IMPRINT: Immigrant Professional Integration

Spotlight on Occupational Licensing Reforms

More than 1.9 million immigrants and refugees – talented individuals who arrive in the U.S. having already completed extensive education, job training, or work experience abroad – are unemployed or underemployed, owing to a variety of factors, one of which is the cumbersome licensing processes that create barriers for them.

Licensing requirements that prevent qualified immigrants from finding employment in their chosen professions affect not only the immigrant workers themselves, but also consumers who rely on the services they provide, and states that lose tax revenue as a result of these talented individuals’ underemployment.

U.S. licensing and certification processes often are overly restrictive and time-consuming, and in many cases both the certification requirements and the professions that require licenses differ significantly from state to state. As a result, many states and the federal government are exploring ways to reduce or streamline licensing barriers, even for native-born workers. Foreign-trained professionals have even a tougher road, with most professions lacking streamlined processes for evaluating foreign credentials or defined pathways for these professionals to re-enter licensed occupations in the U.S. Currently, about 1.2 million foreign-trained immigrant and refugee professionals live in the U.S. with in-demand skills that go unused, in part because they cannot overcome the barriers to re-licensure or re-certification.

States must better balance the need to protect consumers while at the same time ensuring that immigrants and refugees have access to jobs in their professions. While Interstate Compact agreements have made headway in reducing licensing barriers for American workers who wish to transfer their credentials between states, these agreements do not address the barriers to initial licensure faced by foreign-trained professionals authorized to work in the U.S.

Canada, by contrast, has made significant advances in removing barriers for some foreign-trained professionals. One example: “practice ready assessment programs” in seven provinces offer licensing pathways for physicians whose degrees from international institutions are not automatically recognized in Canada. These programs assess physicians for up to three months to determine if they are competent to practice. Successful physicians can apply for a provisional license to work in rural and underserved communities under the supervision of a fully licensed physician. Participants in these programs typically have a “return of service” commitment of three years or more in those communities and over time may qualify for a full medical license. Overseen by provincial medical authorities and conforming to provincial standards, with support and coordination at the federal level, these programs are a promising model for the U.S.

Some progress has been made in the U.S. In 2015 a comprehensive report on occupational licensure issued by the Obama White House, the U.S. Department of Treasury, and the U.S. Department of Labor contained recommendations for reform at the federal and state levels, including identifying licensing criteria that are burdensome or create unnecessary barriers to labor market entry, and improving portability and reciprocity for some licenses across state lines. In addition, the Department of Labor issued a grant to fund a consortium of eleven states to focus on populations disproportionately impacted by occupational licensing requirements, including work-authorized immigrants, individuals with criminal records, members of the military, veterans and their spouses, as well as dislocated workers.

The project has received bipartisan support and is coordinated by the National Conference of State Legislatures, the National Governor’s Association, and the Council of State Governments. WES is proud to be actively involved in this effort, whose goal is to increase access to professions among the priority populations and to identify and eliminate unnecessary barriers to licensure. To date Colorado, Maryland, and Nevada have specifically identified foreign-trained immigrants as a priority for their work under the grant.

Several other states have already taken necessary steps to reduce licensing barriers. Refer to IMPRINT’s Policy Map for details.

California In 2016 the Little Hoover Commission found the state’s licensing process had a disproportionately harmful impact on foreign-trained professionals and recommended measures to remove barriers, including bridge programming and apprenticeship programs, and called for a comprehensive review of the state’s licensing regulations.

Massachusetts Legislation has been introduced establishing a task force to examine streamlining licensing processes in the state for physicians and potentially other medical professionals, with a goal of strengthening medical care in rural and underserved areas. The bill has received strong support but is still going through the committee process.

Michigan Michigan’s Department of Licensing and Regulatory Affairs, LARA, in partnership with Upwardly Global, has created an online resource for skilled immigrants, providing important information on how to become a licensed professional in Michigan. The goal is to simplify the process for skilled immigrants and refugees in translating their education and talents to meet Michigan’s licensing requirements and to promote Michigan as a destination for skilled immigrants. Another LARA program, Michigan International Talent Solutions (MITS), offers free job search training and coaching to help skilled immigrants return to their professions.

Minnesota After establishing a Foreign-Trained Physician Task Force in 2014 to promote economic integration among foreign-trained physicians, Minnesota was recognized by the White House Task Force on New Americans as the first state to implement a comprehensive program to integrate immigrant medical graduates into the physician workforce. The program addresses barriers to practice and support pathways to licensure for immigrant and refugee physicians and seeks to increase access to health care in underserved communities in the state.

Missouri In response to a severe doctor shortage in the state, Missouri was the first state in the U.S. to pass legislation creating a new category of healthcare professionals known as “assistant physicians.” The new law is designed for individuals who graduate from medical school and pass key medical exams but cannot secure spots in residency programs, a challenge often faced by international medical graduates. Once certified as assistant physicians, individuals can practice under the supervision of a licensed physician in underserved areas in the state. The measure, which went into effect in August 2017, had the support of the Missouri State Medical Association. Since its passage, Arkansas, Kansas, and Utah have passed related legislation, and several other states have considered similar programs.

Tennessee The Tennessee Supreme Court recently expanded access for foreign-trained law school graduates making it less burdensome for graduates of foreign law schools to sit for the Tennessee bar exam and become practicing lawyers in the United States.

Now, upon demonstrating that their undergraduate education and legal education were substantially equivalent to a bachelor’s degree and an American law degree, applicants who have graduated from a law school in a foreign jurisdiction may qualify to take the Tennessee bar examination.

Prior to this change, foreign trained lawyers only qualified to take the Tennessee bar examination upon showing that they had earned an LL.M. degree in the United States in a program designed to train lawyers to practice law in the United States, were admitted to the practice of law in a foreign jurisdiction and are in good standing, and had been actively engaged in the practice of law for five of the past eight years.

West Virginia West Virginia issues teaching certificates only to U.S. citizens who meet the qualifications. However, permits to teach in the public schools may be granted to an exchange teacher from a foreign country or an immigrant who otherwise meets teaching requirements.

Wyoming Wyoming no longer requires that applicants for law licenses be U.S. citizens and noncitizens seeking entry into the Wyoming state bar are allowed to do so if they meet all licensing requirements.

States and local communities stand to benefit greatly from reducing barriers to employment for professional immigrants and refugees. Facilitating pathways to employment for skilled immigrants will help states and localities meet labor shortages in in-demand fields and will result in increased spending by immigrant and refugee professionals as well as additional tax revenue. As discussed, in recent years there has been a growing interest in occupational licensing reforms. Today many successful models exist, including state laws aiming at reforming licensing requirements to remove unnecessary barriers for immigrants, state task forces to examine licensing requirements, and the creation of alternative pathways to licensure for the foreign-trained. While these approaches do not address all the workforce barriers facing foreign-trained professionals, they can be part of comprehensive strategies to ensure that talented newcomers with in-demand skills and experience are able to fully contribute to their communities.

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