IMPACT
REPORT

In June, FSMB launched a national public awareness campaign—Care Matters—to spotlight the critical role state medical boards play in protecting patients and supporting quality care.

The campaign features a series of short video ads on Instagram and Facebook, aimed at primarily reaching women ages 18–55. These videos highlight the vital role physicians play in life’s most important health moments—while also emphasizing how state medical boards work behind the scenes to support safe, ethical, and high-quality care. By reinforcing the connection between trusted care and effective regulation, the campaign builds public understanding of the value medical boards bring to the healthcare system.

A Lifetime of Care You Can Trust

FSMB partnered with the nationally recognized branding agency Mekanic to develop CareMatters.org—an easy-to-use resource where the public can:

• Learn about the mission and work of state medical boards
• Look up their physician’s credentials through DocInfo.org
• Find contact information for their state board

Since launch, the campaign has generated more than 19 million views across social media and driven over 20,000 website visits to CareMatters.org.

FSMB is also making campaign videos available for boards to use on their own websites and social channels. Additional resources are in development based on member feedback and will be available in the coming months.

Want to learn more or use these resources?
Visit www.carematters.org or email jknickrehm@fsmb.org for information about how your board can participate.

John Bremer, Managing Director, Advocacy & Policy; Lisa Robin, Chief Advocacy Officer; and Dr. Jorge Alsip, FSMB Board/Alabama Board of Medical Examiners, met with the Alabama congressional delegation in June to voice FSMB support for the SHARE Act.

FSMB continues to advocate for solutions to support a strong and flexible health care workforce—most recently through support of the SHARE Act (States Handling Access to Reciprocity for Employment Act). The SHARE Act would reduce barriers to health care licensure across states by streamlining how state licensing boards access federal criminal background check information. It would authorize the FBI to share this information directly with state boards for individuals seeking licensure through interstate compacts, such as the Interstate Medical Licensure Compact (IMLC) and the PA Licensure Compact (PA Compact). FSMB has formally endorsed this legislation and is actively working to secure passage of the SHARE Act in both the U.S. House and Senate.

By improving access to essential background check data, the SHARE Act would help:

• Speed up the licensure process for health care professionals practicing in multiple states
• Improve workforce mobility, helping to address health care shortages—especially in underserved communities
• Strengthen patient safety by ensuring licensing boards have the information they need to make informed decisions

In recent months, FSMB’s advocacy staff, members of our Board of Directors, and representatives from state medical boards, have met with legislators in Washington, DC, to voice strong support for the bill and emphasize the importance of improving licensure pathways in today’s rapidly evolving health care environment.

FSMB will continue to work with policymakers and member boards to advance legislation that supports safe, efficient licensure across state lines.

FSMB has released the latest edition of its biennial census of licensed physicians, offering a comprehensive snapshot of the U.S. physician workforce.

As of 2024, there are 1,082,187 licensed physicians across the United States and the District of Columbia—a 27% increase since the census was first published in 2010. State medical boards issued a record 146,000 new licenses last year alone, representing a 13% increase over 2022 and 43% more than in 2020.

Key findings from the 2024 census include:

Physicians represent:

Women now represent:

Most physicians hold a license in a single state, but IMGs are more likely to be licensed in multiple states, often practicing in underserved areas. This trend is contributing to growing legislative interest in alternative licensure pathways for internationally trained physicians—particularly those who have practiced abroad but haven’t completed a U.S. residency.

These developments reflect broader shifts in health care delivery and demand, and the census continues to be a valuable resource for state and federal policymakers, regulators, and workforce planners.

View Census licensing data by state or read the full Census article in the Journal of Medical Regulation (link to come).

Trailer: Educational Series on Physician Professional Boundaries

FSMB, in collaboration with the FSMB Foundation and Administrators in Medicine Foundation, has launched a new educational video series designed to help physicians navigate complex situations involving professional boundaries in clinical practice.

Maintaining appropriate boundaries is essential for protecting patient trust, upholding ethical standards, and ensuring safe, respectful care. This series offers real-world scenarios that highlight where those boundaries can sometimes become blurred.

The video series explores three common situations:

• Writing prescriptions for friends or family members
• Pursuing inappropriate romantic relationships with patients, their guardians, or close contacts
• Conducting intimate examinations without clear communication and patient consent

Each scenario is followed by expert commentary offering guidance on how to recognize, manage, and prevent boundary violations—reinforcing the importance of professionalism, ethical conduct, and trust in the physician-patient relationship.

This educational resource is intended for a wide audience, including:

• Medical students and residents
• Practicing physicians
• State medical and osteopathic board members and staff
• Patients and others in the medical regulatory community

By addressing these often difficult but critical topics, the series aims to support safe, ethical care and strengthen patient-physician interactions.

The video series is available online, and participants are eligible to receive continuing medical education (CME) credit upon completion. For more information, email edu@fsmb.org.

