THE TEXAS MEDICAL BOARD HAS AN APPLICATION FOR THIS PATHWAY.
Enacted June 20 and effective September 1, 2025, requires (“shall”) the Texas Board to issue a provisional license to qualified “foreign license holding” applicants that have: been granted a degree of doctor of medicine or substantially similar from a program that meets ECFMG requirements; been licensed and in good standing in another country, without any pending investigations; completed a residency program or a substantially similar postgraduate medical training in their country of licensure; been in clinical practice 6 months of the past 2 years, complete any clinical competency assessment offered by KSTAR, PACE, or CPEP, pass the Texas medical jurisprudence examination; English language proficiency; has Federal work authorization; passed USMLE Steps 1 & 2 or an equivalent exam (LMCC, NBOME, NBME, FLEX (TX Occ Code § 155.0511); and has an offer of employment by a an ACGME or AOA affiliated facility. Please see the attached TXIMGEligibilityChecklist.pdf for further qualification information.
The Board is empowered to promulgate additional requirements by rule. Provisional licenses cannot be issued to applicants without visas from countries deemed by the U.S. Director of Intelligence as a “threat to national security” in their annual threat assessment, or be subject to prohibitions in the International Traffic in Arms Regulations, which is promulgated by the U.S. Dept. of State. This list includes China, Russia, Belarus, Cuba, Iran, North Korea, and Syria. Here is the Medical School List.
The provisional license is valid for two years, but may be renewed if the licensee has passed USMLE Steps 1 and 2 and is ECFMG certified. Licensees with renewed provisional licenses must practice in a setting affiliated with ACGME or AOA. The Board shall issue a full license to an applicant that has passed all parts of one the LMCC, NBOME, NMBE, FLEX, or USMLE (TX Occ Code § 155.0511), is not subject to pending discipline, Board investigation, or been convicted of a felony or a misdemeanor involving moral turpitude. The Board is empowered to adopt rules pertaining to the issuing of the provisional license, its renewal, full licensure, and the reporting of board specialty certification requirement information. Regarding physician graduates (PGs – analogous to assistant/associate physicians), requires the Board to create a licensure class for PGs, individuals that: are Texas residents; U.S. citizens or legal permanent residents; have English proficiency; have graduated from a U.S. or Canadian medical or osteopathic school or an international medical school that the Board deems acceptable within the last two years; or if the applicant is licensed and in good standing in another country and: passed USMLE Steps 1 & 2 or an equivalent exam (LMCC, NBOME, NMBE, FLEX (TX Occ Code § 155.0511)); is not enrolled in a Board-approved residency; has not been subject of disciplinary action from a licensing board; and meets any other requirements prescribed by the Board. HB 2038 (2025) 14 Last Updated: July 2025
State Status Detail Citation
Physician graduates must practice under an agreement with a specialty board certified supervising physician who has no past or current disciplinary actions. The Board will determine the number of PGs a physician can oversee. PGs may only work in rural counties (population < 100,000), within their supervising physician’s specialty, with the physician assuming legal responsibility for their actions, and under the terms of a supervising practice agreement that is detailed in the legislation. They can use physician titles, be classified as “general practitioners” for CMS, and renew their licenses if they meet CME requirements and maintain their practice agreement. Notably, the bill does not address converting a PG license to full licensure.
