If you’re an International Medical Graduate (IMG), you’ve probably been told that the only way to work as a doctor in a U.S. hospital is to get a residency there. We learn it over and over again. But what if I told you that isn’t completely true?
Getting into a residency program is the most common goal, but it’s not the only way to start your medical career in the U.S. right now. Indiana is one of the states that offers other ways to get there. Indiana allows IMGs to work as supervised, institutional doctors without having to complete a full U.S. residency first.
These aren’t just shadowing jobs but paid jobs that give you real clinical experience, a way to make money, and a chance to meet U.S. doctors. Don’t think of it as a diversion; think of it as a step up. You can keep practising medicine while you work on your residency application for the future.
Let’s look at how the Indiana Limited License pathway works and how IMGs might use it to their advantage.
So, what does it mean to have a “Limited License” in Indiana? It’s not a way to become full-fledged attending, but it is a legal way to practice medicine in a certain area.
A Limited License Physician in Indiana is a doctor who can only practice in a specific setting, such as a university, teaching hospital, or research facility. You aren’t starting your own private practice. Instead, you work for an organisation to do a certain job.
The Indiana Professional Licensing Agency (IPLA) gives out this license, which is directly related to your job. It lets IMGs:
Get structured, hands-on clinical experience while being watched.
Take part in research or academic medicine in a meaningful way.
Work for approved organisations where your job is clear.
You have a restricted license, which means that you are always under the care of a fully licensed doctor, but you are not just watching; you are also working.
You might be thinking, “Is this really legal, or is it a way to get around the law?” It’s completely legal, and the Indiana Code says so.
The Indiana Medical Licensing Board is responsible for issuing medical licenses in Indiana. The Board can give out different kinds of licenses based on an applicant’s qualifications, according to Indiana Code Title 25 Article 22.5. Section 25-22.5-2-7 says that the board can “issue an unlimited license, a limited license, or a temporary medical permit, depending on the applicant’s qualifications.”
There are a few good reasons for these laws:
Addressing Physician Shortages: It lets hospitals fill certain supervised roles in areas where they are most needed.
Helping Education: Teaching hospitals can hire people from other countries for fellowships or research.
Integration: It gives IMGs a legal way to join the system while keeping patients safe by requiring strict supervision.
As you gain experience, the law requires that a U.S.-licensed doctor always be present to supervise patient care.
What Indiana is basically saying:
“If you’re an experienced international physician with strong recent practice, completed training abroad, and are willing to serve an underserved community under supervision, you may qualify for a limited license and potentially full licensure after five years.”
Eligibility Requirements for IMGs
You can’t just get this license; you have to meet certain requirements. Here are the things that IMGs usually need to meet:
Education and a medical degree
You need to have an MD or a degree equivalent to an MD from a well-known international medical school.
Check Credentials
The Educational Commission for Foreign Medical Graduates (ECFMG) will probably need to give you a certificate. This shows that your education meets U.S. standards.
You must have certification from the Educational Commission for Foreign Medical Graduates. This confirms your education and exam equivalency.
You must:
You must complete residency, internship, or postgraduate clinical training abroad.
And it must be considered substantially comparable to training accredited by the Accreditation Council for Graduate Medical Education (ACGME).
You must have practised medicine: At least 5 of the last 6 years
This is one of the strictest “recent practice” requirements in the U.S. If you have long clinical gaps, Indiana may not be a fit for you.
You must already have federal immigration/work authorization.
You must demonstrate English fluency.
Institutional Sponsorship (The Most Important Step)
You can’t get this license on your own. You need a job offer and sponsorship from a hospital or university in Indiana that meets the requirements. They are your sponsor.
Need for supervision
You must agree to work under the supervision of a fully licensed doctor who is in charge of the care of the patients.
The Application Itself
Once you get the job, the institution helps you with the application process, which includes background checks and document verification through the IPLA.
Where IMGs with a Limited License Can Work in Indiana
Under Indiana’s limited licensure pathway, IMGs can work only at board-approved healthcare facilities located in medically underserved areas designated by the Indiana Department of Health. These include:
Examples:
Examples:
Examples:
This may include:
Let’s talk about cash. Your pay structure is different because you don’t live here, but that doesn’t mean you’re not getting paid. These jobs are real and pay real money.
Salaries vary a lot depending on the school and your job, but here are some reasonable estimates for 2026:
Research Physician Roles: These jobs usually pay between $60,000 and $85,000 a year. These are great if you want to write and add to your academic CV.
Clinical Fellow or Supervised Physician: If your job involves taking care of patients directly (like a clinical fellowship), you can expect to make between $70,000 and $110,000.
Academic Physician Roles: If you work as a junior faculty member or an instructor with clinical duties, you can expect to make between $80,000 and $120,000.
The financial benefits are huge, in addition to the base salary:
Health insurance: Most of these jobs in institutions come with full benefits.
Visa Sponsorship: Some schools may help you get a J-1 or H-1B visa for these jobs.
