The interstate medical licensure compact

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The interstate medical licensure compact


The Interstate Medical Licensure Compact is highly important for physicians. Often, physicians do not want to restrict their practice to just one state. Like other citizens, they want the freedom to move and expand their practice and skillsets in other states. However, for every state they practice in, physicians need a new license. For this reason, the Interstate Medical Licensure Compact is essential. The Compact is a formal agreement among participating U.S. states to streamline the licensing process for physicians who want to practice in multiple states. Participating in the Compact is entirely voluntary. Physicians who qualify are offered an expedited pathway to licensure. Thereby, they forgo the average lengthy amount of time and can practice sooner.

Why Participate in the Interstate Medical Licensure Compact?

Those who live in rural or underserved areas in the United States do not have regular healthcare access. It is often the case that they have a lengthy commute to their physician’s office or other obstacles preventing them from receiving quality care at an appropriate time. For this reason, the Compact aims to increase access to health care – particularly for patients in rural or underserved areas. The Compact extends a physician’s reach, improves patients’ access to medical specialists, and utilizes new medical technologies, like telemedicine. Additionally, the Compact allows states to share investigative and disciplinary information about their physicians. Due to this embedded feature, the Compact strengthens public protection and ensures each participating physician is of the highest quality.

According to the Interstate Medical Licensure Compact website, the Compact currently includes 29 states, the District of Columbia, and the Territory of Guam. Here is an interactive map of the territories under the Compact. 43 different medical and osteopathic boards in these jurisdictions provide licenses to physicians. Other states are currently in the process of introducing legislation to adopt the Compact.

How Does the Interstate Medical Licensure Compact Work?

Physicians who wish to practice medicine across state lines must first check if they meet the Compact’s eligibility requirements. If they are eligible, they can qualify to practice medicine in multiple states by filling out just one application. Once reviewed and approved, this simple procedure gives the physician separate licenses for each state in which they intend to practice medicine.

Just as with the standard licensing process, each individual state issues a license. But because the application is routed through the Compact, the overall process of receiving a license is streamlined. Consequently, physicians receive their licenses much quicker and with fewer burdens.

Although physicians may receive all their licenses at once, each license is still state-based. To clarify, the Commission does not issue a “Compact license” or one nationally recognized medical license for physicians. Accordingly, each physician must have a specified license from each state.

Only states that have formally joined the Compact can participate in this streamlined licensure process. However, to participate in the Compact, states must pass legislation authorizing it.

How Does the Compact Streamline Licensure?

Physicians that want to participate in the Compact must first submit their SPL or State of Principal License. The SPL is the physician’s full and unrestricted medical license for the state where they currently practice. To obtain licenses for other states, the physician must designate an SPL and complete an application. Afterward, they will receive a formal Letter of Qualification from that state. This letter verifies that the physician meets the Compact’s strict eligibility requirements. States that take part in the Compact streamline licensure by using expedited information-sharing. One component of this shared information includes whether physicians have previously submitted in their State of Principal License. If they have, states can quickly confirm whether the physician meets the requirements for another license.

Eligibility Requirements for Physicians Who Want to Participate in the Compact

To participate in the Compact, physicians must first possess a full, unrestricted medical license in a Compact member-state. This license will serve as the aforementioned declared State of Principal License (SPL). Following this, physicians will need to designate a state as an SPL. As taken from the Interstate Medical Licensure Compact (IMLC) website, physicians must ensure at least ONE of the following apply:

  • The physician’s primary residence is in the SPL
  • At least 25% of the physician’s practice of medicine occurs in the SPL
  • The physician is employed to practice medicine by a person, business, or organization located in the SPL
  • The physician uses the SPL as his/her state of residence for Federal Income Tax purposes

It should be noted that the State of Principal License has the proper information and authority to determine if a physician meets the qualifications above.

Additionally, physicians must meet the following criteria as declared by the IMLC:

  • Have graduated from an accredited medical school or a school listed in the International Medical Education Directory
  • Have successfully completed ACGME- or AOA-accredited graduate medical education
  • Passed each component of the USMLE, COMLEX-USA, or equivalent in no more than three attempts for each component
  • Hold a current specialty certification or time-unlimited certification by an ABMS or AOABOS board
  • Not have any history of disciplinary actions toward their medical license
  • Be entirely clear of any criminal history
  • Be completely free of any history of controlled substance actions toward their medical license
  • Not currently be under investigation

Additional Compact Application Requirements

Physicians must pay a $700 non-refundable fee when they fill out a Compact application. In addition to the expense, they must submit their fingerprints to the designated criminal justice agency in their SPL. These elements are required to conduct a criminal background check on each applicant. Rest assured, each physician that participates in the Compact and obtains multiple licenses is a physician truly worthy of providing top-quality care.

The Compact treats all physicians equally, regardless of specialty. Moreover, any physician who meets the stringent requirements is eligible to participate and is responsible for obeying all state laws.

How do States Join the Interstate Medical Licensure Compact?

If a state chooses to join the Compact, it must first pass legislation. The state’s legislature must enact a bill authorizing the state to join. The language of the Compact must be consistent and apply to each state that enters the agreement.

States that participate in the Compact make an informed and definitive decision to accept the terms of the Compact. This is made possible by the formal legislation that adopts the Compact’s Terms and Conditions and signs it into law.

In conclusion, the Interstate Medical Licensure Compact is a useful agreement that helps physicians expand their reach to those who are in need of their care.


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Works Cited

“Physician License.” Interstate Medical Licensure Compact, 2020 Interstate Medical Licensure Compact, 26 Oct. 2020,