Texas has passed a law designed to ease barriers for international medical graduates and address physician shortages, especially in rural and underserved areas. The new legislation, known as the DOCTOR Act (HB 2038), allows qualified foreign physicians to practice supervision-based medicine while they work toward full licensure.
What the New Law Does
Under the DOCTOR Act, foreign medical school graduates who graduate or trained abroad but did not secure a U.S. residency match may now receive provisional medical licenses in Texas. These physicians can work under supervision by a sponsoring physician or medical facility. After four years, they may then transition to an unrestricted license, provided they pass the required U.S. medical licensing exams and meet continuing education standards.
Before this law, many foreign-trained doctors, despite completing rigorous training, were required to redo residency training in the U.S., significantly delaying their ability to serve Texas communities.
Texas is projecting a 10,000-doctor shortage by 2032, with the gap only expected to widen unless action is taken. By opening a supervised practice pathway, the law aims to bring more physicians into underserved regions more quickly. It also responds to a mismatch: there are more medical graduates in Texas than available residency slots.
Considerations & Watch Points
- Scope of supervision: Physicians under this law must practice under licensed oversight until they meet all requirements for full licensure.
- Licensure transition: After four years and successful completion of exams and education benchmarks, provisional providers can apply for full licensure.
- Restrictions on nationality: The law explicitly excludes graduates from certain countries (e.g. China, Russia, Iran, etc.) even if they meet qualification criteria.
- Impact on career trajectory: Some industry observers express concern that using this pathway could affect perceptions of a physician’s credentials or advancement in competitive settings.
At Zhang-Louie PLLC, we monitor state-level licensing reforms that intersect with immigration law. While we do not handle physician licensing, many foreign medical professionals are also navigating visa or immigration paths (e.g., O-1, EB-1) to support their practice in the U.S. Because licensing and immigration rules often dovetail, staying up to date on laws like Texas’s DOCTOR Act helps us better advise clients on realistic planning and timing.
If you are a foreign-trained physician exploring practice options in Texas or elsewhere, and also dealing with immigration strategy, having guidance that understands how licensing and visas intersect can give you a smoother path forward.
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