30 states seek to hire more foreign-trained physicians: 5 notes

In recent years, a swell of states has adopted laws to lessen the requirements for foreign-trained physicians to join the U.S. workforce.  

The laws aim to combat the nation’s growing physician shortage, which is becoming more urgent as patient acuity rises, more physicians approach retirement age and a plethora of other factors. One tactic to staunch the shortage is reducing residency requirements for internationally trained medical school graduates to gain employment in the U.S.

Eighteen states have laws allowing internationally trained physicians to gain full licensure, three states grant limited licensure, three other states have pending bills related to limited licensure and another six state legislatures are considering pathway bills in 2026.

International medical graduates account for about one-fourth of physicians practicing in the U.S., according to the American Medical Association, which supports these pathway laws. 

Five things to know about this strategy: 

1. As of December 2025, 18 states have enacted legislation allowing internationally trained physicians to gain full licensure without U.S.-accredited postgraduate training, according to the Federation of State Medical Boards. Those states are Arkansas, Florida, Iowa, Idaho, Illinois, Indiana, Louisiana, Massachusetts, Minnesota, North Carolina, Nevada, Oklahoma, Oregon, Rhode Island, Tennessee, Texas, Virginia and Wisconsin. 

2. At least three states have pathways for internationally trained physicians to gain limited U.S. licensure without additional graduate medical education, according to the FSMB. Those are California, New York and Washington. 

3. Seventeen other state legislatures were considering bills in 2025 to simplify licensure. Six of them will continue weighing the proposals in 2026 — Georgia, Kansas, Maine, South Carolina, Vermont and Washington. 

4. Michigan’s bill for temporary and limited licenses is pending, as are New Hampshire’s bill for provisional licensure and Pennsylvania’s bill for full licensure. 

5. The bills failed in Arizona, Connecticut, Kentucky, Maryland, Missouri, North Dakota and Wyoming.

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