LICENSING PATHWAYS BY STATE

Arkansas offers a specific pathway for International Medical Graduates (IMGs) via a new provisional license (effective 2025), allowing practice without U.S. residency, requiring ECFMG certification, USMLE exams, valid foreign license, and supervised work in underserved areas for two years, leading to full licensure after continued service. This path addresses physician shortages by recognizing prior training and offers a quicker route to permanent licensure than traditional routes

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Arkansas IMG Provisional Pathway (Effective 2025)

1. Eligibility: Must be a graduate of an accredited foreign medical school, have passed USMLE Steps, hold a valid ECFMG certificate, and possess an unencumbered foreign license.
2. Placement: Secure full-time employment with an approved Arkansas healthcare provider in a medically underserved area (HPSA).
3. Supervised Practice: Obtain an "academic      license" for two years of full-time supervision.
4. Full Licensure: After two years, you can apply for a full, unrestricted license, provided you stay with the same employer for at least one more year (totaling three years in  Arkansas). 

Florida offers IMG’s pathways to licensure, including a traditional route via U.S. residency and a new, streamlined process (Senate Bill 7016) that allows qualified IMGs with foreign practice experience to bypass U.S. residency by showing equivalent training, an active foreign license, ECFMG certification, and a Florida job offer, leading to a provisional license and eventual full licensure after supervised practice, addressing physician shortages. 

Traditional Pathway (Requires U.S. Residency) 

1. ECFMG Certification: Verify credentials, pass U.S. licensing exams (USMLE Steps 1 & 2), demonstrate English proficiency, and get certified by the Educational Commission for Foreign Medical Graduates (ECFMG).
2. U.S. Residency: Complete at least two years (or more depending on specialty) of residency/fellowship training in an ACGME-approved program.
3. Apply for License: Meet Florida Board of Medicine requirements, pass background checks, and pay fees. 

New Pathway (Senate Bill 7016 - Residency Alternative)

1. Active Foreign License: Hold an active, unencumbered medical license in another country.
2. Practice Experience: Have practiced medicine for the four years preceding the application.
3. Equivalent Training: Complete postgraduate training substantially similar to an ACGME-accredited residency.
4. ECFMG & Exams: Possess ECFMG certification and have passed required exams (USMLE Steps 1 & 2, OET-Medicine).
5. Florida Job Offer: Secure a full-time job offer from a Florida healthcare provider.
6. Provisional License: Begin a period of supervised practice (around two years).
7. Full License: Transition to full licensure after meeting performance criteria and fulfilling employment requirements. 

Key Steps for Both Paths

• Credential Verification: ECFMG evaluation is crucial.
• Background Checks: Fingerprinting and criminal history checks are mandatory.
• Application: Submit to the Florida Board of Medicine with all fees.

Immigration: Maintain valid federal immigration status.  

Iowa offers a specific provisional pathway for International Medical Graduates (IMGs) starting in 2025, allowing up to three years of supervised practice in underserved areas for those with five years of prior practice, leading to full licensure after meeting requirements like USMLE exams, ECFMG certification, and background checks, bypassing traditional residency. The core requirements for this path include being in good standing, having an M.D., passing background checks, English fluency, and securing a supervised position in a shortage area. 

Key Steps for Iowa's IMG Pathway:

1. Meet Eligibility Criteria: Have an M.D., good standing in your home country for 5+ years, 5 years of practice post-residency (or equivalent training), fluency in English, and pass a background check.
2. ECFMG Certification: Get evaluated by the Educational Commission for Foreign Medical Graduates (ECFMG).
3. USMLE Exam: Pass the USMLE exams, typically Step 1.
4. Provisional License: Secure a supervised position in an Iowa shortage area and apply for a provisional license.
5. Supervised Practice: Complete 3 years of supervised practice under a fully licensed physician.
6. Full Licensure: After successful supervised practice and meeting all other requirements, you can apply for full licensure. 

