Physician Staffing Agency USA

StaffBank is a specialist physician staffing agency for the USA, helping healthcare organizations build long-term physician workforce pipelines through internationally trained doctors.

We manage ECFMG certification, USMLE coordination, J1 waiver processes, and state medical licensing — delivering complete support from brief to start date.

Physician Staffing Agency USA

International Medical Graduates Are Not a Supplement to the US Physician Workforce. They Are Its Foundation.

As of 2022, there were 239,632 non-US international medical graduates licensed in the United States, comprising approximately 23 percent of the total physician workforce according to research published in the Annals of Internal Medicine in 2025. In internal medicine, the proportion of IMGs is 39 percent. In psychiatry, 30 percent. In neurology, 31 percent. In paediatrics, 25 percent. These are not niche or edge cases. They are the disciplines where IMG physicians carry the heaviest load in the US healthcare system — and where the consequences of restricted IMG access would be most severe.

The 2026 Match — the National Resident Matching Program — saw 44,344 total residency positions offered, a record, alongside 53,373 registered applicants, also a record according to ECFMG’s March 2026 report. IMGs remain an essential and irreplaceable component of the physician workforce pipeline. Persistent physician shortages in primary care and rural medicine underscore the urgency of maintaining robust pathways for qualified IMGs to enter and complete US graduate medical education. The Health Resources and Services Administration released updated physician workforce projections in November 2024 showing a shortfall of more than 187,000 physicians by 2037.

Nine US states have now enacted legislation enabling additional pathways to licensure for internationally trained physicians as of February 2025, with another 19 states considering similar legislation according to the Annals of Internal Medicine. Tennessee’s SB1451 allows IMGs to obtain a temporary licence to practise medicine without completing a US residency, provided they meet specific qualifications including completion of a 3-year postgraduate programme abroad and an employment offer from an accredited Tennessee healthcare provider. Florida, Iowa, Idaho, Illinois, Louisiana, Massachusetts, Virginia, and Wisconsin have enacted similar legislation. The US healthcare system is formally acknowledging what rural and underserved communities have known for decades: IMGs are not a supplement. They are the workforce.

More than 46 million Americans — 15 percent of the population — live in rural areas, but only 10 percent of doctors currently practise in these regions.

IMG primary care physicians are more likely than US-trained equivalents to practise in rural persistent poverty locations according to research published in the Journal of Rural Health.

Rural hospitals already struggle to recruit enough doctors to meet local needs, with many closing for financial reasons. The worsening physician shortage threatens to compound this long-standing geographic maldistribution.

The J1 Waiver

The Most Important Tool in Rural Physician Staffing

The J1 visa has a two-year home country requirement — meaning physicians who enter the US on a J1 visa for residency training are generally required to return to their home country for two years before obtaining another US visa. The J1 waiver allows this requirement to be waived for physicians who commit to practising in medically underserved areas or Health Professional Shortage Area designated communities for a minimum period — typically 3 years.

This is one of the primary pathways through which internationally trained physicians enter rural US medical practice. The Conrad 30 waiver programme allows each state to sponsor up to 30 J1 waivers annually for physicians who commit to practising in designated shortage areas. States like Tennessee and Iowa have optimised their Conrad 30 programmes to attract IMGs to their most underserved communities. StaffBank has specific expertise in advising candidates and healthcare organisations on J1 waiver pathways — including which states have the most accessible programmes, which shortage area designations are most favourable for the candidate’s specialty, and how to manage the timing of the waiver application within the overall licensing and employment process.

Alternative State

Licensure Pathways for IMGs in 2026

The nine states that have enacted alternative IMG licensure pathways represent a significant expansion of options for internationally trained physicians. These pathways vary by state but typically allow physicians with completed postgraduate training abroad and a qualifying employment offer to obtain a temporary licence to practise without completing a US residency — subject to supervision requirements and a defined pathway to full licensure after a period of good standing.

