What Is the IMLC and How Does It Work?

What Is the IMLC?

The Interstate Medical Licensure Compact (IMLC) is an agreement among participating U.S. states to streamline the process of obtaining medical licenses in multiple states. Instead of submitting full applications to each individual state board, eligible physicians can apply once through the IMLC and gain expedited access to licenses across other member states.

Why Was the IMLC Created?

The IMLC was developed to address growing healthcare needs, especially for patients in underserved and rural areas. By making it easier for doctors to get licensed in multiple states, the compact enables more flexible physician deployment, supports telemedicine, and strengthens emergency preparedness across state lines.

Who Oversees the IMLC?

The IMLC is administered by the Interstate Medical Licensure Compact Commission (IMLCC), a body composed of representatives from member medical boards. They ensure the compact operates fairly and efficiently and provide oversight for license eligibility verification and application processing.

How Does the IMLC Work?

Here is a high-level overview of the process:

1. Eligibility Check: Physicians must meet specific criteria, such as holding a full, unrestricted license in a compact state and having graduated from an accredited medical school.
2. Application Submission: Candidates apply through the IMLCC portal and designate their State of Principal License (SPL).
3. Verification: The SPL verifies the applicant's credentials, including background checks, education, and licensure history.
4. Letter of Qualification (LOQ): If verified, the SPL issues an LOQ, which can then be used to purchase licenses in other compact states.
5. State License Activation: Applicants choose the states they wish to be licensed in and pay each state’s individual fees.

What Is a State of Principal License?

Your SPL is the state through which your application is submitted and verified. To qualify, one of the following must apply:

• It is your primary residence.
• You conduct at least 25% of your medical practice there.
• Your employer is located there.
• It is the state of residence listed on your federal income tax return.

What Are the Benefits of the IMLC?

• Speed: Once verified, you can get licensed in new states in days, not months.
• Simplicity: One centralized process for eligibility and credentialing.
• Flexibility: Ideal for telemedicine, locum tenens, and multi-state practitioners.
• Security: Background checks and verification ensure integrity across member boards.

How Many States Participate in the IMLC?

As of now, more than 35 states, the District of Columbia, and Guam are members. The list continues to grow as more boards join the compact. It’s important to verify participation and licensing rules for each state you plan to practice in.

Does the IMLC Provide a Multistate License Like the Nursing Compact?

No. The IMLC does not issue a single multi-state license. Instead, it facilitates individual licenses for each requested state. Each license is subject to the rules, renewal cycles, and disciplinary processes of its issuing board.

What Does the Application Process Look Like?

The process typically follows these steps:

1. Create an account on the IMLCC website.
2. Select your SPL and submit the application.
3. Pay the IMLC application fee (non-refundable).
4. Complete a fingerprint-based criminal background check (if required).
5. Await verification and issuance of the LOQ.
6. Use the LOQ to purchase licenses from other compact states.

Can You Still Apply to States Outside the Compact?

Yes. Physicians can still apply independently to states that aren’t part of the compact or that don’t participate in the IMLC process. Some professionals mix compact and traditional licensing based on career needs.

Is the IMLC Available to International or Non-U.S. Graduates?

Yes, as long as you meet all IMLC criteria. This includes having graduated from an accredited medical school, passed required board exams (USMLE/COMLEX), and holding a full, unrestricted license in a compact state. However, specific eligibility may vary and foreign-trained physicians should check for additional verification requirements.

What’s the Catch?

While the IMLC simplifies the process, it's not without complexity:

• You still pay individual state fees per license.
• You must maintain good standing in your SPL and all licensed states.
• Renewals are managed per state — not centrally through the IMLC.

Final Thoughts

The IMLC offers a transformative solution for physicians needing rapid, multi-state licensure. Whether you're practicing telemedicine, working locum tenens, or simply expanding your reach, the compact removes much of the traditional friction.

Understanding how it works — from eligibility and application to license activation — is the first step toward taking full advantage of the opportunity. And while the process is simpler, it still demands accuracy, organization, and proactive planning.