Traditional Pathway (for context, less common for IMGs without US Residency):

• This route requires ECFMG certification and completing an accredited U.S. residency program (GME). 

Where to Find Official Info:

• FSMB's overview on Iowa's pathway
• Iowa Medical Board website (for application details) (This link is implied, but the search results point to the Iowa Medical Board as the authority)
• AMA brief on IMG pathways 

Idaho offers a specific Provisional-to-Full License Pathway for International Medical Graduates (IMGs) starting in 2025, allowing experienced IMGs to gain full licensure without U.S. residency by completing supervised practice in underserved areas, requiring ECFMG certification and USMLE exams, and fulfilling 3 years of clinical experience and 500 hours of supervision in Idaho, ultimately addressing physician shortages. 

Key Steps for the Idaho IMG Pathway:

1. ECFMG Certification: Obtain Educational Commission for Foreign Medical Graduates (ECFMG) certification (or equivalent), which includes passing USMLE Step 1 & 2 and demonstrating English proficiency.
2. Meet Experience Criteria: Have at least 3 years of clinical experience outside the U.S. and an active foreign medical license.
3. Apply for Provisional License: Apply to the Idaho Board of Medicine (IDBoM) for a provisional license.
4. Secure Supervision: Practice under a fully licensed physician in an approved Idaho facility, focusing on rural/underserved areas.
5. Complete Supervised Practice: Fulfill 500 hours of supervised practice and a total of 3 years of supervised clinical work in Idaho.
6. Convert to Full License: After successfully completing the supervised period, you become eligible for full licensure, without needing to complete a U.S. residency or pass USMLE Step 3. 

Important Considerations:

• Focus on Underserved Areas: This pathway targets physician shortages, requiring practice in designated rural or underserved communities.
• Provisional License Details: The license is valid for 3-6 years, renewable every two years, with specific scope of practice tied to the supervisor.
• Official Source: Always check the Idaho Board of Medicine website for the most current forms, guidelines, and application details as this is a new pathway. Add an answer to this item.

Illinois offers a new pathway for International Medical Graduates (IMGs) starting in 2025, allowing a 2-year provisional license to work in underserved areas after ECFMG certification and USMLE exams (Step 1 & 2 CK), with a potential path to a full license after further supervised practice, bridging gaps for IMGs needing residency or working toward full licensure in medically underserved areas. Applicants need U.S. work authorization, ECFMG certification, USMLE Step 1 & 2 CK, and must be sponsored by an approved healthcare organization to serve in designated shortage areas. 

Key Requirements & Steps (New 2025 Pathway)

1. ECFMG Certification: Obtain certification from the Educational Commission for Foreign Medical Graduates (ECFMG).
2. Pass USMLE Exams: Pass USMLE Step 1 and Step 2 CK (Step 3 may also be required for full licensure).
3. Secure Sponsorship: Get sponsored by an Illinois-approved healthcare provider.
4. Work in Underserved Areas: Practice for two years under supervision in designated Health Professional Shortage Areas (HPSAs).
5. Provisional License: Apply through the Illinois Department of Financial & Professional Regulation (IDFPR) for a Provisional License.
6. Path to Full License: After the supervised period, you become eligible for a Restricted License and then a Full, Unrestricted License. 

Traditional Pathway (For Comparison)

• Typically requires ECFMG Certification, USMLE Steps 1, 2 CK & 3, and completion of a U.S. residency program for full licensure. wer to this item.

Indiana offers a pathway for International Medical Graduates (IMGs) to get a limited license without a U.S. residency, requiring ECFMG certification, passing USMLE Step 1 & 2, having substantial practice experience (often 3-5+ years), demonstrating English fluency, and securing an agreement with a participating Indiana healthcare facility in underserved areas, with rules evolving but generally aiming to address physician shortages. 

