Several states in the USA require that a foreign medical school obtain licensure or other formal approval prior to sending students to that state for clinical clerkships and for graduates to undertake residency appointments or obtain licensure.

The Medical Board of California has formally approved the American University of the Caribbean since 1986. This enables AUC to conduct clinical clerkships for its students in that state and also means that the school's educational program and M.D. degree will be accepted toward meeting California's requirements for graduates applying for residency and / or licensure.

AUC was approved by the New York State Department of Education in 2003 and now AUC offers many clinical clerkships in that state. About 1/3 of the residency programs in the USA are located in New York and AUC graduates are also now eligible to undertake post-graduate training there. In New York, foreign medical students may only rotate for up to 12 weeks of clerkships UNLESS the school's medical education program has been approved by the Department of Education. Also foreign medical graduates may not accept a residency appointment in New York if their medical school is not approved, however they may apply for licensure.

The State of Florida requires that all non-public educational institutions obtain licensure to operate or offer programs in that state. AUC was granted a license to operate in 1996 and it has been licensed to conduct clinical clerkships in Florida since 2002. There is no restriction for foreign medical graduates to apply for residency of licensure in the State of Florida.