International Doctors will still need to do step1/2/3, and possibly even a full home-country residency just to be able to work as GPs in Tennessee. This would open up the floodgates with physicians from across the world lining up to work there and thus creating a downward pressure on demand and in turn compensation which will further drive out AMGs and IMGs -who completed their residency in the US- from Tennessee and further exacerbating the physician shortage.