Maternal mortality rates in North Carolina are climbing at an alarming rate. The CDC reports that over just a two-year span, the number of women who have died within six weeks of giving birth doubled — jumping from 22 deaths per 100,000 births to a staggering 44. And the growing lack of access to care, as rural hospitals close maternity wards or shut down altogether, often because of staffing shortages, is at least partially to blame. The distressing situation leaves rural mothers no choice but to commute further to find care, increasing health risks for themselves and their newborn babies.  

This crisis is not isolated to North Carolina but extends across the nation, where the demand for healthcare services outpaces our ability to supply enough physicians to meet that demand. By 2030, the United States is projected to face a staggering 120,000 physician shortage. That means thousands of people, mostly in rural areas, will lose their doctors. And with the added concern that nearly 40% of American physicians will reach retirement age by that year, the data paint a worrisome picture of the future of healthcare access. 

North Carolina is especially vulnerable as a significant portion of the state, a total of 100 counties, already grapples with a scarcity of primary care physicians. By 2030, the Tar Heel State will face a shortage of 1,885 primary care physicians. This shortage disproportionately impacts rural areas, which could leave more than 600 small towns without a doctor altogether. Given the high-stakes nature of pregnancy and childbirth, these challenges pose life-threatening consequences. But there are ways forward.  

Training more physicians and healthcare providers nationwide is crucial to address the increasing demand for medical services. Internationally licensed physicians offer one solution that can immediately assist patients in North Carolina. Thousands of highly skilled healthcare professionals, both within the United States and abroad, are eager to contribute to the well-being of North Carolinians. However, doctors licensed outside the United States must currently find a faculty position at a North Carolina medical school or else repeat multi-year residency training before they can obtain a medical license.  

Increasing accessibility to pathways for internationally licensed doctors to practice in rural states like North Carolina would increase access for those who need it most — without compromising the care they receive. A provision under consideration by the state legislature would do just that by allowing physicians licensed in another country to practice in the state without having to repeat their entire training regimen. And it has already cleared the state Senate. 

Under this law, all North Carolina hospitals and rural healthcare facilities would be able to hire high-quality, internationally trained physicians who meet the State Medical Board’s standards, but those doctors would not have to repeat their three-plus years of post-medical graduate training in the United States.  North Carolina already lets medical-school faculty members treat patients without repeating residency, so this bill simply opens more doors for rural clinics and hospitals across the state to do the same, by hiring talented doctors to meet the desperate and growing need.  

Tennessee recently passed a similar law that allows healthcare providers to sponsor high-quality international doctors for provisional licenses, converts provisional licenses to full licenses after two years of successful practice, and preserves the Medical Examining Board’s authority to ensure that internationally trained physicians possess the requisite skills, test scores, and experience to provide exceptional care. Neither Tennessee’s law nor the North Carolina Senate’s proposal requires physicians to repeat a three-year, or longer, residency training program.  

But the demand extends beyond doctors residing abroad; there are already thousands of skilled healthcare professionals living in the United States. This bill simplifies the paths for these healthcare workers to fully utilize their medical expertise to help meet the growing need. Remarkably, a recent study revealed that nearly 40% of the international US labor force holding healthcare professional and doctorate degrees are working in jobs outside healthcare. Removing repetitive training requirements for foreign-licensed doctors benefits refugees, immigrants pursuing citizenship, US citizens with foreign medical training, and North Carolina patients most at risk of losing access to essential care.  

North Carolina moms need better access to doctors to improve their health outcomes.  Internationally trained doctors can and should be part of the solution to both rising maternal mortality and rural physician shortages. North Carolina can tackle the physician shortage and promote a healthier future for all its residents by supporting this commonsense solution to streamlining pathways to practice for international doctors.