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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.

*IMGs who will be training in an ACGME or non-ACGME clinical fellowship program should refer to the application requirements for the Physician Limited Application.


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

  • Be a Washington state resident for at 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
  • To qualify as a sponsoring facility, please ensure that the supervising physician is employed at an "appropriate medical practice" as referenced in WAC 246-919-345:

(1) The commission may issue a limited physician and surgeon clinical experience license to an applicant who does not qualify for licensure under RCM 18.71.050 or Chapter 18.71B RCW and who does meet the  requirements established in RCW 18.71.095(6) for the purpose of gaining clinical experience at an approved facility or program.
(2) An appropriate medical practice, as referenced in RCW 18.71.095 (6)(a), is a practice that meets the following criteria:
(a) The practice is physically located in the state of Washington and is providing clinical care to Washington patients.
(b) The practice falls within one of the following categories:
(i) Is a practice setting within a federal system such as military, Indian health services, tribal health setting, or community health center; or
(ii) Is a practice setting that:
(A) Has three or more physicians for the purposes of delivering direct patient care; and
(B) Has a quality review, improvement, and assurance program for practitioners.

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.