More states cut residency requirements to get international graduates working

Mariah Taylor – Thursday, March 14th, 2024

Tennessee was the first state to scrap residence requirements for international medical graduates almost a year ago, and 13 more states have followed or are attempting to follow suit, MedPage Today reported March 14.

About one-fourth of all U.S. physicians are international medical graduates, according to the American Medical Association. It is estimated that about 165,000 immigrants with international healthcare degrees in the U.S. are unemployed or underemployed.

So far eight states have passed legislation to reduce requirements for international medical graduates, and six states have proposed similar cuts and alternative paths to licensure.

Four states have eliminated or greatly reduced residency requirements for certain graduates:

  • Tennessee passed a bill, which will go into effect July 1, that will enable international medical graduates to skip residency and get a two-year provisional license to work at a healthcare facility. After two years, they can apply for a full license. 
  • Illinois’ new law, which will take effect Jan. 1, will allow international graduates to work for two years with a provisional license under supervision of a licensed physician, then apply for a full license.
  • Florida’s provision will allow international graduates to skip residency requirements if they have completed similar post-graduate training that meets state and national standards.
  • Virginia will allow graduates to obtain a two year provisional license to work at an academic center with an accredited residency program. Afterward, they can apply for a full, unrestricted license.

Florida’s and Virginia’s bills have been passed by their respective legislatures and await the signature of the governor in those states.

Meanwhile, four more states are cutting down residency length and establishing temporary pathways for licensure.

  • Alabama recently passed a law that allows international graduates to apply for a license one year earlier during their training, cutting the residency requirement from three years to two years.
  • Colorado shortened its residency requirements from three years to one.
  • Idaho is allowing temporary licenses to international graduates who have applied to an accredited residency program in the state who were “forcibly displaced.” They must work in underserved areas for at least three years after residency.
  • Washington will give temporary two-year licenses to international graduates who have lived in the state for a year. 

Arizona, Iowa, Massachusetts, Missouri, Nevada and Vermont have introduced legislation to shorten the residency requirements to one year, issue temporary licenses or offer provisional licenses for a set period.

Supporters of these types of legislation say the cuts could help reduce barriers and improve the workforce issues for clinicians in rural or underserved areas.

However, physicians have raised concerns about candidates being held to different standards across states, and some said they worry hospitals could benefit from a less expensive labor force — pushing American physicians out of jobs.

“The primary mission of state medical boards is to protect the public, and we want to make sure that access to care is being addressed though this particular approach, and that patients are protected and not harmed,” Humayun Chaudhry, DO, president and CEO of Federation of State Medical Boards, told MedPage. “We’re going to be starting some conversations about criteria or competencies that a state board should expect before they issue a temporary license.”

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