Is it Possible to Work As a Doctor in the USA Without USMLE

For many people, working in the Americas and Europe is a dream come true. This also applies to healthcare practitioners such as Doctors who chase after this opportunity because they know it will provide them with better working environments and better pay. Unfortunately, the battle to get certified can be quite difficult and lengthy, as there are several difficult exams and regulatory hurdles to conquer.

The United States Medical Licensing Exam (USMLE) and Professional and Linguistic Assessments Board (PLAB) are some examples of the exams taken in the US and the UK. However, the process of applying and preparing for these exams can be quite costly. So it comes as no surprise that some potential doctors may wonder if it is possible to work as a doctor in the USA without USMLE. In the coming paragraphs, we’ll delve deep into this.


The Educational Commission for Foreign Medical Graduates (ECFMG) requires International Medical Graduates (IMG) to fulfill certain requirements before they can acquire further training and jobs. The USMLE is a three-step exam designed to assess and ensure that you meet the level of competence required to treat the citizens of the United States. This exam tests your readiness, knowledge, and skills to provide safe and effective patient care. Divided into Step 1, Step 2 Clinical Knowledge (CK), and Step 3, these exams range over diverse topics and test your capabilities in more than one way.

Necessity of the USMLE

Passing the USMLE with great scores helps to open numerous doors of opportunity to IMG as there are quite a number of doctors applying and writing the exams with you, so the competition is stiff. Therefore, hospitals and employers are most likely to choose the people with the highest scores and certifications. Here are some more reasons why the USMLE is important:

  1. Integration into the US healthcare system: People who pass the exam demonstrate that they are capable of integrating into the healthcare system, as it assesses your clinical decision-making and communication skills to ensure that you can provide your patients with safe and effective care. The USMLE is a pre-requisite for international graduates to acquire a license to practice in the USA and to participate in specialty exams that grant you Board certification to establish expertise in a specific specialty.
  2. Standardized Assessment of Medical Competence: The USMLE provides a standardized and uniform evaluation of medical competence in applying medical knowledge and principles to patient care. This is helpful to doctors who graduated from medical schools that are not on the Accreditation Council for Continuing Medical Education (ACCME) list, as employers will be able to see how you perform against those who are.
  3. Residency program Admission: In order to be considered eligible for most residency positions in the US, you must have passed all three steps of the exam. Residency programs typically use USMLE scores as a criterion for selecting candidates.
  4. Competitive advantage: Scoring high in the exams will play in your favor as it will allow you to stand out in a river full of recent graduates. It enhances your competitiveness and shows residency programs and employers that you operate at a level higher than average level with a strong foundation of medical concepts and techniques.
  5. Global recognition: The USMLE is recognized worldwide as a measure of medical competence, and passing it provides versatility to your portfolio, allowing you the option to practice or pursue further education in other countries.

Most doctors recommend the use of a trusted and qualified question bank when preparing for the USMLE, as they contain past questions used from actual exams. Really good ones like CanadaQbank also contain features that will accurately simulate actual exam scenarios.

Can doctors work without USMLE?

Doctors do 5 kinds of work: administration, clinical, education, management, and research. In the most technical sense, only clinical work requires you to have passed the USMLE. This does not mean that every job in the other field is now available to you, as certain employers will still value the presence of a pass, but below are some available opportunities:

  1. Clinical Research Positions: Positions are available in research, and these focus on non-clinical roles like conducting research studies and gathering data. These positions are available in academic institutions, pharmaceutical companies, or research organizations.
  2. Teaching Positions: IMGs with strong teaching skills and relevant experience in their expertise can find jobs teaching at medical schools, institutions or teaching hospitals. These roles do not involve direct patient care.
  3. Limited Licensure Programs: Some states in the US offer limited licensure programs that allow medical school graduates and those who have passed a comparable exam in their home country to practice in the US under restrictions and supervision, often in underserved regions. These programs are designed to address healthcare shortages and may involve additional assessment, interviews, or specific practice restrictions.
  4. Military services: The US Armed Forces have specific programs to recruit physicians and healthcare professionals trained outside the States. Each branch of the US military has its accession programs for healthcare professionals, and they can offer specific training in exchange for a service commitment of a few years.
  5. Telemedicine Positions: this is an emerging field that offers doctors the chance to provide consultations and remote patient care. However, it is highly limited and regulated and is usually available under public health emergencies or during collaborative agreements, where IMGs may work with licensed physicians or healthcare institutions.
  6. O-1 Visa: Given to individuals who have shown extraordinary ability or achievement in their field, this visa is rarely given and then only to exceptional graduates. This visa allows you to participate in activities that showcase your exceptional skills, but it is not designed as a substitute for medical licensure.
  7. J-1 Visa: This visa category is commonly associated with cultural exchange programs. It includes the J-1 exchange visitor physician category, allowing foreign medical graduates to complete their graduate medical training in the US. They also have the option to work in underserved regions of the US in exchange for a waiver of the two-year home county residency requirement. This can be a pathway to employment, especially in areas with doctor shortages.
  8. Public Health and Policy: There are opportunities for IMGs to contribute to public health initiatives and policy development. This can involve working with NGOs, government agencies, or international health organizations.
  9. Healthcare Administration and Management: IMGs with strong administrative and managerial skills can choose to explore roles in healthcare management. Rather than direct patient care, these positions focus more on the business and operational aspects of healthcare.


While passing the USMLE is an integral step in the path for an international medical student looking to practice freely and fully in the United States, it is not the only way to find employment in the States. There are other alternate routes that you can take to acquire a job and a source of livelihood. Whether your goal is to wait a bit to prepare and raise money for the exam or a retest or to start working and building your career in a non-clinical direction, we hope this article was of use to you.