What the compact is
The Interstate Medical Licensure Compact (IMLC) is an expedited pathway to full, unrestricted licenses in member jurisdictions. You designate a state of principal license, get verified once, then request additional licenses in days rather than months.
The Compact covers 44 member states plus the District of Columbia and Guam — 46 jurisdictions. Alaska became the 44th member state in June 2026. In March 2026 the Compact issued 3,633 licenses, and more than 221,000 since 2017. Source: Interstate Medical Licensure Compact Commission, 2026.
Two things physicians frequently get wrong:
- Hawaii and Vermont are members, but neither can serve as your State of Principal Licensure. If one of them is your only license, the Compact is not open to you yet.
- The Compact is for MDs and DOs only. APRNs use the APRN Compact and PAs the PA Licensure Compact; neither is covered here.
Verify membership before you plan around it. Published lists of non-member states currently disagree with each other. Check membership directly with the Compact.
What it is not
- It is not one license valid everywhere. You receive a separate license, and pay a separate fee, for each state.
- It does not exempt you from each state's renewal cycle, CME rules, or controlled substance registration.
- It does not cover every jurisdiction. California, among others, is outside it.
- It does not touch credentialing.
Eligibility, briefly
You need a full unrestricted license in a member state, ABMS or AOA board certification, no history of discipline or active investigation, and a clean criminal record. Physicians who fail eligibility use FCVS to speed conventional applications instead.
Why credentialing still takes months
Licensure is the state's permission to practice. Credentialing is a single hospital's verification of you: primary-source verification of training, every malpractice claim, gaps in employment, peer references who actually reply, and a medical executive committee that meets monthly. Nothing in the compact accelerates a committee calendar.
Practical consequences:
- Start credentialing the moment an assignment is verbally agreed.
- Keep a current CV with exact dates, an FCVS profile, and a claims history summary ready to send in one email.
- Ask who at the agency owns your file, and ask for the committee date.
DEA registration
A DEA registration is address-specific. Additional state registrations may be required where you prescribe, and some states require a separate controlled substance license. Budget for both time and fees per state.
Sources
- Interstate Medical Licensure Compact Commission, 2026 — membership count, Alaska accession, licenses issued.