Who Reviews Your IMLC Application?
Your designated State of Principal License (SPL) handles the first and most important review of your IMLC application. They assess your eligibility and decide whether to issue your Letter of Qualification (LOQ). Other compact states rely on that LOQ to issue licenses quickly, so this step is critical.
What Are Boards Actually Looking At?
Each board reviews your application based on a standardized checklist defined by the IMLC — but they also consider local rules and discretion. Here’s what they evaluate:
- License status: Must be full, unrestricted, and in good standing
- Disciplinary history: No open cases or recent sanctions
- Criminal background: No felony or disqualifying misdemeanor convictions
- Education: Graduation from an LCME/COCA-accredited medical school (or ECFMG-recognized foreign school)
- Exams: Passing scores on USMLE or COMLEX
- Board certification or recent exam completion: Must be certified or have passed the final licensing exam within the last 3 years
- Residency and practice location: Must meet SPL residency or practice criteria
Do They Cross-Check With Other Systems?
Yes. Boards verify your information against national databases including:
- Federation of State Medical Boards (FSMB)
- National Practitioner Data Bank (NPDB)
- National Provider Identifier (NPI) registry
- State and federal criminal records (via fingerprinting)
Any inconsistencies or red flags here can delay or derail your application.
What Red Flags Will Trigger a Rejection?
- Any current disciplinary order or pending investigation
- Unresolved malpractice claims (depending on severity)
- Gaps in work history that aren’t explained
- Inconsistent contact info or mismatched license numbers
- Expired board certification with no recent exam
Even something as simple as inconsistent name formatting between documents can slow things down.
How Can You Make Your Application Stronger?
- Submit all documents clearly and completely
- Use the same name, address, and credentials across all materials
- Explain any non-obvious issues in a cover letter or addendum
- Submit fingerprinting early to start the background check process
If you’ve changed names, moved practices, or had previous licenses, make sure your documentation connects those dots clearly.
What If You Have a Past Issue?
Minor infractions or resolved actions don’t always result in rejection. Be transparent, disclose what happened, and provide documentation that shows resolution. Boards are often more concerned with concealment than with the issue itself.
Do All Boards Interpret the Rules the Same Way?
No. While they all follow the IMLC guidelines, each SPL has discretion. Some are strict; others are more flexible depending on the case. That’s why choosing the right SPL — one you clearly qualify for — is key to a smooth application.
Final Thoughts
Getting licensed through the IMLC starts with earning the trust of your SPL. Their job is to protect patients by vetting your background, qualifications, and conduct. Your job is to make that easy by submitting a clear, clean, and complete application.
Anticipate what boards are looking for, fix inconsistencies in advance, and stay responsive during the process. That’s how you turn a gatekeeper into an ally — and get your LOQ without delay.