On August 1, 2019 the governor of North Carolina signed into law a bill (House Bill 228) that, among many other provisions affecting the regulation of the medical profession, eased the licensing of foreign-trained physicians. Under existing physician-licensure requirements, international graduates of international medical schools had to complete three years of training and could not use proof of specialist certification as a basis for licensure. The new law provided that applicants would have to complete two years of training or provide proof of certification by a specialty board recognized by the North Carolina Medical Board, as well as pass an exam acceptable to that board.