New medical license pathway for international doctors could help alleviate Illinois shortage

Before moving to Chicago from Russia, Dr. Filipp Prikolab had a thriving medical practice.

The 34-year-old ran a department of 26 people caring for elderly patients at a Moscow hospital. Before that, he completed his residency in internal medicine, intensive training programs in geriatric and family medicine and earned his medical degree from First Moscow State Medical University. He started his journey to becoming a doctor when he was a 16-year-old in Ukraine taking pre-med classes.

In 2019, he followed his mom to Chicago. While the move was scary, he’s fallen in love with the city, especially living near Lake Michigan. He says living in America is like he “won a lottery ticket.”

But he hasn’t been able to work as a doctor, because until now he would have had to repeat a residency in the United States. So, for the last six years, he has worked as a medical assistant for an internal medicine doctor, also of Russian-Ukrainian origin, at Advocate Lutheran General Hospital in Park Ridge.

“I want a chance to fully use my skills and my experience,” he says. “I also want to grow my skills and become more proficient in other aspects of medicine.”

Tyler Pasciak LaRiviere/Sun-Times

He is one of thousands of Illinoisans with an international medical degree. And despite receiving similar training as students at American medical schools and residency programs, the pathway to becoming a licensed doctor for Prikolab and his peers is difficult and can take years.

But that’s all changing thanks to a law that went into effect this year in Illinois to make it easier for people like Prikolab to get their state medical license.

The law, passed in 2023, created a limited license that allows doctors trained abroad to practice for two years under a supervising physician. They must either treat an underserved population or practice in an area of “unmet medical need.” After the two years, they’re given a provisional license for another two years, which allows them to mostly work independently, while still supervised. Then, they’re granted a full, unrestricted medical license.

Tyler Pasciak LaRiviere/Sun-Times

Piyush Vyas, president of the Illinois State Medical Society, says this new license will help alleviate the state’s doctor shortage and fill gaps where access to care is restricted or nonexistent.

The Migration Policy Institute predicts the state will be short 6,200 doctors by 2030. Meanwhile, over 12,000 Illinois residents have an international medical degree they can’t use, according to Upwardly Global, an organization that helps immigrant and refugee professionals find work in the U.S.

And it’s not just a problem for Illinois. The American Hospital Association projects a national shortage of 3.2 million health care workers by 2026, including nurses, lab technicians and other positions. By 2033, the U.S. will be short up to 124,000 doctors and will need to hire at least 200,000 nurses a year, according to the association.

Nearly 99 million Americans live in an area with a shortage of doctors or other primary care professionals, according to Upwardly Global.

As of January, most Illinois counties — 81 out of 102 — have a shortage of primary care providers, according to the federal Health Resources and Services Administration. Eleven of the counties have a shortage in some areas, like Cook County. Only 10 counties have no shortage at all.

“Illinois has had a physician workforce shortage for several years, and it is not improving,” Vyas says. “With further training under physician supervision, [doctors who had been trained abroad] will help alleviate the shortage of medical professionals in key areas of our state.”

State Rep. Theresa Mah, who championed the bill that created the new license, says more diversity among physicians also is good for the state’s diverse population and improves health outcomes for patients.

“It’s in the best interest of our state. We want these taxpayers, we want people to choose to live in Illinois because of these opportunities,” Mah says, “especially in light of the health care shortage and the need for bilingual and culturally competent providers.”

The Illinois Department of Financial and Professional Regulation, which will be issuing the limited licenses for international doctors, has received about 200 inquiries since December from people asking about them, a spokesperson said.

The agency has not begun accepting applications or issuing licenses as lawmakers and department officials are still working out the administrative rules for the licensing process. The spokesperson didn’t know when they will start taking applications.

‘Take a chance on us’

Despite the fact that Dr. Ayobami Oduwole had a medical degree, it took her over seven years to get a job as a doctor in Chicago.

In that time, she swabbed noses during the early days of the pandemic, worked as a caregiver at a nursing home and drew blood as a phlebotomist. The mother of two even spent two years flying to Missouri every weekend to volunteer at a rural health clinic.

