This is a historic moment for international medical graduates (IMGs) aspiring to practice in the U.S. but fearing the residency match. Oregon is stepping up to provide a real option and I’m going to divide it down how it works, who qualifies, and what it means for your career.
Research Disclaimer: This blog’s content is based on Oregon’s legislation (SB 476) and the OMB’s updates as of March 2026. Specifics such as application fees are not yet finalized because the OMB is currently developing the final rules through mid-2026.
For decades, the avenue to practising in the United States for International Medical Graduates (IMGs) has been a single, narrow road: pass the USMLEs, endure an arduous residency match, and complete years of postgraduate training. But let’s be real, matching into a U.S. residency is cutthroat competitive, especially for non-U. S. citizens. It sidelines thousands of experienced physicians, despite the fact that they have been practising medicine safely for years in their home countries.
Oregon is leading the way on this. On the heels of Senate Bill 476 (2025), Oregon is paving a new journey for experienced international physicians to enter their healthcare workforce without repeating residency. This new law provides a provisional license for IMGs to practice medicine under supervision with a direct pathway toward full licensure. Let’s take a closer look at how this Oregon law works in practice.
Oregon’s new provisional license for internationally trained physicians is already enacted, but it becomes operative on January 1, 2027.
So, what did Oregon actually do? In July 2025, Governor Tina Kotek signed SB 476, a bold new law aimed at addressing the people gap in Oregon’s healthcare workforce. At the heart of this legislation is a new provisional license for Internationally Trained Physicians (ITPs).
This is not a loophole, it’s a program designed. The law provides for the Oregon Medical Board (OMB) to issue a provisional license to IMGs who qualify but have not yet completed their training and practised abroad. Rather than training as a resident, you would be employed by an Oregon health care facility (such as a hospital or clinic) and would practice under the supervision of a fully licensed physician in Oregon.
Consider it a paid, monitored acclimation period. You have a chance to do your job, you can show what you can do, and the state gets a much-needed physician. The law is now at the implementation stage. The OMB will be organising workgroup meetings throughout 2026 to finalise the rules on supervision standards and application processes. The good news? They will begin accepting applications on January 4, 2027.
This path isn’t for new graduates, it’s geared toward seasoned physicians. Though final rules have not yet been released, the law and guidance documents lay out the essence of what you need to do to qualify.
You should have completed your degree from an accredited international medical school. This often means that you must have a standard certificate with the Educational Commission for Foreign Medical Graduates (ECFMG).
You must complete residency, internship, or postgraduate clinical training outside the U.S.
And that training must be considered substantially similar to an approved U.S. training program.
You must hold a valid certificate from the Educational Commission for Foreign Medical Graduates (ECFMG).
You should have completed a training program in your country of origin that is analogous to a U.S. graduate medical education program. Plus, you have to demonstrate that you’ve been around the block, the law requires at least three years of medical practice abroad.
You must secure a written employment offer from an Oregon clinical facility, and that facility must agree to supervise and formally assess your performance.
You must show:
• Good moral character
• Good standing in every country or jurisdiction where you trained or practised
• No unresolved disciplinary issues.
Additional Requirements
That includes a comprehensive background check, credential verification and proof of English proficiency. All the usual Oregon Medical Board licensing rules must also be followed to protect patient safety.
Now that you have that provisional license in your pocket, what are you really allowed to do? The aim is to make you part of the health care team, not to sideline you.
You will be able to practice under the supervision of a licensed Oregon physician in approved practice settings, such as a hospital, academic centre, or community health organisation. You will be practising medicine, diagnosing patients and devising treatment plans.
IMGs have pretty flexible options as to where to work under Oregon’s Provisional license. These include:
This includes:
Examples in Oregon could include hospital systems affiliated with graduate medical education.
These centres serve underserved populations and primary care communities. The examples may include:
Oregon law leaves room for:
This is a provisional license, mind you, the first step. For most people, the end goal is full, unrestricted licensure, and Oregon has set forth a clear path to that destination.
After completing four years of supervised clinical practice on a provisional license, according to the Oregon Medical Board, you are eligible to apply for full medical licensure. This is the point at which you move from being a supervised physician to an independent doctor, treated no differently than any other doctor in the state.
