A tireless advocate for occupational licensing reform, the R Street Institute’s Shoshana Weissmann recognizes the need to fix this problem. “It’s been wonderful to see states follow Arizona’s lead after Governor Ducey enacted universal licensing recognition,” she told me. “There is so much more to do for those moving from one state to another or from another country to ours. When we put arbitrary restrictions on what jobs immigrants can perform and what credentials transfer here, we prevent people from having access to all kinds of services and prevent immigrants from succeeding.”

She observes that legislators have noticed, too. During the pandemic, some states — including New York, New Jersey and Massachusetts — let immigrant doctors and foreign medical school graduates work to varying degrees for brief periods. This model needs to be expanded dramatically.

Weissmann points to a recent attempt in Missouri to change the way that state treats foreign-trained doctors. She writes, “Missouri state Rep. Derek Grier … introduced House Bill 1211, which would allow physicians trained in other countries to work in the U.S. if certain conditions are met.” The conditions are simple, she continues, explaining that they require evidence that the physician “graduated from an international medical program that provided ‘substantially similar’ training to that required to practice in Missouri, be in good standing with their country’s licensing board, and have completed their residency in a qualified international medical program.”