Skip to content
Menu

Advisory Commission Releases Recommendations to Inform Legislation on Licensing Internationally-Trained Physicians

Nine recommendations focus on eligibility requirements for internationally-trained physicians entering into additional licensure pathways

WASHINGTON, D.C. (February 4, 2025) - The Advisory Commission on Additional Licensing Models has released its first set of recommendations to guide and advise state medical boards, state legislators, policymakers and others, as they develop and implement laws specific to the licensing of physicians who have already trained and practiced medicine outside the United States or Canada. 

The Advisory Commission was formed in December 2023 by the Federation of State Medical Boards (FSMB), Intealth™, and the Accreditation Council for Graduate Medical Education (ACGME) in response to increasing interest among state policymakers to improve patient access and reduce workforce shortages by changing licensure requirements for physicians who have completed training and/or practiced abroad. Some of these proposals bypass certain requirements, including requirements related to U.S. postgraduate training, that are designed to ensure physicians have acquired the necessary knowledge, skills, abilities, and attitudes to provide safe and competent patient care.

The following nine recommendations, which are not intended as an endorsement, focus on the aforementioned eligibility requirements and related considerations for entry by internationally-trained physicians into additional licensure pathways. They were drafted based on areas of concordance in legislation already introduced and enacted, as well as expert opinion that was collected during a monthslong public comment period in which more than 150 individuals and organizations participated. The following recommendations are offered for consideration by state medical boards, state legislators, policymakers, and other relevant parties:

  1. Rulemaking authority should be delegated, and resources allocated, to the state medical board for implementing and evaluating any additional licensure pathways.
  2. An offer of employment should be required for pathway eligibility. State medical boards should be authorized to define what is an appropriate clinical facility for the supervision and assessment of internationally trained physicians (ITPs) for their provisional licensure period.
  3. ECFMG Certification and graduation from a duly recognized medical school should be required for pathway eligibility.
  4. Completion of postgraduate training (graduate medical education) outside the United States should be required for pathway eligibility.
  5. Possession of authorization from another country or jurisdiction to lawfully practice medicine in that country or jurisdiction, and at least three years of experience in medical practice should be required for pathway eligibility.
  6. A limit on the physician’s time “out of practice” that is consistent with that state’s existing re-entry to practice requirements should be considered.
  7. A successfully completed period of supervision and assessment by an employer should be required of ITPs to transition from provisional licensure to full licensure.
  8. State medical boards should preserve their authority to assess each candidate for full and unrestricted licensure.
  9. State medical boards implementing additional licensure pathways should collect and share data to evaluate the program’s effectiveness.

The full guidance document and recommendations can be viewed here

Additional recommendations from the Advisory Commission, which will be essential to supplement the initial recommendations being shared today for feedback, are anticipated later in 2025 to address other important areas, such as the criteria or assurances that should be required for a physician to transition from provisional to full and unrestricted licensure.

About FSMB

The Federation of State Medical Boards (FSMB) is a national non-profit organization representing the medical boards within the United States and its territories that license and discipline allopathic and osteopathic physicians and, in some jurisdictions, other health care professionals. The FSMB serves as the voice for state medical boards, supporting them through education, assessment, research and advocacy while providing services and initiatives that promote patient safety, quality health care and regulatory best practices. The FSMB serves the public through Docinfo.org, a free physician search tool which provides background information on the more than 1 million doctors in the United States. To learn more about the FSMB, visit www.fsmb.org. 

About Intealth

Intealth is a private, nonprofit organization that brings together the expertise and resources for advancing quality in health care education worldwide in order to improve health care for all. Through strategic integration of its divisions, ECFMG® and FAIMER®, Intealth offers a flexible and multi‐layered portfolio of services. These services enhance and support the education and training of health care professionals, verify their qualifications required to practice, and inform the development of health workforce policies around the world. By leveraging these combined competencies, Intealth powers innovation in areas critical to the health professions. Learn more at www.intealth.org. 

About ACGME

The Accreditation Council for Graduate Medical Education (ACGME) is an independent, 501(c)(3), not-for-profit organization that sets and monitors voluntary professional educational standards essential in preparing physicians to deliver safe, high-quality medical care to all Americans. Graduate medical education (GME) refers to the period of education in a particular specialty (residency) or subspecialty (fellowship) following medical school; the ACGME oversees the accreditation of residency and fellowship programs in the US.

arrow_upward