The report examines issues concerning graduates of foreign medical schools applying for endorsement licensure and the question of whether they are subject to dissimilar and unfair requirements compared with those for graduates of U.S. medical schools. The investigation's objectives were to: (1) identify any differences between the states' endorsement requirements for graduates of foreign medical schools and for graduates of U.S. medical schools; and (2) determine the reasons for and merits of any differences. The investigation revealed that the states had no uniform standards or requirements to determine competence and that most states had different endorsement requirements for graduates of foreign and U.S. medical schools. The American Medical Association, the Federation of State Medical Boards, and directors of state medical licensing boards were found to disagree with organizations representing foreign school graduates on the merits of different requirements related to documentation of educational background. Despite the differences of opinion, it was agreed by all concerned that different examination requirements for foreign medical school graduates have no merit and that it would be desirable to have a clearinghouse to maintain and verify records to help eliminate states' duplicative verification efforts and streamline the licensing process. (GLR)