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Understanding Tennessee’s New Pathway to Licensure for International Medical Graduates

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In the complex world of medical licensure, understanding new legislation can be challenging, especially for foreign-trained physicians. The recent amendments to medical practice laws in Tennessee seek to integrate more international medical graduates into the healthcare system. Here, we’ll guide you through these changes in a Q&A format, clarifying what you need to know about practicing medicine in Tennessee if you’re an international graduate.

[UPDATED] on March, 2025

The application process for international medical graduates (IMGs) in Tennessee is now officially open! If you meet the eligibility criteria (details below), you can start your application immediately.

This is a unique opportunity to obtain a provisional license and practice medicine in Tennessee, even without repeating residency in the U.S.

You can download the application form HERE. This application form was taken from the Medical Board of Tennessee website here.

How did the application process for international medical graduates in Tennessee change?

The recently amended legislation has broadened the scope of who can apply to practice medicine in Tennessee. Now, international medical graduates who completed residency outside the U.S. can apply to practice medicine in Tennessee.

What are the requirements for international medical graduates to practice medicine in Tennessee?

If you have completed residency outside the United States and would like to get a license to practice medicine in the state of Tennessee, you need the following:

Completed a postgraduate training program of a minimum of three years in the graduate’s licensing country; and has otherwise practiced as a medical professional performing the duties of a physician for the last three years outside the United States.
Evidence of being an international graduate
A job offer from a healthcare provider in Tennessee that runs an ACGME-accredited post-graduate training program (residency or fellowship program).
The board’s assessment of demonstrated ‘competency’.
ECFMG Certification: You must have your ECFMG certification to be able to practice in Tennessee.
USMLE Examinations: Applicants should have completed all three exams of the USMLE examinations (STEP1, STEP 2CK, STEP3) within ten (10) years from the date of whichever step of the examination was successfully completed first.

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What is the main challenge for international graduates with this new law?

Finding a job in an institution with an ACGME-accredited residency or fellowship training. These jobs are generally not easy to find and 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.

Do I need to complete the STEP exams to be able to practice in the U.S.?

Yes, you need to successfully complete all three (3) steps of the USMLE examinations.

What is needed to get the ECFMG certification?

You need to pass STEP 1, STEP 2 CK, OET exam, and apply to one of the 6 pathways to become ECFMG certified. You can find more information about the 6 pathways for ECFMG certification here.

What is a provisional license?

A provisional license is a permit granted to an international medical graduate who meets the stipulated requirements. This license only allows medical practice at healthcare providers running an ACGME-accredited residency program. That means you cannot practice at a private practice without an ACGME-accredited residency training. You don’t have to be enrolled in residency in that institution, but you must be in an institution that has a residency program. The Board has the power to revoke this license if the licensee violates medical safety, competency, or conduct standards. The revoked licensee has a right to appeal the decision within 120 days.

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How can a provisional temporary licensee transition to a full and unrestricted license?

Once a provisional licensee maintains good standing for two years post initial licensure, the board must grant them a full and unrestricted license. With this, the licensee isn’t limited to practicing at healthcare facilities with a residency program. That means you can practice anywhere in Tennessee, including private practices without an ACGME-accredited residency training.

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In conclusion, the new law in Tennessee is a welcome development for international medical graduates. By recognizing their experience and skills, the state opens more doors for these medical professionals, which may eventually contribute to better healthcare provision across Tennessee.

By Malke Asaad