Credentialing & Financial Resources

What you need to know about the Interstate Medical Licensure Compact

Image of the United States with a red ribbon and the number 40

Updated April 11, 2024.

The Interstate Medical Licensure Compact is an agreement between its member states to expedite and streamline the state licensing process for physicians. It helps doctors obtain medical licenses in other states faster and with less hassle. This is especially helpful for those who work locum tenens in multiple locations and tend to accumulate multiple state licenses. Here’s what you need to know about IMLC licensure.

The IMLC simplifies the process of working in multiple states

The IMLC is great for patients because it makes it easier for physicians to come to their state and practice medicine. This is especially true for patients in underserved areas, where the hospitals and clinics may rely heavily on locum tenens physicians. From a doctor’s perspective, the IMLC also makes taking on assignments in these locations more attractive because there’s less administrative hassle.

For example, Dr. Siamak Karimian has been working as a full-time locum tenens physician for more than 15 years. He holds medical licenses in more than 30 states. Most of these licenses he obtained on his own before the IMLC even existed. But for the last two or three licenses, he followed the pathway made possible by the compact, describing the process as “a piece of cake” in comparison to figuring things out on his own.

When physicians work with Weatherby, your recruiter may be able to help you obtain a license through the IMLC. This license allows you to work assignments in new states faster.

Which states belong to the IMLC?

The IMLC currently has 40 states as members, plus Washington D.C. and the territory of Guam. Not all of the members participate in the IMLC to the same extent, so be sure to note the differences.

Map of IMLC member states

Member states that have implemented the IMLC 

  • Alabama*
  • Arizona
  • Colorado
  • Connecticut*
  • Delaware
  • District of Columbia
  • Georgia
  • Guam
  • Idaho
  • Illinois
  • Indiana
  • Iowa
  • Kansas
  • Kentucky
  • Louisiana
  • Maine
  • Maryland
  • Michigan
  • Minnesota
  • Mississippi
  • Montana
  • Nebraska
  • Nevada
  • New Hampshire
  • New Jersey
  • North Dakota
  • Ohio
  • Oklahoma
  • South Dakota
  • Tennessee
  • Texas
  • Utah
  • Vermont*
  • Washington
  • West Virginia
  • Wisconsin
  • Wyoming

*Alabama, Connecticut, and Vermont are not currently “States of Principal Licensure” (SPL). This means you can get a license issued for these states through the compact when you qualify through another SPL, but none of these states qualify as an SPL for licensing in other states.

What to know: Physician tips: What it takes to get licensed in a new state as a locum

Member states in the process of implementation

Member states who have passed IMLC licensure legislation, but implementation is either in process or delayed:

  • Florida
  • Hawaii
  • Missouri
  • Pennsylvania
  • Rhode Island

States that have pending IMLC legislation

States must pass legislation to join the IMLC, and three more states currently have legislation related to the IMLC pending:

  • Massachusetts
  • New York
  • North Carolina

States that are not members of the IMLC

With so many states involved to one degree or another, it might be easier to keep track of the eight nonmember states:

  • Alaska
  • Arkansas
  • California
  • New Mexico
  • Oregon
  • South Carolina
  • Virginia

Keep in mind that these states could introduce legislation to join at any time, so if you’re licensed in one of these states, it doesn’t necessarily mean you’ll never have the option to join the IMLC.

State of principal licensure

A state of principal licensure is the state where the physician holds a medical license and is the physician’s primary state of residence. When applying to the compact, this state will verify your qualifications and eligibility and issue a letter of qualification on your behalf.

When you apply to the IMLC, you’ll need to identify your SPL. If your medical license is held by one of these three states, you cannot join the compact using that state license:

  • Alabama
  • Connecticut
  • Vermont

However, if your state of principal licensure is another compact member state, you can obtain a medical license for any of these three states through the compact.

IMLC application process

All physicians who want to use the IMLC must obtain a letter of qualification (LOQ) from their SPL. Note that the process takes some time and requires a background check. Depending on the state, it can take a couple of weeks to several months to receive your LOQ.

If you don’t already have an LOQ, it may make more sense to apply for a state license directly instead of going through the Compact. For example, if you’re a Wisconsin-based physician who wants to practice in Montana, you’d need to wait four to six months for your LOQ and then another one to two weeks to receive your Montana license through the Compact. Conversely, if you apply for a Montana license directly, it takes about four to six weeks.

Whether you should begin the IMLC process or apply for a state license directly depends on where and how often you see yourself practicing in the future. For physicians who plan on working locums frequently in various states or wish to work telehealth, beginning the IMLC process by requesting an LOQ makes sense. Once you have a letter in hand, getting a new Compact license takes very little time.

If you’re only planning to work one assignment or aren’t sure locums is right for you, it may make more sense to apply for a specific state license directly.

IMLC licensure going forward

With a growing physician shortage, the ability to practice medicine where you’re needed the most is more important than ever. The IMLC makes it easier for many physicians to quickly obtain state licenses and provide care outside of their home state, which ultimately benefits everyone.

We have open locum tenens jobs in every IMLC state. Check out our job board to view the latest locum tenens job opportunities.

About the author

Dave Nielsen

Dave Nielsen lives in Salt Lake City. He writes about healthcare, technology, and business.