Articles
From the President: Law opens new pathways to licensure
In my last message, I wrote about NCMB’s hopes to speed the pace of its licensing process by seeking the authority to offer expedited licensure to applicants who are already licensed in another state or US jurisdiction. While that particular bill is still working its way through the NC General Assembly, another bill is now law, creating multiple new pathways to licensure in North Carolina.
Please note that none of the licensure provisions described in this article will be in effect until January 2026.
North Carolina to be a “Compact” state
Session Law 2025-37/HB67 authorizes North Carolina to join the Interstate Medical Licensure Compact (IMLC), as well as the Physician Assistant Licensing Compact. Being part of these Compacts will allow NCMB to offer expedited licensure to both physicians and PAs who are currently licensed in another Compact state. The IMLC has been operational since 2017 and currently includes more than 40 member states/US territories. When fully implemented, physicians who are licensed in a Compact state will have a quicker path to licensure in NC. Due to efficiencies in how the applicant’s credentials are verified, an IMLC application is expected to take less time to process than a traditional NC medical license application.
SL2025-37/HB67 also authorizes our state to become a member of the PA Licensure Compact. The PA Compact is organized much like the IMLC and, once fully operational, will allow an expedited path to NC licensure for PAs who hold full licenses in Compact states. NC is one of about 20 states that have adopted legislation allowing participation in the PA Compact but, as yet, no states are issuing licenses via the Compact.
Easing rural physician shortages with internationally trained physicians
SL2025-37/HB67 also includes a new pathway to licensure for physicians who completed medical education and postgraduate training outside of the US, provided they meet very specific criteria detailed in the law. The new license type will only be available to applicants who have been offered full-time employment at a NC hospital or medical practice in certain rural counties where an NC licensed physician is physically practicing on-site. Additional requirements apply and are described in the statute and in NCMB’s summary of the new law. After four years of successful practice in NC, physicians with this new license type would have the opportunity to apply for full licensure.
Waiving supervision for experienced PAs
One other provision in SL2025-37/HB67 that deserves special note is one that, for the first time in NC history, allows certain PAs to practice without a primary supervising physician. To qualify, a PA must have more than 4,000 hours of clinical practice experience as a licensed physician assistant and more than 1,000 hours of clinical experience within their medical specialty AND practice in a team-based setting. PAs will be required to register with the Board before practicing without a primary supervising physician, which will include submitting proof that they satisfy all criteria for team-based status. If PAs leave a team-based setting or practice in a different specialty, they must either reestablish with a primary supervising physician or update their registration for team-based status. PAs who do not qualify for team-based status must continue to practice with a primary supervising physician under the current supervisory requirements, which remain the same. PA team-based practice will not be in effect until NCMB adopts rules or on June 30, 2026, whichever comes first.
NCMB staff are working diligently to plan and implement all of the administrative details that must be worked out before the licensure and workforce provisions described can take effect. We will have more specific information available about each change closer to the effective dates.
Send feedback to fourm@ncmedboard.org.
Please note that none of the licensure provisions described in this article will be in effect until January 2026.
North Carolina to be a “Compact” state
Session Law 2025-37/HB67 authorizes North Carolina to join the Interstate Medical Licensure Compact (IMLC), as well as the Physician Assistant Licensing Compact. Being part of these Compacts will allow NCMB to offer expedited licensure to both physicians and PAs who are currently licensed in another Compact state. The IMLC has been operational since 2017 and currently includes more than 40 member states/US territories. When fully implemented, physicians who are licensed in a Compact state will have a quicker path to licensure in NC. Due to efficiencies in how the applicant’s credentials are verified, an IMLC application is expected to take less time to process than a traditional NC medical license application.
SL2025-37/HB67 also authorizes our state to become a member of the PA Licensure Compact. The PA Compact is organized much like the IMLC and, once fully operational, will allow an expedited path to NC licensure for PAs who hold full licenses in Compact states. NC is one of about 20 states that have adopted legislation allowing participation in the PA Compact but, as yet, no states are issuing licenses via the Compact.
Easing rural physician shortages with internationally trained physicians
SL2025-37/HB67 also includes a new pathway to licensure for physicians who completed medical education and postgraduate training outside of the US, provided they meet very specific criteria detailed in the law. The new license type will only be available to applicants who have been offered full-time employment at a NC hospital or medical practice in certain rural counties where an NC licensed physician is physically practicing on-site. Additional requirements apply and are described in the statute and in NCMB’s summary of the new law. After four years of successful practice in NC, physicians with this new license type would have the opportunity to apply for full licensure.
Waiving supervision for experienced PAs
One other provision in SL2025-37/HB67 that deserves special note is one that, for the first time in NC history, allows certain PAs to practice without a primary supervising physician. To qualify, a PA must have more than 4,000 hours of clinical practice experience as a licensed physician assistant and more than 1,000 hours of clinical experience within their medical specialty AND practice in a team-based setting. PAs will be required to register with the Board before practicing without a primary supervising physician, which will include submitting proof that they satisfy all criteria for team-based status. If PAs leave a team-based setting or practice in a different specialty, they must either reestablish with a primary supervising physician or update their registration for team-based status. PAs who do not qualify for team-based status must continue to practice with a primary supervising physician under the current supervisory requirements, which remain the same. PA team-based practice will not be in effect until NCMB adopts rules or on June 30, 2026, whichever comes first.
NCMB staff are working diligently to plan and implement all of the administrative details that must be worked out before the licensure and workforce provisions described can take effect. We will have more specific information available about each change closer to the effective dates.
Send feedback to fourm@ncmedboard.org.