Industry Trends

Interstate Medical Licensure Compact Facts vs. Myths

compact_facts_300Ever since the Federation of State Medical Boards (FSMB) announced plans to introduce an Interstate Medical Licensure Compact in 2013, news reports about the Compact have come out fast and furious. However, many myths and misconceptions have cropped up, too, as outlined in a fact sheet developed by the FSMB.

The following is an up-to-date recap detailing facts about the Compact, how it’s designed to function, and how it could affect your locum tenens opportunities.

Compact basics

Last September, the FSMB released its finalized Compact model, spelling out how the multi-state licensure agreement will allow physicians to practice in participating states without having to apply for separate licenses with each state board. Instead, Compact members agree to rely on the verified professional, education, and other pertinent information a physician submits to the resident state medical board to obtain licensure. In essence, the Compact removes the redundancy of re-verifying the information. As of February 9, 12 states have introduced the model as proposed legislation—Iowa, Maryland, Minnesota, Montana, Nebraska, Oklahoma, South Dakota, Texas, Utah, Vermont, West Virginia, and Wyoming.

The Compact was initially conceived as a means to expand telemedicine services. Its proponents assert the Compact could also result in placing clinicians, such as locum tenens physicians, in underserved regions more quickly.

“License portability is important to increase healthcare accessibility. The Compact expedites the licensing process for qualified physicians, allowing them to get full and unrestricted licenses in a new state so they can provide care where it’s most needed,” Eric Fish, FSMB’s senior director of legal services, exclusively told Weatherby Healthcare. “It turns into a win-win situation for both physicians and patients.”

Myth: The Compact would change a state’s Medical Practice Act.


  • States that adopt the Compact will continue to maintain their existing Medical Practice Acts.
  • The “practice of medicine” is defined as the location where patients receive care. Therefore, doctors who opt for Compact licensure will be working under the jurisdiction of that location’s state medical board. For example, if you agree to a locum tenens contract in Iowa under the Compact, then Iowa’s medical board has authority while you’re in-state.
  • The state medical boards retain oversight and authority for physician accountability and patient protections.
  • Additionally, each state is required to share compliant and investigative information with other Compact members.

Myth: Physicians must participate in the Compact.


  • Both state and individual participation in the Compact is completely voluntary.
  • Doctors who wish to obtain a state license via the traditional route still have that option.
  • The legislation does not alter any state’s Medical Practice Act or licensure application process.

Compact physician qualifications

For physicians, including locum tenens providers, to take advantage of the multi-state licensure, they must meet nine criteria:

    1. Graduate from an accredited medical school
    2. Pass the USMLE or COMLEX
    3. Complete graduate medical education
    4. Obtain specialty certification (ABMS) or a time-unlimited specialty certificate
    5. Possess a full and unrestricted medical license by a Compact member board
    6. Remain free of convictions, adjudications, deferred adjudication, community supervision, or deferred disposition of any offense by a court of appropriate jurisdiction
    7. Be devoid of disciplinary action on any state medical license
    8. Lack history of discipline related to a controlled-substance license
    9. Not be the subject of an active investigation of any licensing agency

According to FSMB, approximately 80 percent of all licensed physicians meet these requirements.

Another requirement is that a physician’s principal license is issued by a Compact member. Principal license is defined by the location of a doctor’s place of employment, the state of residence used for federal state purposes, or where a minimum of 25 percent of the doctor’s practice takes place.

Myth: The Compact demands doctors obtain Maintenance of Certifications (MOC) for MDs or Osteopathic Continuous Certification (OCC) for DOs.


  • There is no language in the legislative model that mandates physicians partake in MOC or OCC.
  • Licensure renewal remains with the medical board issuing the principal license. Physicians must meet those requirements, including continuing medical education minimums, just as they do currently.

Compact impact

Not only have state legislatures embraced the idea of multi-state licensure and how it could expedite medical care in their communities, but the Compact also has been endorsed by physician professional organizations and dozens of state medical and osteopathic boards.

We encourage more states to sign on to the Compact so that we can ensure standards of care are maintained, whether treatment is provided in person or via telemedicine,” stated Steven J. Stack, MD, the president elect of the American Medical Association, in a November press release.

For locum tenens professionals, enactment of the Compact could open up contract possibilities because it builds in even more flexibility to meet facilities’ staffing needs in a timely manner.

“A major challenge for our clients with locations across multiple states is the different licensing requirements in each state and the related delays in getting providers in place to support their locum tenens staffing needs,” says Trevor Strauss, MBA, a strategic account manager with Weatherby Healthcare’s Business Development division.

“Also, from a provider’s perspective, this creates a new opportunity to become a more attractive candidate,” he adds.

For more information on the Interstate Medical Licensure Compact and to keep track of which states have submitted legislation to adopt it, check out

About the author

Anne Baye Ericksen

Anne Baye Ericksen is a journalist and locum tenens subject-matter expert with more than two decades of experience. She was a regular contributor to LocumLife, Healthcare Traveler and Healthcare Staffing and Management Solutions magazines.

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