with standards established by the board by rule
- Provided evidence, as determined sufficient by the board, that the applicant is of good moral character and in good standing in each country or jurisdiction in which the applicant practiced and received education and training
An internationally trained physician provisionally licensed under this section shall practice under the supervision of a licensed physician who is in good standing with the board and meets the requirements established by the board relating to supervision; and
(A) In a facility in this state with an approved training program;
(B) In a federally qualified health center that provides primary care and other services to underserved populations, as determined by the board; or
(C) In any other clinical location that demonstrates that the location meets the requirements established by the board by rule
An internationally trained physician provisionally licensed under this section is considered a fully licensed physician in this state for all purposes, including but not limited to credentialing and insurance billing
How can one acquire a permanent license in Oregon after a period of provisional license?
An internationally trained physician provisionally licensed under this section may, after completion of four years of full-time equivalent practice, successful completion of a clinical assessment evaluation as determined by the board by rule and satisfaction of the requirements for licensure under ORS 677.100, apply for licensure under ORS 677.100.
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Pending Bills
Washington
What does the new bill in the state of Washington change for internationally trained physicians?
The new bill eliminates the need for repeating residency training in the U.S. for internationally trained physicians.
Bill Status
Introduced January 13, 2025 and pending 25% progression
Requirements
The commission may issue a limited license to an international medical graduate if the applicant:
- Has been a Washington state resident for at least one year;
- Provides proof the applicant is certified by the educational commission for foreign medical graduates;
- Has passed all steps of the United States medical licensing examination; and
- Submits to the commission background check process required of applicants generally.
- A satisfactory rating in all categories by the supervising physician with a commission approved clinical assessment evaluation.
What does working under a limited license consist of?
A license holder under this subsection may only practice:
(i) Under the supervision and control of a physician who is licensed in this state and is of the same or substantially similar clinical specialty; and
(ii) Within the nominating facility or organization.
How can a provisional license be converted to a full license in the state of Washington?
A license holder may apply for a full license by providing
- The required documentation of a minimum of 48 months of supervised full time clinical practice at the level of a physician,
- Satisfactory clinical assessment evaluations for the period of supervised practice
- An attestation from the supervising physician, a written endorsement from the medical director of the practice site if different than the supervising physician, proof of board certification (The commission accepts only ABMS and AAGP board certifications), and supplying any further information required by the commission.
Options of exceptional applicants
An applicant may obtain an exceptional qualification waiver, waiving requirements determined by the commission in rule or statute, if they possess an acceptable body of work related to research, medical excellence, or employment, and have the recommendation of other national or international experts in the same specialty or field.
For exceptionally qualified international medical graduates, the commission may establish an abbreviated assessment program to determine competence and skill level for the purposes of issuing a full and unrestricted license.
Source – https://legiscan.com/WA/text/SB5185/2025
Note – There is another act that allows IMGs to practice with a limited license that can be renewed only once and it will require doing residency in the U.S for a full license for more information on this follow the link below.
New York
What does the new bill in the state of New York change for internationally trained physicians?
The new bill eliminates the need for residency training in the U.S. for internationally trained physicians.
Bill Status
Introduced on March 25 2025. And pending.
Georgia
What does the new bill in the state of Georgia change for internationally trained physicians?
The new bill eliminates the need for residency training in the U.S. for internationally trained physicians.
Bill Status
Introduced on February 11 2025. And pending.
South Carolina
What does the new bill in the state of South Carolina change for internationally trained physicians?
The new bill eliminates the need for residency training in the U.S. for internationally trained physicians.
Bill Status
Introduced on February 25 2025. And pending.
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Pennsylvania
What does the new bill in the state of Pennsylvania change for internationally trained physicians?
The new bill eliminates the need for residency training in the U.S. for internationally trained physicians.
Bill Status
Introduced on March 31 2025. And pending.
Vermont
What does the new bill in the state of Vermont change for internationally trained physicians?
The new bill eliminates the need for residency training in the U.S. for internationally trained physicians.
Bill Status
Introduced on April 3 2025. And pending.
Kansas
What does the new bill in the state of Kansas change for internationally trained physicians?
The new bill eliminates the need for residency training in the U.S. for internationally trained physicians.
Bill Status
Introduced on February 4 2025. And pending.
Maine
What does the new bill in the state of Maine change for internationally trained physicians?
The new bill eliminates the need for residency training in the U.S. for internationally trained physicians.
Bill Status
Introduced on January 8 2025. And pending.
New Jersey
What does the new bill in the state of New Jersey change for internationally trained physicians?
The new bill eliminates the need for residency training in the U.S. for internationally trained physicians.
Bill Status
Introduced on January 13 2026. And pending.
Mississippi
What does the new bill in the state of Mississippi change for internationally trained physicians?
