Interstate Medical Licensure Compact states

The Interstate Medical Licensure Compact is a voluntary expedited pathway for qualified physicians to obtain separate licenses from participating state boards. It requires a qualifying State of Principal License and Letter of Qualification and does not cover NPs or PAs.

Separate licenses, not one national license

Applications go through the Compact. Each chosen state must participate, and each state board issues its own license.

As stated on imlcc.com, approximately 80% of U.S. physicians meet the criteria, the Compact includes 37 states, DC and Guam, and it has been operational since April 2017. Check the site for the current list. This pathway covers MD and DO physicians only, not NPs or PAs.

State of Principal License and Letter of Qualification

Apply for a Letter of Qualification (LOQ) through a State of Principal License (SPL). Without an SPL and LOQ, there is no Compact license. You must hold a full, unrestricted license in a Compact state and meet at least one of these SPL connections:

  • Your primary residence is in the SPL.
  • At least 25% of your practice occurs in the SPL.
  • Your employer is located in the SPL.
  • The SPL is your state of residence for U.S. federal income tax purposes.

Maintain SPL status. You may redesignate the SPL to another participating state for which you qualify. If you no longer qualify for an SPL, all Compact licenses are terminated.

Check general eligibility before applying

  • Graduate from an accredited medical school or one listed in the International Medical Education Directory.
  • Complete ACGME- or AOA-accredited graduate medical education.
  • Pass each USMLE, COMLEX-USA or equivalent component in no more than three attempts per component. The LMCC does not meet this requirement.
  • Hold current specialty certification or time-unlimited certification from an ABMS or AOABOS board.
  • Have no medical-license disciplinary history, criminal history or controlled substance actions on a license.
  • Not be currently under investigation.

Physicians self-determine eligibility before applying. Application fees are non-refundable, so check eligibility first.

Application steps

  1. Confirm eligibility.
  2. Apply online through the Compact.
  3. Receive the LOQ.
  4. Choose participating states.
  5. Pay each state’s license fee.
  6. State boards issue the licenses.
  7. Respond to additional information requests from a state board.

Adding states and renewing licenses

You can add states while the LOQ is unexpired. LOQs are valid for one year.

Each state sends a renewal notice, but you are responsible for knowing renewal dates and fees. Renew Compact licenses through the Compact website.

Frequently asked questions

Does the Compact issue one license for all states?

No. Each chosen participating state issues a separate license through its own board.

Can an NP or PA use this pathway?

No. The Compact pathway described here covers physicians with MD or DO qualifications only.

What happens if I no longer qualify for an SPL?

If you no longer qualify for a State of Principal License, all Compact licenses are terminated. You may redesignate to another participating state for which you qualify.

Can I add states after receiving my LOQ?

Yes, while the LOQ remains unexpired. LOQs are valid for one year.

Sources

General information, not legal, tax or insurance advice. Confirm details with the source and with your state board, employer or insurer.

Additional state license checklistMulti-state physician licensing