Texas will become the 13th state to lower barriers for foreign-trained physicians with the implementation of House Bill 2038, known as the DOCTOR Act. The legislation aims to address the state's looming physician shortage, projected to exceed 10,000 doctors by 2032, by allowing qualified foreign medical graduates to practice under supervision without first completing a U.S.-based residency.
Previously, Texas required even highly trained international physicians to repeat residency training, often for three to five years, to practice in the state. The new law allows these physicians to apply for provisional licenses after a vetting process and to work under the supervision of a licensed physician or medical director. After four years and successful completion of the USMLE exams, they may become fully licensed.
Sponsored by Rep. Dr. Tom Oliverson (R), an anesthesiologist, the law also opens a path for U.S. citizens who attend foreign medical schools and fail to match with a U.S. residency program. The state will permit them to work in rural or underserved areas as 'Graduate Physicians' under physician supervision.
“This law is very much rooted in improving access to care,” said Dr. Ezekiel Silva, chair of the Texas Medical Association’s council on legislation. “We want to ensure it’s implemented correctly, with no double standards.”
Despite broad support, the law is not without controversy. It bans participation from physicians trained in Belarus, China, Cuba, Iran, Myanmar, North Korea, Russia, Syria, and Venezuela, raising concerns about discrimination.
Critics also note the law is a short-term fix, urging more permanent solutions like expanding residency positions and rural health infrastructure.
“It may create a perception that some doctors entered through the back door,” said Ogan Gurel, BioHealth Innovation Specialist at UT-Arlington. “Residency still matters long-term for professional growth.”
Even with limited data from similar laws in other states, Texas leaders are optimistic. The DOCTOR Act could bring immediate relief to communities in dire need of care, especially in medically underserved areas.