Here's a breakdown of the typical requirements and pathways:

Key Requirements for the Indiana Pathway (Non-Residency)

• ECFMG Certification: You must be certified by the ECFMG (Educational Commission for      Foreign Medical Graduates).
• USMLE Exams: Passing scores on USMLE Steps 1 & 2 (Clinical Knowledge) are generally required.
• Medical Degree: A medical degree from a WHO-recognized international medical school.
• Clinical Experience: Significant practice as a physician outside the U.S. (e.g., 3-5+ years, often in the last 6 years).
• English Fluency: Proof of basic English language proficiency.
• Employment/Assessment: An agreement with a participating Indiana facility (like a Federally Qualified Health Center or hospital) for assessment and practice in underserved areas. 

General Steps

1. ECFMG & USMLE: Get your ECFMG certificate and pass the required USMLE exams.
2. Practice Verification: Gather documentation of your years of practice as a physician abroad.
3. Secure Facility Agreement: Find a facility in an Indiana shortage area willing to sponsor you for assessment.
4. Apply for Limited License: Submit your application to the Indiana Medical Licensing Board, meeting all specific criteria.
5. Obtain Restricted License: You'll likely receive a restricted license for a period, allowing practice under supervision or in shortage areas, with potential for renewal or progression. 

Important Considerations

• Evolving Laws: Licensing rules change; always check the latest regulations from the Indiana Medical Licensing Board.
• Work Authorization: You must have appropriate federal immigration status and work authorization to practice in the U.S..
• Official Source: The Federation of State Medical Boards (FSMB) website offers detailed, regularly updated information on state requirements. Add an answer to this item.

Louisiana offers an alternative pathway for International Medical Graduates (IMGs) through a temporary permit (Act 646/HB 972) allowing supervised practice in approved hospitals for two years, leading to full licensure without U.S. residency, provided requirements like ECFMG certification, USMLE steps, and an employment offer are met. This path involves a temporary license for supervised work in underserved areas, then a limited license, and eventually full licensure after meeting experience and exam (USMLE Step 3) criteria, aiming to address physician shortages. 

Key Requirements & Steps:

1. ** ECFMG Certification:** You must be ECFMG certified or equivalent, which includes      verifying your medical school and passing relevant exams (USMLE Steps 1 & 2).
2. Employment Offer: Secure a full-time supervised job offer from a Louisiana Board-approved hospital or FQHC.
3. Temporary License: Apply for a 2-year temporary license, renewable once, allowing supervised practice.
4. Limited License: After 2 years, pass USMLE Step 3 and demonstrate skills to get a 2-year limited license for independent practice in underserved areas, renewable once.
5. Full License: After at least 4 years of practice under these permits and meeting all criteria, you can apply for a full medical license. 

Core Eligibility Criteria (per Act 646/HB 972):

• Recognized foreign medical degree.
• Good standing with your home country's medical board.
• At least one year of authorized practice or residency in your country.
• USMLE Steps 1 & 2 or equivalent.
• Basic English fluency.
• Legal right to work in the U.S. (citizen/visa/permit). 

This pathway provides a significant opportunity for experienced IMGs to practice in Louisiana without completing a U.S. residency, though specific rules and documentation are still being finalized by the Louisiana State Board of Medical Examiners (LSBME). 

Massachusetts offers a new Physician Pathway Act (PPA) for International Medical Graduates (IMGs) creating a streamlined route by allowing a limited license for 2-3 years of supervised practice in underserved areas, leading to full licensure, bypassing the traditional U.S. residency requirement for some, though standard licensing (ECFMG, USMLEs) still applies for other routes or full unrestricted licenses. IMGs must still meet core standards (good moral character, education verification) and can apply for full licenses after supervised practice under the new PPA, which addresses primary care shortages. 

The New Massachusetts PPA Pathway (for Eligible IMGs)

1. Physician Pathway Act: Signed into law in late 2024, this creates a      pathway for IMGs already licensed in another country.
2. Limited License: Eligible IMGs can get a 1-year limited license to work under supervision at approved health centers or hospitals in underserved areas.
3. Supervised Practice: After 2-3 years (or more) of this supervised practice, they can apply for a full, unrestricted license.
4. Credentialing: Facilities evaluate competence, and the IMG must still meet state requirements for education, exams (like USMLEs), and character. 

