The coastal community of Hoquiam, Washington, located about two hours from Seattle, is designated as a Health Professional Shortage Area, where demand for care outpaces the supply of health professionals. Many Hoquiam residents haven’t seen a physician in years.
Dr. Win Kyin is helping to change that. She attended medical school in Myanmar, where she spent more than a decade as a general practitioner running her own free clinic. Simultaneously she applied what she’d learned in graduate school earning a master’s in public health to her work of overseeing hospital management at Myanmar’s Ministry of Health.
When the military seized control of the government in February 2021, Dr. Kyin spoke out against the coup. Fleeing arrest, she left her clinic and patients behind. She arrived in the United States in January 2022—bringing her years of training and dedication to patient care with her.
“Taking care of patients as a physician is my childhood dream,” she said.
Dr. Kyin is exactly what communities like Hoquiam need. Yet validating her credentials was challenging due to the military coup, and she faced barriers in the U.S. licensing system. Despite years of education and experience practicing medicine, internationally trained physicians (ITPs) like Dr. Kyin are typically required to repeat their graduate medical education, also known as a medical residency. This structural barrier not only delays individual careers and prevents ITPs from contributing their skills and experience, it also leaves patients waiting. WES has documented this gap through credential evaluations and engagement with partners and ITPs on the ground, demonstrating that the barrier stems not from qualifications, but outdated systems. This expertise laid the groundwork for a national policy effort.
State Innovation Sparks a National Model
With a national physician shortage projected to reach 86,000 by 2036, states are leading the way in modernizing systems to unlock the talent already in their communities. WES has been part of that effort from the beginning—working alongside policymakers and partners on the ground to help draft model bill text, advance legislation, coordinate state and national partners, and support states as they move from passage to implementation.
While exploring her options, Dr. Kyin took a job as a pharmacy technician at Walgreens in Portland, Oregon, in March 2022, where she learned about the U.S. health care system and improved her English proficiency. Her administrative and public health background soon opened another door—the refugee organization that had connected her with the job at Walgreens hired her to oversee its community health programs. She managed a bilingual team serving patients from Afghanistan, Ethiopia, Myanmar, Russia, Ukraine, and more.
“It was a privilege for my professional life and my personal life,” Dr. Kyin said.
It was meaningful work, but Dr. Kyin wanted to return to practicing medicine—her lifelong dream and the career she had trained for. Washington State was working to make that possible, establishing an alternative pathway to licensure that didn’t require ITPs to repeat their training.
Washington’s pathway maintains rigorous standards while eliminating unnecessary barriers to practice. Rather than repeating years of training they’d already completed, ITPs could demonstrate their qualifications through a structured, supervised assessment period.
In 2021, Washington became the first state to enact legislation granting temporary licensure to ITPs. Five years later, in 2026, it updated this policy to eventually permit ITPs to transition to full licensure. States nationwide quickly followed suit. In 2022, Colorado opened up to ITPs a re-entry program initially designed for U.S.-educated physicians. Then, state by state, a trend emerged rooted in the idea that when immigrants can fully contribute their skills, everyone benefits. These states recognized the experience and education of immigrant health care providers, and designed pathways to connect these individuals with in-demand jobs that match their skills sooner.