Tennessee -- SB1451 allows temporary licence for IMGs with 3-year postgraduate programme abroad and employment offer from accredited Tennessee healthcare provider. Full licence after 2 years of good standing
Florida, Iowa, Idaho, Illinois, Louisiana, Massachusetts, Virginia, Wisconsin -- each has enacted specific legislation with varying requirements. StaffBank advises on which state's pathway is most accessible for each candidate's specific qualifications and target specialty
19 additional states -- considering similar legislation. StaffBank tracks these developments and advises clients on sourcing strategy implications as new pathways become available

Medical Specialties

We Place IMGs Into in the USA

Primary care -- family medicine, internal medicine, and general practice in Health Professional Shortage Areas, FQHCs, and rural critical access hospitals. J1 waiver pathways available
Psychiatry -- the US mental health crisis is driving unprecedented demand for psychiatrists. IMGs account for 30 percent of the US psychiatry workforce
Internal medicine -- 39 percent of US internal medicine physicians are internationally trained. Consistent high demand across all US healthcare settings
Paediatrics -- 25 percent of US paediatric physicians are internationally trained. Growing demand driven by paediatric service expansion
Neurology -- 31 percent of US neurologists are internationally trained. Significant specialist shortfall in both hospital and outpatient settings
Geriatrics -- rapidly growing demand driven by ageing US population. IMG physicians carry a disproportionate share of geriatric care in underserved settings

StaffBank has delivered international healthcare recruitment at NHS England national programme level — supporting the NHS England Global Fellows Programme for Emergency Medicine, the NHS Global Learners Programme for International Nurse Recruitment, and the NHS England
International Diagnostic Radiography Recruitment Programme.

Alongside these national programmes, StaffBank supported the Devon Alliance for International Recruitment across six NHS Trusts in Devon, where the programme celebrated its 1,000th international nurse arrival in
August 2023 and continues to grow.

Frequently Asked Questions

Can internationally trained physicians practise in the USA without completing a US residency in 2026?

Yes — in nine states that have enacted alternative IMG licensure pathways, physicians with completed postgraduate training abroad can obtain a temporary or restricted licence to practise without completing a US residency. Tennessee’s SB1451 is the most widely known example. These pathways have specific requirements — typically including completion of a 3-year postgraduate programme abroad, a qualifying employment offer, and supervision arrangements during a probationary period leading to full licensure. StaffBank advises candidates and healthcare organisations on which state’s pathway is most suitable for the candidate’s specific qualifications, specialty, and target practice location.

How does the J1 waiver programme work for rural physician placement and does StaffBank manage it?

The J1 waiver removes the two-year home country requirement for physicians who trained in the US on J1 visas, in exchange for a commitment to practise in a Health Professional Shortage Area or Medically Underserved Area for a minimum of 3 years. The Conrad 30 programme allows each state to sponsor up to 30 J1 waivers annually. StaffBank manages the J1 waiver application process for both the physician and the employing healthcare organisation — advising on state programme requirements, shortage area designation, supervision arrangements, and the timing of the waiver application within the overall employment and licensing process. We also advise on which states have the most favourable Conrad 30 programmes for specific specialties.

What is the ECFMG certification and why is it required for all internationally trained physicians in the USA?

ECFMG — the Educational Commission for Foreign Medical Graduates — certifies that internationally trained physicians meet the educational requirements for entry into US residency programmes. ECFMG certification requires verification of the physician’s medical degree from a WHO-listed medical school, passing scores on USMLE Step 1 and Step 2 CK, and English language proficiency. ECFMG certification is the foundational step for all internationally trained physicians seeking to practise in the USA through the standard residency pathway. For physicians accessing alternative state licensure pathways, ECFMG certification requirements vary by state. StaffBank manages ECFMG certification applications and coordinates the USMLE preparation and examination scheduling for every physician we work with through the standard pathway.

Which internationally trained physician profiles are most suitable for immediate US placement in 2026?

The physician profiles most suitable for immediate US placement — meaning placement within 6 to 18 months rather than 3 to 5 years — are those who have already completed ECFMG certification and US residency, those who qualify for alternative state licensure pathways in Tennessee or other states that have enacted direct-access legislation, and those eligible for J1 waiver placement in rural and underserved settings. Physicians from the UK, Ireland, Australia, Canada, and other comparable healthcare systems who have completed fellowship-level training are the most likely to meet the qualification standards of alternative state licensure programmes. StaffBank assesses every candidate’s specific placement pathway at the sourcing stage and is transparent about realistic timelines from the first conversation.