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Compliance with State Authorization

State authorization laws are constantly changing, and many states have exemptions for clinical rotations. The AAMC has put together these resources about state authorization and the State Authorization Reciprocity Agreement (SARA) to help institutions and students understand these issues.

If you're considering an away rotation, follow these steps:

  • Identify if your institution is a SARA institution. Your medical school—if not a stand-alone institution—may already fall under the umbrella of your broader institution’s SARA membership.  We encourage you to check with your Office of General Counsel.
  • If your medical school is a SARA institution in a SARA state, it appears that you are now compliant with every other state’s current authorization requirements and no further action is necessary for clinical rotations.
  • If your medical school is NOT a SARA institution, there are at least nine states that may require state authorization for medical students to do clinical rotations: Alabama, Kentucky, Nevada, New Hampshire, North Carolina, Oregon, West Virginia and Wyoming. Details about these states’ requirements are provided in the AAMC guidance, but you should also contact the state’s higher education office for additional clarification.      
  • Your institution may choose to register with individual states, some of which have negligible requirements to do so. Medical students should not attend clinical rotations in any states where your institution is not authorized.  

Review Ensuring Medical Education Compliance with State Authorization  for additional guidance on this process.

If you have any questions, contact Matt Shick at in the AAMC Office of Government Relations and Regulatory Counsel.