Home » IMGs May Not Need to Complete Their Residency in the US to Work in Tennessee

IMGs May Not Need to Complete Their Residency in the US to Work in Tennessee

8 min


Two IMGs in a hospital working in the US after bypassing US residency.


As of May 2023, the governor of Tennessee signed a bill that will allow some international doctors to bypass the need for a residency in the US to practice unsupervised medicine in Tennessee if they have already completed one abroad. In this blog post, we will address some key questions related to this new law, including its impact on international medical graduates (IMGs) who want to work in the US. We will discuss eligibility criteria, how to apply under these new pathways in Tennessee, and the possibility of other states following Tennessee’s example.


For more information regarding IMGs and US residency, see the following blog posts:

2023-2024 Match Cycle Residency Application Timeline

Residency Application Timeline for IMGs

Top Most IMG Friendly Residency Specialties

Things IMGs Can Do to Improve Their Chance of US Residency Matching

5 Things US IMGs Should Know When Applying to Residency


What Does This Mean for IMGs?


The newly enacted Tennessee law, HB1312, enables IMGs who have passed all three USMLE steps and completed a residency abroad to obtain a provisional medical license in Tennessee. While this does not mean you will be able to practice medicine unsupervised right away, it will allow IMGs to bypass the 3-7 year residency requirement and application in the US. Instead, IMGs will need to complete two years of supervised practice at a Tennessee hospital with an accredited residency program before receiving an unrestricted medical license.


This law was introduced in response to the severe shortage of physicians in the US. A 2020 paper published by Human Resources for Health predicted a shortfall of nearly 6,000 physicians in Tennessee by 2030. Along with the record match rate for IMGs into a US residency during the 2023 match cycle, this law may indicate a more IMG-friendly approach in US hospitals.


Are Other States Likely to Allow IMGs to Bypass US Residency as Well?


As the first of its kind in the United States, this law aims to remove barriers for foreign doctors and address the worsening physician shortage nationwide. Whether other states will follow Tennessee’s lead in allowing IMGs to bypass US residency training remains uncertain. Each state has its own licensure requirements and processes, leading to varying perspectives on this subject.


We can expect states across the US, particularly those with severe physician shortages or large underserved populations, to closely monitor the impact of Tennessee’s law. If the law proves successful in improving healthcare access and attracting qualified doctors globally, other states may be more inclined to adopt similar measures.


Who Is Qualified to Bypass US Medical Residency as an IMG?


According to the new Tennessee law, HB1312, international doctors and surgeons can apply to work in Tennessee by submitting a written application to the board of medical examiners.


To qualify, IMGs must meet the following requirements:


  • Be an IMG from an ECFMG-accredited school.
  • Pass all three USMLE Steps.
  • Completed an accredited medical residency abroad or have legally practiced medicine and held a valid medical license for at least three of the past five years.
  • Be a legal US citizen, permanent resident, or legally entitled to live or work in the US (e.g., have a legal visa with a work permit), OR be sponsored and employed by a Tennessee healthcare provider that also trains residents.
  • Demonstrate basic fluency in English.
  • Provide evidence of an offer of employment from a Tennessee health provider operating an accredited residency program. Yes, you need to have a job offer before applying for the provisional license.


What Do You Need to Apply?


Applications can be submitted online at the Board of Medical Examiners website. You can find this, and other forms here. You will also need to request official verification of your Tennessee provisional license by emailing [email protected], and pay a $400 fee for the provisional license. The application must include the following documents:


  1. A certificate from a medical school with an acceptable curriculum, as judged by the board.
  2. A copy of a permanent ECFMG certificate.
  3. A non-refundable application fee.
  4. Sufficient evidence of good moral character, such as recommendation letters and proof of ethical conduct in medical practice.
  5. Evidence of US or Canadian citizenship or legal entitlement to live and work in the US.
  6. Evidence of satisfactory completion of a three-year post-graduate training program approved by the American Medical Association.


The Bottom Line


The new HB1312 presents an intriguing opportunity for IMGs to practice medicine in the US. It is difficult to predict how many positions will be filled through this new pathway. However, this law reflects an interest in attracting talented doctors from around the world to address the physician shortage.


If this law proves successful, it may encourage other states to adopt similar policies, thus offering more opportunities for IMGs in the US.

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