The new bill eliminates the need for residency training in the U.S. for internationally trained physicians.
Bill Status
Introduced on January 8 2026. And pending.
New Hampshire
What does the new bill in the state of New Hampshire change for internationally trained physicians?
The new bill eliminates the need for residency training in the U.S. for internationally trained physicians.
Bill Status
Introduced on January 7 2026. And pending.
Michigan
What does the new bill in the state of Michigan change for internationally trained physicians?
The new bill eliminates the need for residency training in the U.S. for internationally trained physicians.
Bill Status
Introduced on September 11 2025. And pending.
Arizona
What does the new bill in the state of Arizona change for internationally trained physicians?
The new bill eliminates the need for residency training in the U.S. for internationally trained physicians.
Bill Status
Introduced on January 20 2026. And pending.
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Failed Bills
North Dakota
What does the new bill in the state of North Dakota change for internationally trained physicians?
The new bill eliminates the need for residency training in the U.S. for internationally trained physicians.
Bill Status
Introduced on January 20th, 2025. and failed.
What are the requirements for internationally trained doctors to get a provisional license in the state of North Dakota under the new bill?
- Has been granted a medical doctorate or substantially similar degree by a domestic or international medical program in good standing
- Maintained good standing with the medial licensing authority of the licensing country within the previous five years without pending disciplinary action
- Completed either:
A residency or substantially similar postgraduate medical training program OR
Seven years of practice as a medical professional performing physician duties in the licensing country after completing a medical doctorate - Practiced medicine as a fully licensed or authorized physician in the licensing country after completing the requirements
- Obtained certification by the educational council for foreign medical graduates or a successor organization approved by the board
- Passed all three steps of the United States medical licensing examination
- Demonstrates English language proficiency
- Has an offer of employment from a health care provider operating in this state
- Is eligible to obtain appropriate federal immigration status for medical practice
- Passed all three steps of the United States medical licensing examination
- Completes the required application and pays applicable fees
Note – This bill does not necessarily require completing residency in your home country; eligibility can also be based on a certain number of years of experience as a practicing physician
How can a provisional license be converted to a full license in North Dakota?
A provisional license converts to a full medical license automatically after three (3) years of active practice in this state
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Wyoming
What does the new bill in the state of Wyoming change for internationally trained physicians?
The new bill eliminates the need for residency training in the U.S. for internationally trained physicians.
Bill Status
Introduced on January 28th, 2025. and failed.
What are the requirements for internationally trained doctors to get a temporary license in the state of Wyoming under the new bill?
- Has been granted a medical doctorate or substantially similar degree by a domestic or international medical program of good standing
- Has been in good standing with a medical licensing or regulatory institution of the person’s licensing country at all times in the last five (5) years and does not have any pending discipline before the licensing body
- Has completed a residency or substantially similar post-graduate medical training program or has practiced as a medical professional performing the duties of a physician in the person’s licensing country for not less than seven (7) years after the completion of a medical doctorate
- Has practiced medicine as a fully licensed or otherwise authorized physician in the person’s licensing country for not less than five (5) years after the completion of residency training or a residency equivalent
- Has passed steps 1, 2 and 3 of the United States Medical Licensing Examination (USMLE)
- Possesses basic fluency in the English language
- Eligible to obtain federal immigration status that allows them to practice as a physician in the United States
- Has an offer for employment as a physician at any health care provider that operates in this state.
- Complete an application form provided or approved by the board
- Pass a criminal background investigation
- Pay all fees required by the board to obtain a provisional license
Note – This bill does not necessarily require completing residency in your home country; eligibility can also be based on a certain number of years of experience as a practicing physician
How can a provisional license be converted to a full license in the state of Wyoming?
Provisional licenses shall automatically be converted into full licenses to practice medicine in this state after three (3) years of active practice under a provisional license in this state if the licensee has not disciplined and subject to all of the board’s rules and regulations under the Medical Practice Act
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Missouri
What does the new bill in the state of Missouri change for internationally trained physicians?
The new bill eliminates the need for residency training in the U.S. for internationally trained physicians.
Bill Status
Introduced on February 5 2025. And failed.
Kentucky
What does the new bill in the state of Kentucky change for internationally trained physicians?
The new bill eliminates the need for residency training in the U.S. for internationally trained physicians.
Bill Status
Introduced on February 19 2025. And failed.
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Maryland
What does the new bill in the state of Maryland change for internationally trained physicians?
The new bill eliminates the need for repeating residency training in the U.S. for internationally trained physicians.
Bill Status
Introduced on February 6th, 2025 and failed.