The Advisory Commission on Additional Licensing Models (ACALM) – co-chaired by the Federation of State Medical Boards (FSMB), the Accreditation Council for Graduate Medical Education (ACGME), and Intealth™ – has released new guidance and a practical toolkit to support state medical boards, legislators, and potential employers as they consider new pathways for licensing internationally trained physicians (ITPs).

ITPs are individuals who have received medical education and practiced outside the United States. Some proposed licensure pathways would allow ITPs to practice without completing U.S. postgraduate training—requirements designed to ensure physicians are fully prepared to provide safe, competent care. Because these proposals could reshape the conditions under which licensure is granted, the Commission’s recommendations are designed to guide boards, policymakers, and institutions in establishing strong assessment and supervision standards in states where such pathways move forward. The guidance is not an endorsement of pending legislation, but a resource to help ensure that any new pathways to licensure maintain patient safety and professional rigor.

The recommendations emphasize comprehensive oversight, including assessment across six core competencies, initial individualized evaluations, specialty-specific examinations, and ongoing multi-modal evaluations of knowledge, skills and professional practice. They also call for supervision by fully licensed, board-certified physicians in the same specialty, with clear standards set by medical boards for supervisors and training sites. In addition, the guidance underscores the importance of protecting employee rights to ensure fair treatment and access to resources for ITPs.

ACALM was formed in December 2023 in response to growing interest among policymakers in expanding licensure pathways to address physician shortages and improve patient access. The guidance reflects a careful review of educational literature and relevant legislation, combined with input from nearly 100 individuals and organizations across the health care community during a public comment period.

Oregon is among the states working to implement legislation creating a pathway for internationally trained physicians to contribute to its health care workforce.

“Drawing from comprehensive stakeholder recommendations, this new framework provides the infrastructure we've long needed to tap into a valuable pool of qualified physicians who previously had no clear route to serve State patients,” says Nicole Krishnaswami, JD, Executive Director of the Oregon Medical Board. “As we prepare for implementation, we recognize this is somewhat uncharted territory – we're building the processes and systems, but the ultimate success will depend on whether internationally trained physicians embrace these new opportunities. What we do know is that this is fundamentally the right approach. Too many skilled physicians have been unable to contribute their expertise to addressing healthcare access issues in underserved communities simply due to licensing barriers rather than clinical competency.”

The release of this guidance and toolkit marks an important step in shaping safe and effective licensing pathways for ITPs. State-level implementation efforts will provide valuable insights into how the framework works in practice, helping to inform future policy decisions across the country.

Access the full guidance document

Explore the implementation toolkit

When the Maryland Board of Physicians faced an overwhelming challenge – reviewing thousands of historical disciplinary orders to identify permanent sanctions – it turned to an unlikely partner: artificial intelligence.

Through a first-of-its-kind collaboration with FSMB, Maryland combined regulatory expertise with cutting-edge technology to tackle a problem once thought impossible. The result was not only a breakthrough in efficiency and transparency, but also a model for how human–AI partnerships can transform medical regulation.

A Transparency Challenge in Maryland

Maryland’s public profile system contains detailed disciplinary information, but for many years, orders lacked summaries. Even when summaries were included, variation in authorship and inconsistent use of the word “permanent” meant that permanent sanctions were often buried and difficult to identify.

The scope of the challenge was enormous: 6,000 historical disciplinary orders dating back to 1999. Staff had managed to identify 11 permanent sanctions manually, but finding each would have required reading every page of every order – an impossible task given the board’s workload. Plus, permanent sanctions are distinct from other board actions. For example, a probation or reprimand may end with an active license, but a permanent sanction results in a lasting restriction. Identifying these cases was critical for transparency and public safety.

Adding to the complexity, Maryland had used three different systems to track board orders over time. None of them flagged permanent sanctions, and even after consolidating the systems, this gap remained.

From AI Pilot to Transformative Results

Rather than abandon the effort or hire additional staff, Maryland pursued a different path. In collaboration with FSMB, the board turned to AI to see if technology could accomplish what staff alone could not.

This was no simple upload-and-run process. The AI was trained like a new analyst and given detailed instructions on what to find, what to ignore, and how to format the output. Subject matter experts defined the task, guided the AI through multiple rounds of refinement, and stayed closely involved at every stage. Over six full cycles of review and adjustment, the model learned to identify permanent sanctions with precision.

The human–AI partnership was key. Maryland’s team brought deep regulatory and legal knowledge, while FSMB’s technology experts supplied the AI tools and know-how to build and fine-tune the system. Together they created a workflow that blended human judgment with machine speed and consistency.

The results exceeded expectations. The AI located all 11 permanent sanctions previously identified by staff and uncovered 20 more that had gone undetected. Along the way, it produced concise, consistent summaries that often improved on earlier human-written versions.

The project also delivered additional, unexpected benefits:

• Flagging legacy documents for potential privacy concerns
• Automatically identifying complex legal terminology such as “crimes of moral turpitude”
• Improving the tracking of sexual misconduct cases
• Creating a well-structured, searchable dataset with long-term value for research and oversight

Today, Maryland’s public profile system features a clear visual indicator of permanent sanctions, displayed prominently at the top of each profile with a direct link to the full sanction order, strengthening public trust and transparency.