Traditional Pathway (Still Relevant)

• ECFMG Certification: Essential for U.S. licensure, requiring medical school verification, passing U.S. licensing exams (USMLEs), and English proficiency.
• U.S. Residency: Traditionally, IMGs needed to complete an accredited U.S. residency (GME). 

Key Steps for IMGs (General)

• Verify Education: Get your foreign medical degree verified by the Educational Commission for Foreign Medical Graduates (ECFMG).
• Pass Exams: Pass the required United States Medical Licensing Examinations (USMLEs) (Steps 1, 2, 3).
• English Proficiency: Demonstrate English language skills.
• Apply to MA Board: Contact the Massachusetts Board of Registration in Medicine (BORIM) for specific application details and forms, especially for the PPA. 

In Summary: Massachusetts now offers a significant alternative to the traditional residency route for IMGs, focusing on supervised practice in underserved areas to address workforce needs. 

Minnesota offers specific pathways for International Medical Graduates (IMGs) through programs like BRIIDGE, requiring ECFMG certification, USMLE Step 1 & 2, and often completion of a state-sponsored supervised residency or fellowship, leading to limited/restricted licenses, with eventual full licensure after meeting experience and exam (USMLE Step 3) criteria, focusing on underserved areas to address workforce needs. 

Here's a general pathway:

1. ECFMG Certification:
   • Graduate from a recognized foreign medical school listed in the  World Directory of Medical Schools.
   • Pass USMLE Step 1 & Step 2 (or equivalent).
   • Meet other ECFMG requirements, including clinical skills  assessment.

1. Residency/Clinical Experience (The Biggest Hurdle):
   • Secure a U.S. residency position through the match, often in primary care/underserved areas.
   • Minnesota has dedicated state-funded residency slots for IMGs  through programs like BRIIDGE.

1. Limited/Provisional Licensure (Through State Programs):
   • BRIIDGE Program: Minnesota Department of Health (MDH) offers this program for IMGs with an MD/equivalent, ECFMG  certification, and documented Minnesota residency, providing supervised       clinical experience.
   • Supervised Practice: Initial licensure is often  limited, requiring supervised practice (2-3 years) in underserved/rural areas.

1. Pathway to Full Licensure:
   • Complete the required supervised training (often 2-4 years total  across provisional/restricted licenses).
   • Pass USMLE Step 3.
   • Apply for full licensure with the Minnesota Board of Medical Practice. 

Key Minnesota Resources:

• Minnesota Department of Health (MDH): Offers programs like BRIIDGE for clinical      preparation and experience.
• Minnesota Board of Medical Practice: The official licensing authority. 

Important Considerations:

• This process is competitive; securing residency is tough.
• Focus on primary care in rural/underserved areas to leverage state      programs.
• Stay updated with MDH and AMA resources for the latest laws and pathways. 

To get licensed in North Carolina as an International Medical Graduate (IMG), you generally need ECFMG certification (proving medical school/language standards), USMLE Step 3, a U.S. residency, and then apply through the NC Medical Board (NCMB) portal, but NC offers pathways allowing evaluation via other national exams or board certification, often requiring practice in underserved areas for initial licensure before full licensure, requiring detailed credential review via NCMB's system. 

