08/09/2025
Without USMLE you can apply for the NORTH CAROLINA
Internationally-Trained Physician Employee License provision in North Carolina Senate Bill 336 (2025–2026 Session):
Internationally-Trained Physician Employee License – Key Provisions
Eligibility Requirements:
The North Carolina Medical Board may issue an “internationally-trained physician employee license” if the following conditions are met:
1. The physician has been offered full-time employment at either:
A licensed hospital in North Carolina, or
A rural medical practice (population < 500 people/sq mile), where a fully licensed NC physician practices on-site.
2. The physician holds an active or recently (within 5 years) expired medical license from another country.
3. They have completed 130 weeks of medical education from a school listed in the International Medical Education Directory and either:
* Completed **two years of postgraduate training**, or
* Practiced medicine for **at least ten years** post-graduation.
4. Demonstrated medical competence through one of the following:
* Passing each part of a North Carolina-approved exam (e.g., USMLE),
* Passing another internationally recognized exam with clinical, communication, and interactive components,
* Holding specialty board certification (e.g., from ABMS or Royal College of Physicians), or
* Completing a Board-approved clinical competency assessment.
* Alternatively, the Board may issue a temporary license and require passing the **Special Purpose Examination (SPEX)** within one year. (NO USMLE IS OK)
5. No history of disciplinary action, ongoing investigations, or criminal convictions related to medical practice.
6. At least five years of medical practice experience.
7. Proficiency in English.
8. Legal authorization to work in the U.S.; license may be applied for pre-authorization, but employment cannot begin until authorization is received.
Pathway to Full License:
After four years of active practice under this provisional license, the physician may apply for a full, unrestricted North Carolina medical license—provided there are no disciplinary actions, pending investigations, or criminal convictions (excluding minor traffic violations) during that period.