Requirements
An applicant shall submit evidence acceptable to the board that the applicant
(1) Has received a degree of doctor of medicine or its equivalent from a legally chartered medical school outside the UNITED STATES, its territories or possessions, PUERTO RICO, or CANADA that is recognized by the world health organization;
(2) Has completed at least 2 years of postgraduate training in the country in which the applicant is licensed that is equivalent to a postgraduate residency program accredited by the accreditation council for graduate medical education;
(3) Had no discipline or competency issues raised during the applicant’s postgraduate training;
(4) Has been licensed or otherwise authorized to practice medicine in a country other than THE UNITED STATES, its territories or possessions, PUERTO RICO, or CANADA, and has practiced medicine for at least 5 years immediately preceding the date of application;
(5) Is in good standing with the medical licensing or regulatory authority in the country other than THE UNITED STATES, its territories or possessions, PUERTO RICO, or CANADA with which the board, the federation of state medical boards, or another nationally recognized medical standards oversight entity is able to verify the physician’s discipline and criminal background history;
(6) Has not been previously disciplined and has no pending disciplinary matters before any licensing or regulatory body;
(7) Has a valid certificate issued by the educational commission for foreign medical graduates;
(8) Has achieved a passing score on step 1, step 2 (clinical knowledge), and step 3 of the united states medical licensing examination;
(9) Has resided in the state for at least 1 year;
(10) Demonstrates oral and written competency in the English language;
(11) Is of good moral character;
(12) Complete a criminal history records check
pay to the board the application fee set by the board.
(13) Has satisfied any other criteria established by the board for issuance of a license under this section.
The board shall adopt regulations:
(1) To establish minimum qualifications and application fees for a license issued under this section;
(2) To establish conditions applicable to a licensee;
(3) To provide a pathway to full licensure after the licensee successfully satisfies any license conditions established by the board under item (2) of this subsection; and
(4) Necessary for the implementation, administration, and enforcement of this section.
The term of a license issued by the board under this section may not exceed 3 years. A license issued by the board under this section may not be renewed
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Connecticut
The new law in Connecticut provides a pathway for physicians licensed in foreign countries to temporarily practice medicine in Connecticut and eventually obtain full licensure after meeting specific requirements without having to repeat residency in the U.S.
Bill Status
Introduced on January 22nd, 2025. and failed
What are the requirements for international physicians to acquire a provisional license in Connecticut?
They’re not mentioned yet, but the IMG should have finished residency training in their home country and then practice under supervision using a provisional license for two (2) years, after which they can apply for a full, unrestricted license.
Limited licensure
New York
Requirements
The following persons shall be eligible for a limited permit:
(1) A person who fulfils all requirements for a license as a physician except those relating to the examination and citizenship or permanent residence in the United States;
(2) A foreign physician who holds a standard certificate from the educational council for foreign medical graduates (ECFMG) or who has passed an examination satisfactory to the state board for medicine and in accordance with the commissioner’s regulations; or
(3) A foreign physician or a foreign intern who is in this country on a non-immigration visa for the continuation of medical study, pursuant to the exchange student program of the United States department of state.
Limit of practice. A permittee shall be authorized to practice medicine only under the supervision of a licensed physician and only in a public, voluntary, or proprietary hospital.
Duration. A limited permit shall be valid for two years. It may be renewed biennially at the discretion of the department.
(4) Fees. The fee for each limited permit and for each renewal shall be one hundred five dollars.
https://www.op.nysed.gov/professions/physicians/license-requirements#limited-permits
California
California still requires U.S. residency training to get a state license. However, under special circumstances, this requirement can be waived through the Special Permits Pathway. You can read more about it HERE.
California is also offers a non-renewable, three-year physician and surgeon license to licensed physicians from Mexico who meet the eligibility criteria. For more details, refer to the link below.
Source: Read Here
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What are the main challenges for international graduates with these new laws?
Finding jobs. Getting a state license will not guarantee you a job. Moreover, it is challenging to get a malpractice insurance if you did not train in the U.S.
Some of these jobs tend to necessitate a robust academic record, with a particular emphasis on leadership qualities and research contributions. If you would like to learn more about research and boost your research portfolio, make sure to check out our research and systematic review courses.
Conclusion
The evolving state laws offer promising new pathways for internationally trained physicians to practice in the U.S. without repeating residency. These changes aim to address physician shortages and enhance healthcare access, particularly in underserved areas. By leveraging these opportunities, IMGs can contribute significantly to the medical field while fulfilling their professional aspirations.
Hopefully, this blog post was informative and shed light on a confusing process. Multiple routes can get you to practice medicine in the U.S. and you don’t necessarily have to repeat your residency training in the U.S.
As we’ve said earlier in the post, we are happy to talk with you more about how to practice medicine in the US. Set up an appointment by signing up HERE.
Good Luck!
By Yoseph Mengistu, Khaled Erekat, Malke Asaad
Updated January 2026
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ERAS Application 2026 Guide! How to Fill Out ERAS Residency Application?
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July 13, 2023
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