MDCMEThe Interstate Medical Licensure Compact (IMLC) is an agreement among participating U.S. states that creates an expedited pathway for physicians to obtain medical licenses in multiple states. Rather than submitting separate applications to each state, eligible physicians can apply once and receive a Letter of Qualification (LOQ) that streamlines licensing across all member states.
Who Should Use the IMLC?
The Compact is particularly valuable for:
- Telehealth providers serving patients in multiple states
- Locum tenens physicians covering assignments across state lines
- Physicians relocating who want to maintain licenses in multiple states
- Border-area practitioners whose patients come from neighboring states
- Healthcare systems employing physicians across multiple locations
If you only need a license in one state, traditional state-by-state application may be simpler.
Current Member States
The Compact includes over 40 member jurisdictions, including most U.S. states, the District of Columbia, and Guam. A small number of states participate as "non-SPL" members, meaning they issue licenses through the Compact but cannot serve as your State of Principal License.
Non-member states (as of January 2026): California, Massachusetts, New York, and South Carolina. Massachusetts has introduced legislation and may join soon.
Note: Michigan is scheduled to withdraw from the Compact on March 28, 2026, though legislation has been introduced to prevent this.
For the current member list: Visit the official IMLCC website, as membership changes periodically.
Eligibility Requirements
To use the IMLC, you must meet all of the following criteria:
State of Principal License (SPL)
You must hold a full, unrestricted license in a Compact member state that qualifies as your SPL. A state qualifies as your SPL if at least one of the following is true:
- It is your primary state of residence
- At least 25% of your medical practice occurs there
- Your employer is located there
- You use it as your state of residence for federal income tax purposes
Medical Education
- Graduated from an ACGME-accredited medical school, OR
- Graduated from a school listed in the International Medical Education Directory
Graduate Medical Education
- Successfully completed ACGME-accredited or AOA-accredited graduate medical education
- Important: GME completed outside the U.S. must have been ACGME or AOA accredited at the time of attendance
- Canadian GME programs generally do not qualify unless specifically ACGME/AOA accredited
Examination Requirements
- Passed USMLE Steps 1, 2, and 3 (or COMLEX-USA equivalents)
- Each component must have been passed in no more than 3 attempts
- Canadian LMCC does not satisfy this requirement
Board Certification
You must hold current specialty certification or time-unlimited certification from:
- An ABMS (American Board of Medical Specialties) member board, OR
- An AOABOS (American Osteopathic Association Bureau of Osteopathic Specialists) board
Note: Maintenance of Certification (MOC) is not required by the Compact.
No Disqualifying History
You must have no history of:
- Disciplinary actions against any medical license
- Criminal convictions
- Controlled substance actions against your license
- Current investigations
Approximately 80% of U.S. physicians meet these eligibility criteria.
Application Process
Step 1: Confirm Eligibility
Self-assess against all requirements above. You are responsible for determining your own eligibility—all fees are non-refundable if you're found ineligible after payment.
Step 2: Submit Application
Complete the online application at imlcc.com. You'll designate your State of Principal License (SPL) during this process.
Step 3: Pay Application Fee
The IMLC application fee is $700 (non-refundable), payable by credit card.
Step 4: Complete Fingerprinting
Your SPL will contact you with fingerprinting instructions. You have 60 days to submit fingerprints, which undergo a national criminal background check.
Step 5: SPL Verification
Your SPL conducts primary-source verification of your training, queries relevant databases, and reviews your qualifications.
Step 6: Receive Letter of Qualification
If approved, you'll receive your LOQ via email. The LOQ is valid for 365 days from issuance. If denied, you can contact your SPL for an explanation.
Step 7: Select States and Pay State Fees
Choose which Compact states you want licenses in and pay each state's individual licensing fee (varies by state, typically $100–$500 each).
Step 8: Receive State Licenses
Individual state medical boards issue your licenses, usually within a few days of receiving your LOQ.
Step 9: Respond to Any Additional Requests
Some states may require additional items such as jurisprudence exams, online profile completion, or work authorization documentation.
Timeline
| Phase | Typical Duration |
|---|---|
| Application submission | 1–2 hours |
| Fingerprinting completion | Several weeks |
| LOQ issuance (from fingerprinting) | 4–8 weeks |
| State license issuance (after LOQ) | A few days |
| Total typical timeline | 6–12 weeks |
This is significantly faster than traditional state-by-state applications, which can take months per state.
Fees
| Fee Type | Amount | Refundable? |
|---|---|---|
| Initial IMLC application | $700 | No |
| Adding states (during LOQ validity) | $100 handling fee | No |
| Individual state license fees | Varies ($100–$500+ per state) | No |
| LOQ re-application (after expiration) | $700 | No |
Example Costs
- Single state: $700 (IMLC) + ~$200 (state fee) = ~$900
- Three states: $700 (IMLC) + ~$600 (state fees) = ~$1,300
- Adding 2 states later: $100 (handling) + ~$400 (state fees) = ~$500
Letter of Qualification (LOQ) Details
- Validity: 365 days from issuance (no extensions available)
- Adding states: You can add additional states any time during the LOQ validity period for a $100 handling fee plus individual state fees
- After expiration: You must reapply and pay the full $700 fee again
- Board certification: Not re-evaluated when obtaining a new LOQ
CME Requirements Still Apply
Important: The IMLC streamlines licensing but does not change or reduce state CME requirements.
Each state maintains its own continuing medical education requirements, and physicians licensed through the Compact must comply with each state's CME rules independently. This means:
- CME hour requirements vary by state (typically 20–50 hours per cycle)
- Cycle lengths differ (annual, biennial, or triennial)
- Mandatory topics vary (opioids, pain management, ethics, etc.)
- Some states allow credit carryover; others don't
If you're licensed in multiple states through the Compact, you'll need to track CME compliance for each one. Our State CME Requirements pages can help you understand what each state requires.
Maintaining Your Compact Licenses
- SPL status: You must continuously qualify for your designated SPL, or all Compact licenses terminate
- Report changes: Notify the Compact of any changes affecting your SPL eligibility
- State renewals: Each state has different renewal requirements and dates
- Disciplinary actions: Any action taken by one Compact state can be adopted by other member states
When to Use Traditional Licensing Instead
The IMLC isn't always the best choice. Consider traditional state-by-state applications if:
- You only need one state license
- Your target state isn't a Compact member
- You don't meet the eligibility requirements (exam attempts, board certification, etc.)
- You have a complicated licensing history that might benefit from individual state review
Resources
- Official IMLCC Website: imlcc.com
- IMLCC Support Email: [email protected]
- IMLCC Support Phone: 303-997-9842 (or toll-free: 720-621-9464)
- Hours: 8 AM – 8 PM Eastern Time
This guide is for informational purposes only. Requirements and member states change periodically—always verify current information at imlcc.com before applying.