States with Enacted and Proposed Additional IMG Licensure Pathways Key Issue Chart (August 2025)
This document provides a comprehensive, state-by-state overview of enacted, pending, and proposed legislation creating additional licensure pathways for internationally trained physicians (ITPs) and international medical graduates (IMGs) in the United States.
18 states (including Florida, Texas, Illinois, and Virginia) have enacted laws allowing eligible ITPs to obtain full or provisional licenses without traditional U.S.-based residency training.
16 states currently have pending or recently proposed legislation.
3 states (California, New York, and Washington) already provide limited licensure without additional graduate medical education.
Nearly all jurisdictions also maintain “eminence” pathways for physicians with extraordinary qualifications.
The chart details each state’s requirements, eligibility criteria, provisional license conditions, and pathways to full licensure, with citations to relevant statutes and bills.
This resource is particularly valuable for internationally trained physicians seeking opportunities to practice in the U.S., as well as policymakers, healthcare administrators, and organizations addressing physician shortages in underserved areas.
