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Earlier this year, I wrote about the potential for North Carolina’s participation in the Interstate Medical Licensure Compact (IMLC) to create a much faster pathway to licensure in our state. Six months later, IMLC is delivering on that promise.

During the first five months of 2026, the North Carolina Medical Board (NCMB) received nearly 1,400 applications from physicians licensed in other IMLC states seeking a license to practice medicine in NC. On average, NCMB issued each license in just 9 days. Before NC became an active member of the IMLC, NCMB routinely advised applicants to allow up to 120 days for their license to be issued.

For medical practices, hospitals, health systems, and any organization that recruits physicians nationally, the impact is clear. In just a few months, the timeline for filling open or newly created physician positions has dropped from as long as four months to less than two weeks. The IMLC is a game-changer, and anyone interested in growing North Carolina’s physician workforce should understand its value. The IMLC also gives North Carolina physicians the opportunity to obtain licensure quickly in more than 40 other states and U.S. territories participating in the Compact. Since Jan. 1, nearly 250 North Carolina physicians have begun that process. Learn more about IMLC in NC in this one page summary.

Obtaining a license through the IMLC takes longer for physicians seeking licensure in other states than for those applying to North Carolina after their eligibility has already been confirmed. The primary reason is that IMLC rules require physicians to obtain a new criminal background check, which is conducted by law enforcement agencies and typically takes about a month to complete. On average, NCMB issues a Letter of Qualification (LOQ) — the document required to begin applying for licensure through the IMLC — in approximately 35 days.

Physicians seeking to benefit from the expedited processing available through IMLC must first register with the Interstate Medical Licensure Compact Commission (IMLCC) and maintain an active LOQ from their home state. At the same time, NCMB has not allowed the success of the IMLC to distract from its broader goal of reducing processing times for all license applications. After adding staff, investing in technology, and rethinking internal processes to improve efficiency, NCMB has reduced average application processing times — from receipt of the application to issuance of the license — to 70 days. That is nearly half the 120 days applicants were once advised to expect.

As Board President, it is gratifying to see such clear results from the organization’s hard work. At the same time, application volumes naturally fluctuate, and NCMB cannot guarantee that processing times will continue to decline or remain near current levels. Staff will, however, continue working to improve efficiency wherever possible.
It is also important to recognize that some of the most time-consuming aspects of the licensure process, including criminal background checks and the transmission of transcripts or examination scores, are outside NCMB’s control.

Even with those caveats, NCMB’s Licensing Department has never processed applications more quickly. Getting physicians to work faster benefits North Carolina patients and the medical professionals and facilities that care for them.

Be well.