How IMGs Can Practice Medicine in Missouri Without US Residency (2025)

Practice Medicine in Missouri Without US Residency (IMGs) – Learn how to qualify, get licensed, and secure positions under new state laws.

Missouri has opened new doors for International Medical Graduates (IMGs) by allowing them to practice medicine without completing a U.S. residency. This initiative aims to address physician shortages in underserved areas while providing qualified IMGs an opportunity to contribute their skills.

Missouri’s Law on IMGs Practicing Without U.S. Residency

In 2021, Missouri passed a groundbreaking law permitting international medical gradutes to practice under the supervision of a licensed physician without completing a traditional U.S. residency program. This law makes Missouri one of the few states offering alternative pathways for IMGs to integrate into the healthcare workforce.

According to Missouri law, International medical graduates may be eligible for a restricted license or temporary license if they meet specific criteria set forth by the state. These licenses allow them to practice medicine, but with certain conditions, including limitations on the scope of practice or supervision requirements.

Eligibility Requirements for IMGs

To practice medicine in Missouri without a U.S. residency, International medical graduates must fulfill several eligibility requirements, which may vary depending on their qualifications and the type of license they are applying for. Below are the general eligibility criteria:

1. Educational Requirements:

• International medical graduates must have completed a medical degree from a recognized international medical school listed in the World Directory of Medical Schools (WDOMS).
• They must provide verification of their medical education and may need to submit a transcript and proof of clinical training.
  

2. Licensing Examination:

• International medical graduates must pass the United States Medical Licensing Examination (USMLE) or an equivalent examination recognized by the Missouri Board of Healing Arts.
• The USMLE consists of three steps: Step 1 (Basic Medical Sciences), Step 2 (Clinical Knowledge), and Step 3 (Clinical Skills). For IMGs, passing Step 1 and Step 2 is usually required, but Step 3 may be waived in some cases for certain restricted or temporary licenses.
  

Clinical Experience:

• International medical graduates must provide evidence of clinical experience, such as rotations, internships, or work experience, especially if applying for a restricted license or a temporary license.
• This experience should ideally be completed in a clinical setting that meets U.S. standards.
  

Postgraduate Training:

• In most cases, International medical graduates are required to complete one year of postgraduate clinical training (internship or residency) in an accredited institution. However, there are exceptions that allow International medical graduates to practice without completing a full residency program, especially if they are applying for specific restricted licenses.
• Alternatively, International medical graduates who have completed residency training abroad may be able to apply for licensure in Missouri without undergoing further U.S. residency, provided their training meets certain equivalency standards.
  

Other Documentation:

• International medical graduates must provide proof of English language proficiency (usually through TOEFL or another recognized test) and submit their personal background and criminal history for verification.
  

Types of Licenses Available

In Missouri, there are two primary types of licenses under which IMGs may practice medicine without completing U.S. residency:

1. Restricted License:

• A restricted license may be granted to International medical graduates who have completed foreign residency programs and meet the state’s criteria, but who are not required to undergo a U.S. residency.
• This license may come with limitations on the type of medical practice and the scope of care the IMG can provide.
• IMGs with a restricted license often work under supervision or in non-clinical roles.
  

2. Temporary License:

• A temporary license is available to International medical graduates who are in the process of completing required exams or training but wish to begin practicing under supervision.
• This license is typically valid for one year, with the possibility of renewal based on progress.
  

Visa Options for IMGs

It’s important to note that while Missouri offers this pathway for IMGs, the state does not facilitate visa sponsorship. Therefore, International medical graduates must independently secure their immigration status, ensuring they have the legal authorization to work in the U.S

Challenges Faced by IMGs to Practice Medicine in Missouri Without US Residency

While it is possible for IMGs to practice in Missouri without completing a U.S. residency, the process is not without its challenges. Some of the most common obstacles include:

1. Limited Scope of Practice:

• International medical graduates with restricted or temporary licenses may face limitations in their practice. They may only be able to treat certain types of patients, and their practice may be closely supervised by licensed U.S. physicians. This limitation can make it difficult to achieve full autonomy in medical practice.
  

2. Competition with U.S. Graduates:

• There is often fierce competition between U.S. medical school graduates and IMGs for residency slots. Even though IMGs may be able to practice without U.S. residency under certain conditions, many employers may prefer candidates with U.S. residency experience. This can make it more difficult for IMGs to secure permanent positions.
  

3. Licensing Process Delays:

• The process of obtaining a medical license in Missouri can be time-consuming. International medical graduates often face long waiting times for approval, and the paperwork involved can be complex. Additionally, there is a need to pass multiple exams, submit documents, and provide verifications, which can delay the licensure process.
  

4. Recognition of Foreign Training:

• One of the most significant challenges for IMGs is the recognition of their foreign medical education. U.S. medical boards often have stringent requirements for foreign degrees, and some IMGs may need to undergo additional training or testing to prove that their education meets U.S. standards.
  

5. Cultural and Language Barriers:

• International medical graduates may also face cultural and language barriers when interacting with patients and colleagues. While proficiency in English is a requirement, IMGs may still encounter challenges in communication, especially if they are not familiar with American medical terminology or local healthcare practices.
  

6. Visa and Immigration Challenges:

• Securing the proper visa status to practice medicine can be an additional hurdle for IMGs. Visa applications can be time-consuming and require extensive documentation, and there may be limitations on the types of visas available to foreign-trained doctors.
  

List of other states where IMGs can practice medicine without US Medical Residency

For more news on which states allow IMGs to practice medicine without U.S. residency, please read the article: States Where IMGs Can Practice Without U.S. Residency (2025).

FAQs

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