Here’s how to get there: You must remain in good professional standing during those four years, comply with all supervision requirements imposed by the board (if it has any), and complete whatever final clinical assessments they require. This is an understatement of the importance. That opens the door to having a full, unrestricted U.S. medical license without ever having to repeat an internship or residency after only four years of working in Oregon. It’s a permanent solution that pays off on your experience.
Now, let’s discuss the practical stuff: money and career progression. And although there are no definitive answers regarding salaries for provisional license holders, we can shed light on the situation by looking at the market.
Since you’re practising as a physician (not a resident), your salary will be at the physician level. Generally speaking, estimates come out around $130,000 to $220,000 a year.
Speciality: There’s naturally a higher demand for facilities that require higher pay.
Location: Some rural and underserved regions in Oregon frequently pay doctors a sizable salary premium.
Facility: Different compensation scales exist between large health systems and smaller, rural clinics.
Rural Oregon often pays even better because of workforce shortages.
Typical benefits may include:
Oregon’s action is more than a state law, it’s a lighthouse of what the future of American health care might be. This is a radical change in opportunity for IMGs. It ends the monopoly of the residency match as the sole entryway into the American medical system.
This pathway values your experience. It argues that if you have been a practising physician for years, there’s no reason to restart the process. It’s a more effective method for fixing doctor shortages, especially in rural communities that have trouble attracting and keeping talent. With this on-ramp, Oregon is tapping a large pool of eager and qualified physicians waiting to serve. And they are not alone; this is a part of a larger national trend, with 18 states currently considering similar models.
This resource provides direct medical board application links and verified step-by-step instructions for IMG alternative licensure pathways across U.S. jurisdictions. Each entry includes the specific license type, responsible board, active application portal link, key eligibility notes, and a sequential how-to-apply guide sourced from official board documentation.
| Oregon | |
| License Type | IMG Qualified Health Care Professional License-SB 2023 |
| Licensing Board | Oregon Medical Board (OMB) — oregon.gov/omb |
| Application Link | oregon.gov/omb → Applicants → New License Applications |
| Key Eligibility Notes | Oregon’s Senate Bill opened a new pathway for qualified international health care professionals, including physicians. Requirements include substantially equivalent training and experience, foreign licensure in good standing, English proficiency, and employment in Oregon. |
| How to Apply — Steps | Step 1: Review the Oregon Medical Board applicant information at oregon.gov/omb/Applicants and confirm the specific application type applicable to international physicians under the enacted Senate Bill. Step 2: Confirm eligibility: completed substantially equivalent medical training, full foreign license in good standing, ECFMG certified, USMLE steps passed per Board requirement, English proficiency, employment offer in Oregon. Step 3: Apply online at oregon.gov/omb/Applicants/Pages/New-License-Applications.aspx. Select the appropriate physician license type. Step 4: Gather and submit: ECFMG certificate, USMLE transcripts, PGT documentation, home country license verification (sent directly from your licensing authority), medical school transcript, and employment offer letter. Step 5: Complete the Oregon background check (fingerprinting) as directed in the application instructions. Step 6: Pay the required application fee. OMB reviews and issues the license upon approval. |
| Quick Reference Links | |
| State Bill | OR Senate Bill — Press Release |
| Medical Board | Board Application Portal |
| FSMB Chart | FSMB IMG Licensure Pathways Chart |
Figuring out a new law, plus a new career path in the U.S, can feel isolating but you’re not alone. At IMG Helping Hands, we’re here to navigate the road just like you through every twist and turn of this journey.
We keep up with emerging opportunities like Oregon’s provisional license so we can help you determine whether you might qualify and how to prepare. We offer hands-on assistance with:
Navigating complex U.S. medical licensure pathways.
Connecting you with job portals and networks in the states that have alternative pathways.
Document, credential evaluations and applications preparation.
Interview coaching and US career planning
Start to prepare even before the rules are official. In Oregon, the application window will open in January 2027, if you’re thinking of applying, now is the time to start gathering your documents.
Contact IMG Helping Hands today. Together, let’s make your mission to practice medicine in the United States a reality.
Get our most valuable tips right inside your inbox, once per month!
