At a time when immigration policy remains one of the most divisive issues in American politics, an area of bipartisan agreement has emerged: expanding licensure pathways for international medical graduates (IMGs). IMGs are physicians who received their training outside of the United States. Communities across the country recognize the urgent need to address physician shortages and that they already have untapped, qualified talent that they can draw upon.
The COVID-19 pandemic exposed and exacerbated many weaknesses in the U.S. healthcare system. Among them is the chronic shortage of qualified physicians. In response, several states took emergency measures to allow IMGs to contribute to patient care. While initially seen as temporary stopgap solutions, these actions catalyzed change and forced policymakers to take note of their communities’ underutilization of skills as well as the policies that were to blame.
Many legislatures are now enacting policies to streamline the certification process for internationally trained physicians, ensuring that their skills meet U.S. standards and can be put to use in a healthcare system that desperately needs them. This growing movement reflects a rare instance of bipartisan agreement on an immigration issue: qualified IMGs should be able to contribute to the medical workforce, benefiting patients and strengthening healthcare access.
Since 2020, states have passed policies ranging from creating clinical readiness programs for IMGs, allowing qualified individuals to obtain a provisional license with an option for transitioning to full licensure, to policies focused on IMG integration and creating clinical readiness criteria for IMGs.
During the 2025 state legislative sessions so far, the American Immigration Council has tracked over 20 bills—introduced by Republicans and Democrats alike—that would advance opportunities for IMGs to support the country’s healthcare workforce needs. Policies include allowing qualified DACA recipients to apply for licensure in New York, removing redundant training requirements in Montana, and creating physician readiness pathways and residency grant programs in New Mexico. Several other bills offer provisional licenses to qualified IMGs with a potential pathway to full licensure (OK HB 2050; AZ SB 1108; KY HB 786; and WY SF 0155).
In recognition of this growing work across the country, the Federation of State Medical Boards (FSMB) and the Accreditation Council for Graduate Medical Education (ACGME) also released recommendations related to state licensing legislation for internationally trained physicians.
These efforts are leading to tangible changes in access to healthcare. In Washington, which passed its first IMG bill in 2019, the state has continued improving its integration of IMGs and now has an additional 40 foreign-trained physicians practicing in the state. In Minnesota, 2015 legislation has led to 15 IMGs being accepted into medical residency programs—which is often required of IMGs, regardless of their previous education and practice experience—of which six now practice medicine in the state.
These examples also demonstrate that IMG policies aren’t just immigration policies, they are healthcare and workforce policies that impact the wellbeing of all Americans. In fact, many states already benefit tremendously from the contributions of immigrants in their healthcare workforce and see IMG legislation as a way to continue to support the health of their communities and their workforce needs. For example, in New Mexico, where the legislature is considering a bill to open critical pathways to allow IMGs to practice in the state, immigrants who already call the state home made up more than 15% of physicians and surgeons in 2022.
While professional licensing falls under the purview of states, federal efforts—like the International Medical Graduate Assistance Act and the Resident Physician Shortage Reduction Act— have tried to address barriers like the limited number of medical residency positions available in the United States, the high cost of re-licensing, credential verification, English language courses, and test fees.
By continuing to modernize IMG policies, states can break down outdated barriers and ensure that every qualified doctor has the chance to contribute their skills where they are needed most. The strong bipartisan support for these policies is a testament to immigrants’ vital role in keeping communities healthy and that when we invest in our immigrant neighbors, we improve outcomes for all Americans.
FILED UNDER: Foreign doctors