Oduwole, 36, originally from Lagos State, Nigeria, completed her medical degree in the Caribbean in 2016. As a part of her schooling, she completed six months of clinical training in Chicago in 2015.

She didn’t plan on moving to America, but then she met her now-husband while working in Chicago. After a year working as a fully licensed doctor in Nigeria, she moved to Chicago in 2017 to be with her husband, a respiratory nurse, and begin trying to work as a doctor here.

Last year, Oduwole matched with Cook County Health’s family medicine program. She’s almost done with her intern year and says she loves her job. She’s interested in one day working in palliative care or maternal health.

Tyler Pasciak LaRiviere/Sun-Times

The new law could have helped Oduwole get her medical license years earlier because she wouldn’t have had to do a U.S. residency. Her eventual success getting into a residency program means she won’t need to apply for the new limited license. But she says she’s grateful a pathway is now available for her peers to get their full license without having to match for residency.

“Hospitals should really be open to international medical graduates. We are very useful, we know a lot of stuff,” she says. “We can help us bridge this gap and fill the shortage. Take a chance on us.”

Every year since moving to Chicago, she applied to dozens of residency training programs, hoping to get “matched” with a hospital. International medical school graduates secure a residency slot only 60% of the time, compared with 93% for U.S. graduates.

“The only difference between myself and an American is where I got my training,” Oduwole says.

Part of the challenge, she says, was she didn’t have anyone to explain and guide her through the match process. She had to learn with each failure, while U.S. medical students get major help from their schools.

“Not having that advantage, I just kept trying, but it was tough,” Oduwole said.

But she didn’t give up. She sought out advice at medical conferences and she followed up with programs to get feedback on her application.

“I don’t think there was a time where I really wanted to quit,” she said. “I would cry and cry on match day but two weeks later I was trying again.”

Strengthening her resolve was the volunteer work she did while working full-time in medical research. Every weekend from 2021 to 2023, she flew to rural Missouri to work for a health clinic that served uninsured patients. Some would travel 30 to 40 miles for care.

“That really opened my eyes, that they were traveling so far to see us,” Oduwole says. “I saw all sorts of patients and saw so many different medical problems. … That experience also showed programs what I’m able to do.”

Learning curve

Oduwole and her peers interviewed by the Sun-Times say they recognize that they need to learn how American medical systems work, and they agree they should work under another doctor for the beginning of their license.

“We know a human life is at stake,” she says. “We are willing to learn, and we have so much potential.”

One of the main differences between her training and an American education is the technology that’s more readily available at U.S. hospitals. For example, she learned how to conduct a more thorough physical exam, while American doctors learn how to rely on scans and lab results to assess their patients.

Lucas Zborek, born and raised in the Chicago area and a Northwestern graduate, attended medical school in Poland and currently works at a hospital in Krakow. He’s considering applying for Illinois’ limited medical license.

Zborek, 34, acknowledged the learning curve to practicing in American hospitals versus the ones he has worked for in Europe. But those differences, he says, mainly come down to variations in technology, like learning a new charting system.

“Patient safety is of course paramount, so that’s why it’s good we’re given two years under a supervisor. That gives you enough time to learn those logistics and adjust to a new system,” Zborek says.

“Otherwise, we learn the same things, we all learn how to take a history and how to do a physical exam.”

‘Skills that we need’

Mah proposed the new licensing pathway after learning about doctors who were unable to practice medicine because they were trained abroad.

“I heard really moving stories about people who found it impossible to regain their licensure, and how difficult it is to get into residency. They had no route that made sense for them and their lives,” she says.

Mah developed the legislation with the Illinois State Medical Society, the Chicago Bilingual Nurse Consortium and Upwardly Global. The bill’s authors looked to other states that offer licenses to internationally trained doctors. Missouri, for example, issues licenses to these doctors, but they must always work under another physician.

“That creates a two-tiered system. Those doctors are never under their own license and can’t ever practice independently. We didn’t want to do that here,” Mah says.

“These are people who have talents and skills that we need,” she adds. “There is a health care shortage and we shouldn’t overlook the contributions of immigrants just because they’re immigrants.”