Alleviating the Doctor Shortage with International Physicians

Morgan Lipman

Issue Areas

The United States is grappling with a worsening physician shortage, projected by the Association of American Medical Colleges to reach nearly 100,000 physicians by 2036. Internationally licensed physicians already possess a wealth of medical knowledge that could help bridge this gap and meet the needs of American patients today. However, these physicians cannot practice independently in almost every U.S. state without repeating residency programs that are expensive, lengthy, and redundant for their level of clinical experience.

The primary justification for U.S.-based residency requirements is simple: training in other countries is insufficient and repeating residency is the only way to ensure that international physicians are delivering quality care to American patients. While this is compelling in theory, the reality is that small programs already exist across the country that allow foreign-trained physicians to practice medicine in various capacities without U.S. residency, and outcomes are far from the healthcare calamity that proponents of these requirements would predict.

In 2021, California implemented its Licensed Physicians from Mexico Pilot Program (LPMPP), which allows the state medical board to issue up to 30 3-year, nonrenewable licenses to Mexican physicians. The program was intended to combat the shortage of Latino physicians in California’s rural areas and has strict requirements to ensure the delivery of quality care, requiring physicians to be licensed in their specialty in Mexico, pass a board review course, and complete a six-month orientation program. However, LPMPP participants need not repeat their residency and, upon issuance of their license, can immediately begin treating patients.

Preliminary evaluations of the program indicate that these physicians are integrating well and demonstrating a thorough understanding of California medical standards. Between August 2021 and May 2023, the LPMPP physicians completed 84,758 patient encounters and are producing patient satisfaction scores that surpass clinic targets. This program and its growing success demonstrate that physicians licensed abroad are capable of meeting American medical standards and providing quality care to the populations most affected by the expanding physician shortage, even without repeating their residency programs.

In addition to the LPMPP, California also offers a faculty license as a pathway to medical practice. This temporary medical license allows internationally trained physicians without a US-based residency to practice medicine while a member of a medical school’s staff. There are currently 26 active faculty licenses in California, and similar faculty licenses exist in many other states, including neighbors like Nevada and Arizona. California, Arizona, Kentucky, and Arkansas even allow faculty licenses to be converted to full, unrestricted licenses after a set time period.

These faculty licenses acknowledge that international physicians receive training in their home countries that equips them to both implement treatments and teach them to American physicians. Under such licenses, international physicians are already successfully practicing medicine at medical schools across the country, engaging with the community and molding the next generation of physicians to practice independently while being barred from doing so themselves. The success of California’s LPMPP and the widespread use of faculty licenses show that internationally trained physicians are knowledgeable, skilled professionals who already contribute to the American medical community, but most states are only scratching the surface of their potential. Wisconsin and 6 other states now offer a pathway to full licensure for foreign doctors, not only those from Mexico or on faculty at a university. More states should follow their lead and continue to open new pathways for physicians licensed abroad to bring quality medical care to vulnerable populations without requiring time-consuming, costly, and redundant training. Underserved communities don’t have time to waste waiting for American physicians that may never come. International physicians possess the necessary expertise to combat the physician shortage today, and it’s time for states to take full advantage.