SECTION .1300 – GENERAL

21 NCAC 32B .1362 APPLICATION FOR INTERNATIONALLY TRAINED PHYSICIAN EMPLOYEE LICENSE

(a) The Internationally Trained Physician License is limited to physicians who have not attended accredited medical schools or graduated from medical education programs in the United States.

(b) In order to obtain an Internationally Trained Physician License, the Board shall receive from the applicant or the primary source:

(1) a completed application containing the following information from the applicant:

(A) personal mailing, physical address;

(B) work mailing, physical, and email address;

(D) social security number;

(E) chronological history of education and employment from your first day of medical school to present;

(F) history of government investigations, substance use history for the past five years, military service, professional liability insurance history, investigations for employment misclassification for the past five years, and history of disciplinary actions and pending investigations by any state, federal, or foreign regulatory agency, hospital privilege, and malpractice; and

(G) an attestation under oath or affirmation that the information on the application is true and complete, and authorize the release to the Board of all information pertaining to the application.

(2) a completed form from (1) a hospital located and licensed in North Carolina attesting to an offer of full-time employment, or (2) a NC licensed supervising physician located at a medical practice in a North Carolina rural county with a population of less than 500 people per square mile attesting to an offer of full-time employment where the supervising physician is physically practicing on-site;

(3) documentation of a legal name change, if applicable;

(4) a photograph, two inches by two inches, affixed to the oath or affirmation that has been attested to by a notary public;

(5) proof of licensure in good standing from the medical licensing authority in a foreign country as required by G.S. 90-12.03(a)(2);

(6) proof of 130 weeks of medical education from a medical school as described in G.S. 90-12.03(a)(3);

(7) furnish an original Educational Commission for Foreign Medical Graduates certification status report;

(8) proof of ECFMG eligibility, which shall include furnishing an original ECFMG certification status report and successful passage of United States Medical Licensing Examination Step 1 and Step 2;

(9) proof of either (1) two years of graduate medical education approved by the applicant's country of licensure or (2) active practice in country of licensure for at least 10 years after graduation. Proof of graduate medical education will require verification from both the graduate medical education program regarding attendance and applicant's country of licensure of approval. Proof of active practice will require verification from employers, with applicable dates, positions and responsibilities; if the applicant was self-employed, the Board may require business documents, tax records, and patient attestations for the 10-year period to confirm the active practice of medicine;

(10) examination transcripts from the examining body that meet one of the requirements of G.S. 90-12.03(a)(4):

(A) if applying on the basis of the USMLE, the USMLE transcript shall show a score on USMLE Step 3 and the applicant must have passed within three attempts;

(B) if applying on the basis of the COMLEX, the COMLEX transcript shall show a score on COMLEX Level 1, Level 2 (cognitive evaluation), and Level 3 and the applicant must have passed each level within three attempts;

(C) if applying on the basis of any other board-approved examination under G.S. 90-10.1 or 21 NCAC 32B .1303, the transcript must be received from the examining body and must show a passing score of each part;

(D) if applying on the basis of a comprehensive assessment, the applicant should submit a proposal to the Board prior to undergoing the assessment to ensure approval. The comprehensive assessment must be performed by independent licensed physicians or medical educators. The assessment must evaluate the applicant's clinical knowledge, skills and judgment, as well as their cognitive state and safety to practice. The assessment must perform the evaluation through multiple choice examination, neuro-cognitive screen, structured clinical interviews, simulated patient encounters, and procedure simulations. The assessment must evaluate and specify all current strengths and weaknesses in the intended area(s) of practice. The assessment must include testing and evaluation by licensed physicians or medical educators. The Board must receive an assessment report from the independent evaluators indicating the applicant's competence, all strengths and weaknesses in practice, and the ability to practice safely; or

(E) if the applicant does not qualify for any of the examinations listed in G.S. 90-12.03(a)(4), the Board may waive the requirement as long as the applicant satisfies all other requirements of G.S. 90-12.03, holds an O-1 visa, and submits the same supporting documentation provided to the US Citizenship and Immigration Services indicating their extraordinary ability is relevant to the practice of medicine. The applicant must successfully pass the Special Purpose Examination or Post Licensure Assessment Systems within one year or the temporary license is rendered inactive.

(11) confirmation from all jurisdictions where the applicant holds, or has held a license, that the applicant has not had a license revoked, suspended, restricted, denied or otherwise acted against and is not the subject of any pending investigation as required by G.S. 90-12.03(a)(5);

(12) criminal background check translated into English and submitted by country of licensure directly to the Board;

(13) submit two completed fingerprint record cards;

(14) submit a signed consent allowing a search of local, state, and national files for any criminal record;

(15) confirmation that the applicant has practiced medicine for at least five years. Proof of active practice will require verification from employers, with applicable dates, positions and responsibilities; if the applicant was self-employed, the Board may require business documents, tax records, and patient attestations;

(16) demonstration of proficiency in English by:

(A) successfully passing an examination required under G.S. 90-10.1;

(B) licensure from a country where English is the primary language utilized by medical education programs; or,

(17) supply a certified copy of applicant's birth certificate or a certified copy of a valid and unexpired U.S. passport if the applicant was born in the U.S. If the applicant does not possess proof of U.S. citizenship, the applicant must provide information about applicant's immigration status which the Board will use to verify applicant's lawful presence in the U.S.;

(18) valid social security number;

(19) pay to the Board a non-refundable fee pursuant to G.S. 90-13.1(a) plus the costs of a United States criminal background check; and,

(20) upon request, supply any additional information the Board deems necessary to evaluate the applicant's competence and character.

(c) All information submitted under Paragraph (b) of this Rule must be delivered to the Board from the primary originating source in English in order to verify the accuracy and authenticity of the information.

(d) An applicant may be required to appear in person for an interview with the Board or its agent if the Board determines it needs more information to evaluate the applicant based on the information provided and the Board's concerns.

(e) An application must be completed within one year of the date of the applicant's oath.

(f) The holder of an internationally trained physician employee license who meets the requirements of G.S. 90-12.03(d) may submit an application to convert their license to a full license after four years of active practice . The Board must receive the following from the applicant or the primary source:

(1) a completed application containing the information listed above in Parts (b)(1)(A) through (b)(1)(H) of this Rule;

(2) submit to a criminal background check, and pay the cost of the criminal background check;

(3) submit a signed consent allowing a search of local, state, and national files for any criminal record; and

(4) report their practice plans, including geographic location of practice, practice setting, and area of specialty.

History Note: Authority G.S. 90-5.1(a)(3); 90-8.1; 90-12.03; 90-13.1;

Eff. August 1, 2026.