Doctors: What to Know About the Interstate Medical Licensure Compact (IMLC)

On April 6, 2017, the Interstate Medical Licensure Compact (IMLC) began issuing Letters of Qualification to doctors to allow them to practice in multiple states. This Compact provides a path for qualified doctors to expedite their state licensure and allow them to start practicing in new states and areas in need sooner.

There are currently a total of 22 states that are part of the IMLC. Read on to learn more about the Compact, whether or not you can qualify, and what states the IMLC is currently live in.

Background on the IMLC

The IMLC was created by a group of state medical board executives, administrators and attorneys in 2014 with the ultimate goal of increasing access to healthcare for patients in underserved or rural areas.

By making it easier for doctors to gain multiple-state licenses, it also would make it easier for these doctors to connect to patients in need through things like locum tenens work and telemedicine.

What Are The Qualifications?

For a doctor to be licensed through the compact, they must meet a series of requirements:

  1. You must hold a full, unrestricted medical license in a Compact Member State that are available to serve as an State of Principal Licensure (SPL) AND at least one of the below must apply:
    • Your primary residence is in the SPL (State of Principal Licensure)
    • At least 25% of your practice of medicine occurs in the SPL
    • Your employer is located in the SPL
    • You use the SPL as your state of residence for U.S. federal income tax purposes
  2. Have graduated from an accredited medical school, or a school listed in the International Medical Education Directory
  3. Successful completion of ACGME or AOA accredited graduate medical education
  4. Passed each component of the USMLE, COMLEX-USA, or equivalent in no more than three attempts
  5. Hold a current specialty certification or time-unlimited certification by an ABMS or AOABOS board
  6. Must not have any history of disciplinary actions toward your medical license
  7. Must not have any criminal history
  8. Must not have any history of controlled substance actions toward your license
  9. Must not currently be under investigation

As stated in the requirements, doctors must claim a state of principal licensure (SPL). This state must meet one of these four requirements:

  1. Doctor lives within the state
  2. At least 25% of the doctor’s business is conducted in the state
  3. Doctor designates the state as state of residence for federal income tax purposes
  4. The doctor’s medical employer is located in the state.

Doctors may be asked to prove that one of these requirements is met if it isn’t clear within the application.

The doctor’s selected SPL is responsible for reviewing the doctor’s application and issuing a Letter of Qualification (LOQ) to the Commission if the doctor qualifies. The doctor is then notified and selects the states within the Compact that they wish to be licensed. Those states then issue a license upon receiving the LOQ.

Where Does Your State Stand?

There are a number of states involved with the IMLC, but their status determines whether or not your SPL can help you qualify. There are five different statuses a state can fall into:

  • IMLC Member State serving as SPL processing applications and issuing licenses: These are the states doctors can claim as an SPL to qualify for the IMLC. The state will also be responsible for conducting the process of verification of the doctor’s qualifications.

  • IMLC Member State non-SPL issuing licenses: These states cannot be claimed as SPLs, but can issue licenses for doctors who have received a letter of qualification from an SPL state.

  • IMLC Passed; Implementation Delayed: These states have passed the necessary legislation to join the IMLC but have not yet implemented it or begun issuing licenses to interested doctors. Reach out to the respective state board if you have questions.

  • Compact Legislation introduced: These states have begun the process of introducing legislation to join the IMLC and it is being processed.

  • State Not in the IMLC: These states are not part of the IMLC and do not have legislation in process to join the IMLC.

Here is where each state stands as of May 8, 2018. You can also see the status of your state on this map created by the IMLC Commission.

IMLC Member States serving as SPL processing applications and issuing licenses:

  1. Alabama
  2. Arizona
  3. Colorado
  4. Idaho
  5. Illinois
  6. Iowa
  7. Kansas
  8. Maine
  9. Mississippi
  10. Montana
  11. Nebraska
  12. Nevada
  13. New Hampshire
  14. South Dakota
  15. Washington
  16. West Virginia
  17. Wisconsin
  18. Wyoming

IMLC Member States non-SPL issuing licenses:

  1. Minnesota
  2. Utah

IMLC Passed; Implementation Delayed states:

  1. Pennsylvania
  2. Tennessee

Compact Legislation Introduced States:

  1. District of Columbia (DC)
  2. Georgia
  3. Kentucky
  4. Maryland
  5. Michigan
  6. New York
  7. South Carolina
  8. Vermont
  9. Guam*

States Not in the IMLC:

  1. Alaska
  2. Arkansas
  3. California
  4. Connecticut
  5. Delaware
  6. Florida
  7. Hawaii
  8. Indiana
  9. Louisiana
  10. Massachusetts
  11. Missouri
  12. New Jersey
  13. New Mexico
  14. North Carolina
  15. North Dakota
  16. Ohio
  17. Oklahoma
  18. Oregon
  19. Rhode Island
  20. Texas
  21. Virginia

*Guam is the only US Commonwealth and Territory currently involved in the IMLC.

If you have questions about the specific status and extent of each state’s participation in the IMLC, the best way to find out more is to reach out to the respective state boards. Here is a list of their contact information for your reference.

The IMLC FAQs are a helpful resource if you have questions.

If you have any additional questions on working in multiple states, feel free to reach out to the Nomad Navigators.

If you’ve already joined Nomad, begin your search for jobs in IMLC states here!

If you haven’t yet registered for Nomad, join here for free! Then you can begin your search instantly.

We’re very excited about the IMLC and their mission to ease the process of providing care to those who need it in underserved areas. This is a vital step in addressing the growing problem of clinician shortages.

Wishing all of our doctors the best of luck with their job search!


The Nomad Team

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