When preparing for short-term clinical work, many physicians and advanced practice clinicians ask the same question: What’s the fastest way to get licensed?
Whether you’re applying in one state or many, choosing between the Interstate Medical Licensure Compact (IMLC) and traditional state medical license applications can shape how quickly you’re able to accept new assignments.Â
This guide walks through each path and explains when it’s helpful to combine them.
Table of Contents
How The IMLC Helps Clinicians In 2025
Since its launch in 2017, the IMLC has helped over 16,000 physicians obtain licenses in states beyond their home state. Today, 42 states, the District of Columbia, and Guam participate in this initiative. Let’s take a closer look at how it works.
Start by selecting a State of Principal License (SPL). You’re eligible if one of the following applies:
- You live in the state
- At least 25% of your practice occurs there
- Your primary employer is located there
- You file federal taxes using an address in the state
Once your SPL verifies your credentials, it issues a Letter of Qualification (LOQ). From there, you can apply for licenses in other compact states through a single online portal. Most approvals are processed within just a few days.
How Traditional Licensing Works
Individual state medical boards review traditional applications. This option is helpful if you’re applying in a state that hasn’t joined the compact.
Expect to provide:
- Medical education and training history
- USMLE or COMLEX exam scores
- Professional references and FSMB reports
- Fingerprints and background check materials
Licensing timelines typically run about 60 days but may stretch longer if documents require verification. Renewal schedules vary significantly. For instance, Alabama requires annual renewal, while Michigan renews every three years.Â
IMLC vs State Licensing: Head-to-Head Comparison
| Feature | IMLC | Traditional Application |
|---|---|---|
| Eligibility | 42 states + DC + Guam | One state only |
| Average speed after LOQ | 3 to 10 days | Around 60 days (can exceed 90) |
| Up-front cost | ~$700 + SPL fee | $50 to $1,000+ |
| Renewal timing | Matches each compact state’s schedule; managed through the IMLC portal | State-specific; managed individually |
Note: CME requirements and renewal fees still apply for each state.
When The Compact Works Best
- Faster approvals: Complete multi-state licensing without having to repeat forms.
- Flexible access: One LOQ can unlock dozens of practice locations.
- Credentialing advantage: Holding multiple licenses may help facilities process your paperwork more efficiently.
Things to keep in mind
- LOQs are valid for 365 days. Be sure to apply for any additional licenses before they expire.
- Not every compact state qualifies as an SPL. For instance, Pennsylvania is excluded.
- Some large states, including California, New York, and Florida, are not compact members.
When Traditional Licensing Is The Better Route
- You plan to practice in only one non-compact state.
- Your home state is not part of the compact, making it impossible to select SPL.
- You already hold an unrestricted license in another state and do not anticipate engaging in cross-state work.
Why Many Clinicians Use Both
A hybrid approach can offer the best of both worlds.
For example, A hospitalist living in Wisconsin holds an LOQ and uses the IMLC to quickly obtain licenses in Minnesota, Iowa, and Illinois for rotating weekend assignments. At the same time, they submit a traditional state medical license application to work in Indiana, which is not yet part of the compact but offers a well-compensated long-term role.
Before applying in multiple states
- Map out assignments 6 to 12 months in advance
- Track renewal cycles to prevent deadlines from overlapping.
- Confirm that malpractice insurance covers each jurisdiction.
Quick Answers to Common IMLC vs State Licensing Questions
Q: Does the IMLC guarantee faster hospital credentialing?
A: No. It shortens licensing time, but each hospital’s privileging process is separate.
Q: Can NPs or PAs use the IMLC?
A: Not yet. Legislation for advanced practice clinicians is still under development.
Q: What happens if I move?
A: You’ll need to select a new SPL based on your updated residence, employer, or tax status.
Let’s Simplify The Licensing Process Together
Applying for a new license doesn’t have to slow you down. Whether you’re using the IMLC, a traditional route, or both, OnCall Solutions can help. As your medical staffing and hospital practice partner, we offer personalized support every step of the way, from licensing to onboarding.
Source: Interstate Medical Licensure Compact Commission, data current as of July 2025.