Core Requirements & Steps:

1. ECFMG Certification: This is a fundamental first step, verifying your medical school meets requirements and you've passed USMLE Steps 1 & 2 (or equivalent) and demonstrated English proficiency (OET).
2. USMLE Steps: Pass USMLE Steps 1, 2, and usually Step 3, or a recognized equivalent licensing exam.
3. U.S. Residency: Complete a U.S. residency program, though NC has options for those with significant post-grad experience or other competency proofs.
4. NC Medical Board (NCMB) Application:
   1. Create an  account on the NCMB portal.
   2. Submit your application, supporting documents, and fees; the review takes about four months.
5. Provisional/Restricted License (If Applicable): NC allows for provisional licenses (2 yrs, non-renewable) and restricted licenses (renewable, for underserved areas), requiring steps like USMLE Step 3, ECFMG, and specific practice agreements before applying for full licensure after 4+ years.
6. State-Specific Pathways: NC considers pathways demonstrating competency through specialty      board certification or approved assessments, not just USMLE. 

Nevada has a new, special pathway for International Medical Graduates (IMGs) via Senate Bill 124 (effective July 2026), allowing a limited license for two years of supervised practice in underserved areas, leading to full licensure, to address physician shortages; this supplements the standard pathway requiring ECFMG certification, USMLE exams, and a U.S. residency, with this new route helping long-term residents bypass full residency. 

New Nevada Pathway (Effective July 2026)

1. Eligibility: For IMGs already in Nevada legally.
2. Limited License: Apply for a limited license.
3. Supervised Practice: Complete 2 years of supervised practice in a designated health care shortage area.
4. Full Licensure: After successful completion, you can earn full licensure, avoiding a full residency.
5. Support: Expect tailored supervision, mentorship, and language support. 

Traditional Pathway (Still Applicable)

• ECFMG Certification: Verify your foreign medical credentials via the Educational Commission for Foreign Medical Graduates (ECFMG).
• USMLE Exams: Pass all steps of the United States Medical Licensing Examination (USMLE).
• U.S. Residency: Complete a U.S. residency program.
• State Application: Apply for licensure in Nevada through the Board of Medical Examiners, meeting their specific requirements. 

Key Steps for IMGs

• Check ECFMG: Ensure your credentials are ECFMG certified.
• Pass Exams: Conquer the USMLE steps.
• Contact Nevada Board: Reach out to the Nevada State Board of Medical Examiners for specifics on both the new SB 124 pathway and traditional requirements. 

Oklahoma offers IMGs a new Limited Medical License (effective Nov 1, 2025) requiring ECFMG cert, USMLE Steps 1, 2, & 3, 3 yrs training/practice, English proficiency, and an ACGME-program-affiliated job for supervised practice, leading to full licensure after 3 yrs good standing & USMLE 3. The traditional path involves ECFMG certification, USMLE Steps, and ACGME residency (12-24 months required). 

New Limited License Pathway (Effective Nov 1, 2025)
This pathway provides a route for IMGs without residency to practice under supervision. 

• Eligibility: ECFMG certified, valid foreign license, USMLE Steps 1 & 2, 3 years post-grad training or 3 years practice in last 5 years, English proficiency (ECFMG determined).
• Requirements: Offer of employment with a facility having an ACGME program, supervision by department chair, background check, source verification.
• License: 3 years, non-renewable.
• Path to Full Licensure: 3 years of supervised practice, USMLE Step 3, good standing, and recommendation. 

Oregon offers standard and alternative licensure pathways for International Medical Graduates (IMGs), with recent legislation (HB 2050) creating a Provisional License for supervised practice, bypassing full U.S. residency initially, while also requiring ECFMG certification, USMLE exams, and agreements with healthcare facilities, aimed at addressing physician shortages. The standard route demands significant U.S. postgraduate training (usually 3+ years), while new pathways allow qualified IMGs to start practicing under supervision, potentially leading to full licensure. 

Standard Licensure Pathway (Traditional Route)

1. ECFMG Certification: Must be certified by the Educational Commission for Foreign      Medical Graduates.
2. U.S. Postgraduate Training: Complete at least three years of approved U.S. or Canadian internship/residency/fellowship training in no more than two specialties.
3. Examinations: Pass all required U.S. Medical Licensing Examinations (USMLE) steps. 

New Provisional Pathway (HB 2050 - 2025)
This pathway aims to address workforce gaps by allowing some IMGs to practice under supervision without immediate full U.S. residency completion. 

