Texas Doctors Act – Huge Breakthrough for IMGs!
If you’re an International Medical Graduate (IMG) dreaming of practicing in the U.S. but feel overwhelmed by the traditional hurdles like USMLE and ECFMG certification, here’s a reason to pause and smile.
The state of Texas has passed a game-changing bill, the Texas Doctors Act (HB 2038), which opens new doors for eligible IMGs to start practicing in the state without needing to complete a U.S. residency.
Yes, you read that right.
Let’s break down what this means, who qualifies, and how you can take the next step.
You can read the full text of the Texas Doctors Act here
But if you would rather watch a video regarding this, click the link below
What Is the Texas Doctors Act?
In simple terms, HB 2038 is designed to address physician shortages in Texas by creating a faster, more practical route for qualified international doctors. The goal is to cut through the red tape and get eligible IMGs into hospitals where they’re most needed.
While it’s officially titled the “Texas Doctors Act,” it’s part of a broader move to decrease occupational certification timelines, obstacles, and regulations, especially in healthcare.
So, who benefits from this new rule?
Eligibility: Do You Qualify?
- Medical Degree from a WHO-recognized Institution
Your medical college must be listed with the World Health Organization, a pretty standard baseline. - Residency Completed in Your Home Country
You must be a specialist in your country. Whether or not you’ve done a fellowship isn’t clearly stated, but your residency should be complete, and you should be actively practicing in that specialty. - Recent Clinical Experience
You must have practiced medicine for at least 5 out of the last 7 years; ideally in the same field you’re applying to work in. - A Job Offer from a Texas Hospital
This is the key. The entire pathway hinges on having a hospital in Texas willing to hire you. Neither the bill nor the medical board assists with this, so it’s your responsibility to secure a job first.
You Qualify. What Now?
Step 1: Provisional Medical License
Once you secure a job offer from a hospital in Texas, you’ll be issued a provisional medical license by the Texas Medical Board.
But there’s a catch:
You’ll need to work under the supervision of a fully licensed physician or surgeon in the same hospital. The law doesn’t specify your position, so this could potentially be structured as a fellowship or another suitable role decided by your employer.
The good news? This isn’t just shadowing work. You’ll be actively practicing under supervision, and your supervising physician will evaluate your performance as part of the licensure pathway.
Some U.S. states offer similar provisional licensing or “alternate entry” options for IMGs.This IMG success guide walks you through exactly how those programs work, and how you can qualify.
If you’re a hospital CEO or senior leader thinking about bringing this new pathway into your hospital, we’ve got your back. Reach out to us. We’d be happy to help you get started.
Step 2: Transition to Full License
After a satisfactory period under supervision, you can apply for a full, unrestricted Texas medical license.
And here’s the big win: insurance companies are mandated to reimburse for services provided by doctors holding a provisional license.
That’s a massive step forward because, traditionally, reimbursement concerns made hospitals reluctant to hire IMGs under non-traditional licenses. This bill helps overcome that hesitation.
Important: Clean License & Good Standing
Like any other U.S. medical license, your license in your home country must be in good standing. No disciplinary actions, no restrictions, and yes, you’ll need to demonstrate English proficiency.
Also, keep in mind, this law is set to go into effect in September 2025, and the Texas Medical Board is expected to begin processing applications around that time.
Does this need USMLE Exams?
The expectations can vary. We wouldn’t be surprised if some hospitals insist on USMLE while others don’t. To transition through the law, you will need USMLE; however, Texas State has two pathways with no USMLE at the time of this writing.
- Temporary License
- Eminent Pathway
Remember this could change. So check the most recent update.
Want to understand more about how this works in other states too? Check out this guide to alternative licensing pathways for IMGs that breaks it all down.
Final Thoughts: What’s the Catch?
The catch is simple but non-negotiable; you must have a job offer from a Texas hospital before you can proceed. This pathway does not help you find a job, nor does the Texas Medical Board facilitate recruitment.
So please don’t call the board asking for help in job placement; they’re not equipped for that. Your energy is better spent crafting a strong CV and reaching out to hospitals actively.
Still Need Help?
This Texas pathway is one of many being rolled out across the U.S. If you’re unsure whether this fits your profile or want to know about other states with similar laws, you can explore alternate routes explained in this video
We’ve covered many of these alternate routes and pathways in more detail. Browse more IMG strategies and licensing insights here.
And of course, if you ever feel lost in the process, we at IMGSecrets are here to help.
Dr. Rajeev Iyer MBBS, MD, MS, FASA (USA)
Associate Professor of Anesthesiology
University of Pennsylvania,
Philadelphia, USA
Disclaimer: The views and opinions expressed in this article are solely those of the author and do not reflect the official policy or position of the University of Pennsylvania or any other institution or entity.
