Developing a unified strategy to expand immigrant access to good jobs in health care requires a shared understanding of how licensure systems operate and where they are changing. Clear, consistent definitions and visibility into pathways for international medical graduates (IMGs), including internationally trained physicians (ITPs) are essential for aligning workforce, policy, and practice efforts across states.
This resource brings together two tools to support that understanding.
The Journey Map, featured on the first page, visually contrasts the conventional pathway for IMGs with the alternative pathway to licensure available in some states to internationally trained physicians (ITPs). IMGs must complete U.S.-based residency before licensure, while ITPs—already licensed and experienced abroad—may qualify for alternative pathways that recognize prior practice. The intention of this Journey Map is to serve as an educational tool to clearly differentiate and define these terms, which are often used interchangeably or confused, and to outline the steps involved in each distinct pathway to licensure in the U.S.
The second page features the Bill Comparison Chart, a simplified reference listing states that have enacted legislation creating alternative licensure pathways for ITPs. This chart provides an overview of where such laws exist and includes bill numbers for easy reference. It also serves as a starting point for understanding state-level activity and identifying where alternative pathways have been established.
These tools provide a structured framework that makes the licensure system easier to understand at a glance and highlight state-level efforts to strengthen pathways to support health care workforces, improve access to care, and make better use of existing talent already present in U.S. communities.
