A move is underway to expand doctor supply by cutting licensing barriers

By HPN Staff

Sixteen states are considering legislation to ease licensing requirements for physicians trained abroad to address persistent shortages, particularly in rural and underserved communities. The proposals follow a five-year trend in which at least 18 states passed similar measures. Supporters say the changes would allow highly skilled foreign-trained physicians to enter the workforce more quickly, reducing regulatory friction while maintaining professional standards.

Lawmakers and advocates say tapping an existing pool of trained physicians could expand access to care faster than relying solely on domestic training pipelines, which can take years to produce new physicians.

Why it matters

Foreign-trained physicians are more likely than U.S.-trained physicians to work in lower-income and disadvantaged communities, making them a key resource for expanding access. The legislation targets physicians who meet strict residency and credentialing requirements, closely mirroring the standards that U.S.-trained physicians must follow in their credentialing process.

The bills have drawn support from conservative groups, trade associations and lawmakers across the aisle, reflecting broad agreement that reducing unnecessary regulatory barriers can increase physician supply efficiently. Advocates say such measures can help address critical shortages without compromising the quality of care.

By simplifying the licensing process, states can more fully utilize highly skilled professionals already in the United States but unable to practice under current regulations. The approach allows markets to respond more quickly to local health care needs while maintaining professional oversight.

However, the National Institutes of Health says there are challenges ahead. These programs can draw physicians from other countries who are already in need of doctors, and NIH suggests that the U.S. develop domestic recruitment. NIH also advocates for transparency with patients regarding a foreign doctor’s background.

The bigger picture

The effort to streamline licensing comes amid ongoing workforce challenges in U.S. health care. Hospitals and clinics continue to face staffing shortages, highlighting the uneven distribution of labor in the industry. Surveys indicate high levels of burnout and job dissatisfaction, with many health care workers considering leaving their roles, further straining the system.

Rural health care faces particular pressures. Rural hospitals carry an outsized share of the nation’s medical needs, making up about one-third of community hospitals, while fewer than 10% of U.S. physicians practice in rural areas. Since 2015, at least 108 rural hospitals have closed or ended inpatient care, and nearly half of those still operating run at a loss. Geographic isolation, aging infrastructure and workforce shortages make it difficult for rural residents to get timely care, leaving many communities without consistent access to primary care, specialty services or coordinated support.

By reducing licensing barriers, states hope to increase the number of qualified physicians in areas where traditional recruitment pipelines have struggled. The effort targets communities most at risk of losing access to essential care while allowing markets and state systems to deploy trained talent more efficiently.