International Medical Graduates: Time to Move!

I quipped in an earlier post about how "...my doctor friends used to complain about tech guys getting to travel and take their work anywhere. It's your decade now!" I really do mean that. Not in the digital nomad sense of popping over to different countries every 3 months, but you have way more options now than you did before.

For decades, the assumption was that you trained in your country, got the best education possible, took board exams, and then were locked in forever to practicing in that country. But the pillars holding up this model are slowly cracking. Labor shortages are the biggest reason why, and something I've harped on as a secular force pushing global mobility forward no matter the political climate. Remote healthcare, popularized during the pandemic, is another big development.

Another crack for inbound physicians to the US appeared in an issue brief published by the American Medical Association in October discussing International Medical Graduates (IMGs). The brief mentions they now make up 25% of the US physician workforce, concentrated heavily in rural and underserved areas.

Seventeen states have recently passed laws creating alternative pathways for internationally trained physicians to get licensed without completing US residency. This is the first real structural challenge to the physician licensing bottleneck in decades.

What's Changing

The traditional pathway forces everyone through US residency matching. US medical school graduates match at 93.5%. Non-US citizen IMGs match at 58.5%. That's one of several chokepoints keeping the US medical supply constrained for 50+ years. These new state laws let you bypass it.

Train abroad, complete residency abroad, practice abroad, then enter the US workforce through a provisional license. No US residency match required. Most states require graduation from "substantially similar" programs, 3+ year international residency, some years of practice experience abroad, passing all USMLE steps, ECFMG certification, and a job offer in underserved areas in hand. Assuming you've got all that, you'll receive a provisional license with supervision and can convert to a normal license after your state board approves.

Who This Actually Serves

I've seen some takes on TikTok (with dozens of kids in the comment section) encouraging US high schoolers to go abroad for med school to take advantage of this "financial loophole." This is risky and complicated. These laws were designed for experienced foreign physicians, not as a backdoor for Americans avoiding US medical school costs. That said, if you were already genuinely planning to build a career abroad and want optionality to return later, these pathways just opened doors for you in ways you didn't have before.

But, and this is a huge but, you're betting on regulations that might not exist or may undergo significant revision by the time you finish. If you're a high schooler or collegiate sophomore considering this route, talk to immigration lawyers and education consultants who specialize in international medical careers, not randos from TT (or me for that matter).