The United States operates as a federation, with individual states retaining significant legislative powers. Consequently, the issuance of medical licenses falls within the jurisdiction of each respective state. Primarily, pursuing a career as a doctor in the US involves navigating two distinct processes: medical licensing and board certification. Board certification, such as the Education Commission for Foreign Medical Graduates (ECFMG) Certification, follows a separate protocol. The ECFMG oversees a comprehensive certification process, rigorously evaluating physicians' knowledge and skills. However, even with board certification, a physician can only practice upon obtaining a medical license from a specific US state. While there are federal positions within entities like the US Military or federal prisons that employ medical personnel, these doctors still require licensure from individual states. Typically, doctors practice within the state that grants them a medical license, which serves as their official authorization to practice medicine in the US. Moreover, the proliferation of information technology has led to the emergence of telemedicine, allowing physicians to diagnose and treat patients remotely. However, certain states have imposed restrictions on telemedicine practices as well.