Networking: You’re getting paid to make connections that could help you get residency letters of recommendation.
Why bother looking for this specific license? Because the benefits are much more than just a pay cheque.
You go from being an outsider to being an insider. You learn how the U.S. healthcare system works from the inside out, like how teams work, how to make charts, and how to talk to patients.
You will work with American doctors who can later be your mentors, advocates, and references for your residency application.
Think about how much better your application to Match would be if you had a year of paid clinical work in the U.S. under your belt. It shows that you are dedicated, capable, and know how the system works. It makes you a person people know.
This is the most important one. You’re getting paid and gaining experience at the same time, so you don’t have to spend all your savings on unpaid observerships.
You can add publications and conference presentations to your CV before you even start residency if you have one of these jobs that lets you do research.
I’m not going to make it sound better than it is; this path has its own problems. It’s not a quick fix, so you should know what you’re getting into.
It’s not independence; the limited license is just that, limited. You can’t bill on your own, and you can’t work outside of your sponsoring institution.
Job-Dependent: You can only work if you have that job. Your license will basically go dormant until you find another sponsor if the position ends.
Temporary Nature: A lot of these jobs are meant to be fellowships or short-term academic positions. You need to see it as a stepping stone, not the end of the road.
Different Requirements: Each school may have its own rules in addition to the ones set by the state.
Plan ahead. Think of this as a plan to get ready for the Match or a long-term career over the next two to three years.
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.
| Indiana | |
| License Type | IMG Provisional License — Substantially Similar PGT Pathway (IC 25-22.5-5-7) |
| Licensing Board | Indiana Medical Licensing Board / Professional Licensing Agency (PLA) — in.gov/pla |
| Application Link | in.gov/pla → Physicians → Licensing Information |
| Key Eligibility Notes | IMGs who completed a residency or PGT that is substantially similar to ACGME-accredited training, hold ECFMG certification, and have a full foreign license in good standing may apply for Indiana licensure. All three USMLE steps required before a license is issued. |
| How to Apply — Steps | Step 1: Confirm eligibility: graduated from a recognized medical school, completed substantially similar PGT to an ACGME-accredited residency, ECFMG certified, full foreign license in good standing with no pending discipline, all three USMLE steps passed (or Step 3 pending — license will not issue until passed).Step 2: Request a letter of good standing (license verification) from your home country licensing body sent directly to: pla3@pla.in.gov.Step 3: Apply online through PLA Online Services at in.gov/pla/license/ — select ‘Apply for a New License’ and choose Physician (MD) or Osteopathic Physician (DO).Step 4: Complete the FSMB Uniform Application for Physician State Licensure (UA) at fsmb.org/uniform-application/ and direct it to Indiana, or complete the Indiana-specific paper application (download from in.gov/pla).Step 5: Submit all required documents: ECFMG certificate, medical school diploma, USMLE transcripts (all steps), PGT verification from each program, NPDB Self-Query, home country license verification, and the $250 application fee.Step 6: Each PGT program must independently verify training dates directly to the Indiana PLA.Step 7: Board reviews; if your medical school or PGT program is not on the approved list, you will be notified and may need to appear in person before the Medical Licensing Board of Indiana. License issues once all three USMLE steps are confirmed passed. |
| Quick Reference Links | |
| State Bill | IN HB 0368 — Bill Text |
| Medical Board | Board Application Portal |
| FSMB Chart | FSMB IMG Licensure Pathways Chart |
Are you feeling overwhelmed? You don’t have to do this by yourself. At IMG Helping Hands, we help IMGs find their way through these exact non-traditional paths.
We know that the hardest part is finding a job that will pay for your schooling. We can help you in the following ways:
Pathway Guidance: We help you figure out if the Indiana Limited License is a good fit for your background and career goals.
Getting Opportunities: We help you find and apply for research jobs, clinical fellowships, and other positions that usually offer this kind of sponsorship.
U.S. Clinical Rotations: We can help you get the initial U.S. experience you need to qualify for these jobs.
Mentorship: We put you in touch with doctors who have been through this and know all the details.
Building Your CV and Profile: We help you make your CV stand out to U.S. colleges and universities that want to hire international students.
Don’t wait for the perfect residency match to come to you. Let’s start now to build a structured way into the U.S. system.
You don’t always have to go through the NRMP Match to become a doctor in the U.S. Indiana has a unique, legal, and useful way for IMGs to start working in supervised medical jobs without first completing a residency.
These chances give you something very important: momentum. You get the money, the clinical experience, and the professional contacts that can help you get a full, unrestricted licence in the future. The Indiana Limited License won’t take the place of residency, but it can definitely help you get there.
At IMG Helping Hands, we believe IMGs should know about every legitimate pathway that can help them progress in the U.S medical system. Understanding opportunities like this can make a big difference in turning your plans into reality.
If you’re ready to stop waiting and start working toward your dream of becoming a doctor in the U.S, look into this path. Ask for help early, make a plan, and take that first step.
Good luck!
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