• Medical Degree & Training: Possess a recognized medical degree and completed foreign residency/postgraduate training.
• ECFMG & USMLE: Meet ECFMG standards and pass relevant USMLE steps (e.g., Step 1, Step 2-CK).
• Experience: May need several years of practice abroad and current practice within the last five years.
• Supervised Practice: Conduct supervised clinical practice in the U.S. (e.g., 500 hours).
• Facility Agreement: Have an agreement with a participating healthcare facility in Oregon.
• Provisional License: Granted a restricted license for supervised practice, with potential paths to full licensure after meeting further requirements. 

Key Steps & Requirements for All Pathways

• Oregon Medical Board (OMB): The primary regulatory body.
• Application: Submit applications to the OMB and pass the Oregon Laws & Rules exam.
• Legal Authorization: Must be legally authorized to work in the U.S.. 

 Rhode Island offers pathways for International Medical Graduates (IMGs) through specific legislation (like H 5108/SB 347) for limited licenses, requiring ECFMG certification, passing USMLE Steps 1 & 2, a recognized medical degree, and an agreement with a participating facility for assessment, leading to practice in underserved areas or conversion to full licensure after evaluation, but as of late 2025/early 2026, the application process for these pathways was not yet fully published, making it a potential but currently inactive route. The traditional route involves full ACGME residency, ECFMG certification, and USMLE Steps 1-3. 

Key Pathways

1. Traditional Pathway (Full Licensure)
   • Education: M.D. from a WHO-recognized school.
   • Certification: ECFMG certification.
   • Exams: Pass all USMLE Steps (1, 2, 3).
   • Training: Complete 2-3 years of ACGME-accredited postgraduate  training.
   • Application: Apply through the Federation of State Medical Boards (FSMB) state licensure page.

1. Alternative Pathway (Limited License Legislation - HB 5108/SB 347)
   • Eligibility: M.D. from a WHO-recognized school, ECFMG  certified, passed USMLE Steps 1 & 2 (within limits), practiced at  least 3 years, licensed in home country, and have an agreement with a  board-approved facility (FQHC, CHC, hospital) in an underserved area.
   • Process: Participate in a board-approved assessment/training program at the facility.
   • Outcome: Receive an International Physician Registration (IPR) for limited practice, potentially leading to a full license.
   • Status: Legislation enacted, but application process not yet published as of late 2025/early 2026, so this pathway is currently unavailable. 

Important Considerations

• ECFMG Certification: A common prerequisite for most IMG pathways.
• USMLE: Steps 1, 2, and 3 are generally required for full licensure; Steps 1 & 2 for alternative pathways.
• ACGME Residency: Required for traditional licensure; alternative pathways try to bypass this.
• State-Specific: Licensure rules vary by state; always check the Rhode Island Board of Medical Licensure and Discipline (BORIM) for current requirements. 

 Key Steps & Requirements:

1. Eligibility Basics:
   • ECFMG Certification.
   • Completion of at least a 3-year residency/training program abroad.
   • Passing USMLE Steps 1 & 2.
   • Evidence of good moral character.
   • U.S. Citizenship or legal work authorization.

1. Employment: Secure a full-time job offer from a Tennessee health system with an ACGME-accredited residency program.
2. Provisional License Application: Apply to the Tennessee Board of Medical      Examiners with required documents and fees.
3. Supervised Practice: Practice under a Tennessee-licensed physician for two years.
4. Full License: After successful completion, apply for a full, unrestricted license. 

Texas offers a new pathway for International Medical Graduates (IMGs) to get licensed without a full U.S. residency, involving a provisional license, supervised practice for U.S. clinical experience, and then a full license, requiring ECFMG certification, USMLE Steps 1 & 2, and proof of international training/practice, to help address physician shortages, especially in underserved areas. 

