A recent post on social media platform X (formerly Twitter) claims that North Carolina, a US state, has passed a law which allows foreign doctors to practice in the state without completing a US residency or passing a qualification exam. However, this is misleading. The truth is that the state has created a new, carefully regulated pathway for internationally trained physicians to work in rural hospitals facing severe doctor shortages.
The post further claims that the law specifically targeted 21 Middle Eastern countries. But in reality the legislation makes no reference to any particular country and applies broadly to all foreign-trained doctors who meet the qualifications.
“North Carolina just passed a law allowing doctors from these countries to practice without completing a US residency or passing a US qualification exam. Not good. #ncpol,” the post read.
North Carolina just passed a law allowing doctors from these countries to practice without completing a US residency or passing a US qualification exam.
Not good. #ncpol. pic.twitter.com/uYLkuyFGdk
— Sloan Rachmuth (@SloanRachmuth) August 16, 2025
What does the law actually allow?
Signed by Governor Roy Cooper on July 1, 2025, the law establishes “new licensure pathways” for doctors trained outside the United States. These doctors will not be exempt from testing. Instead, they must pass their own country’s medical exams and an additional exam chosen by the North Carolina Medical Board.
Importantly, these physicians can only practice at the rural hospital that hires them and they must work under the supervision of a licensed US doctor.
Addressing the doctor shortage
The legislation comes in response to a growing healthcare crisis in North Carolina’s rural areas. An analysis by Concordia University found the state needs 642 additional primary care doctors in rural communities to match urban access. Another 2024 report by the Cicero Institute revealed that 92 of the state’s 100 counties are already designated as health professional shortage areas.
The main motive of the law is to open opportunities for qualified international doctors and it aims to streamline healthcare access in underserved communities.
Requirements for international physicians
According to the law provided by the North Carolina Medical Board, applicants must hold a valid medical license from another country within the last five years and provide proof of at least 130 weeks of medical education at approved schools.
They should also have either completed two years of postgraduate training or gained at least 10 years of active medical practice. In addition, candidates must demonstrate their competency through exams like the US Medical Licensing Examination (USMLE), have a clean record with no disciplinary actions, criminal charges or pending investigations and be legally authorised to work in the United States.
Doctors granted this license may only practice at approved rural hospitals or medical practices where a North Carolina-licensed physician is physically present.
This international physician license is temporary. After four years of supervised practice in North Carolina, eligible doctors may apply for a full state medical license.
When will the law take effect?
The program will begin in January 2026. The North Carolina Medical Board is expected to announce further details, including which exams will be required, closer to the launch date.