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International Medical Graduates Clinical Experience License

In 2021, the legislature passed SHB 1129. This new law requires the Medical Commission (WMC) offer a limited license for International Medical Graduates (IMG) to gain clinical experience. Those meeting specific criteria and requirements below can be licensed for two years, with the option for one renewal for a total practice time of four years.


People wishing to apply for this limited license meet the following criteria:

  • Be a Washington state resident for at least one year;
  • Be ECFMG certified; and
  • Pass all steps of the USMLE.

IMGs meeting these conditions must:

  1. Submit an application;
  2. Complete a background check; and
  3. Maintain practice agreement between the license holder and the supervising physician with the medical commission. The practice agreement portal can be accessed here. If a practice agreement needs to be amended or terminated, it will need to be filed with the WMC at

Supervising Physicians

A supervising physician may supervise no more than two IMG license holders unless the commission grants a request to increase this limit. You may petition the WMC for an increase via email at:

The supervising physician must retain professional and personal responsibility for any act that constitutes the practice of medicine as defined in RCW 18.71.011 when performed by an IMG under their supervision.