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Bhutan has a three-tiered healthcare system with the majority of services remaining Thimphu-centric. At the height of public demand for Immigration Medical Examination services, the two regional referral hospitals put in their efforts to establish the services in Gelephu and Mongar. The Regional Referral Hospitals enabled accessibility to IME services and improved efficiency at the National Referral Hospital by decongesting the number of clients. In this article, we describe how the regional referral hospitals established IME services that meet the standards of the destination country.