Here's a breakdown of the new Texas IMG Licensure Pathway:

Key Requirements for Provisional License

1. ECFMG Certification: Must be certified by the Educational Commission for Foreign Medical Graduates.
2. USMLE Exams: Pass USMLE Steps 1 and 2.
3. International Training/Practice: Complete an accredited international residency or have practiced medicine for at least three years within the last five.
4. No NRMP Participation: Must not have participated in the National Resident Matching Program (NRMP).
5. Employer Offer: Have a full-time job offer from a Texas healthcare provider. 

The Stepwise Process

1. Provisional License: Obtain this to start working under supervision in Texas.
2. Supervised Practice: Gain essential U.S. clinical experience in a supervised role.
3. Full License: Transition to independent practice after meeting      all requirements. 

Virginia offers IMGs a pathway to licensure via a Provisional License (HB 995/SB 1108, effective July 2024) for shortage areas, requiring ECFMG certification, USMLE Steps 1 & 2, 5+ years practice/3-yr residency, and institutional sponsorship, allowing 4 years of supervised practice (2+2 renewal) before potentially qualifying for full licensure. The traditional route still involves U.S. residency (GME) after ECFMG certification. 

Virginia's Provisional Pathway (HB 995/SB 1108 - 2024)
This pathway is designed to address physician shortages in Virginia:

1. Eligibility: International Medical Graduates (IMGs) with ECFMG certification, licensed to practice abroad.
2. Exams: Must pass USMLE Steps 1 and 2.
3. Experience: Have at least 5 years of medical practice or completed a 3-year accredited international residency within the last 5 years.
4. Sponsorship: Need a recommendation/endorsement from a Virginia accredited medical school/hospital.
5. Supervision: Work under supervision for an initial 2 years, renewable for up to 2 more years (total 4) in designated medically underserved areas.
6. Full Licensure: After completing the 4 years of supervised practice, they may apply for full licensure, potentially substituting this for the standard U.S. GME requirement. 

Traditional Pathway (Standard Route)

1. ECFMG Certification: Obtain this certification by verifying credentials, passing      required exams (USMLE Steps 1, 2, 3), and demonstrating English proficiency.
2. U.S. Residency (GME): Complete an accredited U.S. residency program      (ACGME-approved).
3. State Licensure: Apply to the Virginia Board of Medicine for licensure, meeting all their specific requirements. 

 Wisconsin offers an IMG Provisional License pathway for International Medical Graduates, requiring an approved employment offer in a shortage area (like FQHCs/hospitals), ECFMG certification, USMLE Step 3 pass, 5+ years of practice abroad, and a 3-year restricted license under supervision, leading to full licensure after fulfilling specific terms, bypassing traditional US residency. The standard route still needs ECFMG certification and USMLE exams but focuses on U.S. residency, while this alternative addresses workforce gaps, so check the Wisconsin Medical Examining Board for exact details. 

Wisconsin's Provisional License Pathway (Non-Residency):

1. Employment: Secure a full-time job offer from an approved facility (FQHC, hospital, etc.) in a Wisconsin healthcare shortage area.
2. Education/Training: Hold an international medical degree and have completed a residency or equivalent postgraduate training.
3. Experience: Practice as a licensed physician in your home country for at least 5 years post-residency.
4. Certification/Exams: Obtain ECFMG Certification and pass USMLE Step 3.
5. License: Receive a 3-year renewable restricted license to practice under supervision in the designated facility.
6. Full Licensure: After fulfilling the supervised practice (typically 2-4 years), you can apply for a full, unrestricted license. 

Traditional Pathway (Requires U.S. Residency):

• This route involves ECFMG Certification (including passing USMLE Steps 1, 2, & 3, and English proficiency) and completing a U.S.-accredited residency program. 

Key Steps for IMGs:

• ECFMG Certification: The crucial first step, verifying your medical education and skills.
• USMLE Exams: Passing scores are required for both pathways.
• Wisconsin Medical Examining Board: Always consult their official website for      the latest requirements and forms.