What This Means for Medical Boards

This project treated AI as a temporary analyst assigned to a single, clearly defined task. But its success raises a larger question: What could medical boards achieve if AI tools were integrated into daily operations?

The Maryland Board’s experience demonstrates how AI can serve as a powerful workforce multiplier, expanding staff capacity, enhancing public safety, and advancing transparency in medical regulation.

Interested in learning more about this project or piloting similar efforts? Contact Cyndi Streun, VP, Information Services at cstreun@fsmb.org.

Nicole Krishnaswami, JD, speaking at IAMRA’s 2025 16th International Conference on Medical Regulation in Dublin, Ireland.

The International Association of Medical Regulatory Authorities (IAMRA) convened its 16th International Conference on Medical Regulation this September in Dublin, Ireland, marking the organization’s first European gathering in more than a decade. Hosted by the Medical Council of Ireland, the event brought together more than 460 participants representing 37 countries. A highlight of the meeting was the installation of Nicole Krishnaswami, JD, Executive Director of the Oregon Medical Board, as IAMRA’s new chair.

Guided by the theme “People-focused Regulation for a Safer Global Community,” the conference centered on a shared commitment to placing patients and communities at the heart of health practitioner regulation. The proceedings opened with remarks from Dr. Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization (WHO), who spoke to the vital role regulation plays in shaping health systems, strengthening the healthcare workforce, and advancing universal health care.

Throughout the week, participants engaged in rich dialogue on the challenges and opportunities facing regulators worldwide. Former Irish Prime Minister Dr. Leo Varadkar urged attendees to take bold steps in modernizing health systems and regulatory practices. Sessions featured practical strategies for strengthening regulatory effectiveness and responsiveness, alongside interactive workshops that explored tools for integrating artificial intelligence, advancing compassionate regulation, and improving workforce planning. Delegates also examined the importance of inclusive regulation, health equity, and cultural safety, and considered how best to prepare future generations of physicians.

The program also included a pre-conference workshop dedicated to supporting low- and middle-income countries, which built upon the 2024 IAMRA-WHO Memorandum of Understanding. This session underscored IAMRA’s ongoing commitment to global collaboration and capacity-building across health systems.

Ms. Krishnaswami highlighted the strong engagement of participants and acknowledged the leadership of Joan Simeon, CEO of the Medical Council of New Zealand, who completed her term as chair.

IAMRA will host its next conference in Hong Kong, China, in 2027.

Continuing medical education (CME) is a cornerstone of professional growth and a vital tool for ensuring patient safety and public trust. To help state medical boards meet this need, FSMB partners with boards and other organizations to accredit educational programs that deliver high-quality, evidence-based training. These accreditation services, offered at no cost to boards, make it easier to provide meaningful learning opportunities for licensees and other healthcare professionals.

Supporting State-Level CME Programs

The Washington Medical Commission is an example of this collaboration in action. Working with FSMB, the Commission developed Staying at the Forefront of Genetic Advancements, a five-part CME series designed to help physicians apply cancer genetics in daily clinical care.

Accredited for AMA PRA Category 1 Credit™ through April 2027, the modules bring together genetic counselors, oncologists, and primary care physicians to explore topics such as hereditary cancer risk assessment, genetic counseling, testing outcomes, cascade screening, and variant classification. The free, online program equips non-genetic providers with tools to better identify hereditary risks, guide testing decisions, and expand access to genetic services, particularly in underserved communities.

“Partnering with FSMB’s accreditation program has been an invaluable experience. Their education team provided thoughtful guidance and clear direction, enabling the Washington Medical Commission to strengthen the quality and impact of our educational offerings,” said Jimi Bush, Director of Quality and Engagement at the Washington Medical Commission.

“With FSMB’s support, we have been able to develop programs that go beyond traditional topics to address underserved conditions and patient populations. As a result, we are better positioned to deliver relevant, high-quality education that supports our licensees continued professional growth and excellence in practice.”

With FSMB’s support, the Washington Medical Commission was able to deliver a robust, clinically relevant education program that meets national accreditation standards while addressing a timely and evolving area of medicine.

A Mission-Driven Approach

FSMB is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. Since 2017, we’ve served nearly 45,000 learners through a range of CME activities, including live courses, webinars, enduring materials, and online programs.

FSMB’s collaborations with state medical boards and other partner organizations to plan and deliver accredited CME programs reflect the same standards. From early planning through implementation, FSMB’s Education team ensures every program meets ACCME requirements and aligns with our broader mission to promote excellence in medical regulation. Each activity is designed to strengthen professional competence, promote fairness in regulation, and improve patient care through evidence-based education.

By partnering with FSMB, state medical boards gain access to a trusted accreditation framework, expert guidance, and a streamlined process for delivering impactful education that meets the needs of today’s healthcare workforce. To learn more, email edu@fsmb.org.