maybe i am slow, but i don't really undestand this whole temp license deal ... what does that exactly mean?
Three different things:
-- Training licenses/GME permit/temporary education training permits
In some states like NY or CT, the hospital just reports the names of the residents to the medical board which issues a blanket permit. So the resident never has to fill out any paperwork.
In other states, you have to apply for it yourself (e.g. MA or PA). The application process and documentary requirements are a lot simpler than a medical license. Your residency program usually sends you some paperwork or link as to where you have to apply. The usual requirements are USMLE 1-2, graduation from medschool and a pulse. Also, these GME licenses are cheaper, usually not more than $120.
- Tempoary/provisional license
When you apply for a full medical license, depending on the state, the entire medical board has to vote on it. The medical boards convene a couple of times a year, so if they convene lets say 4 times a year you could end up with a 3 month delay of the full license. So, for the interim, usually the executive secretary of the medical board can review your application and if there is no reason why you need detailed review of the board, he/she can issue a provisional license. Some states charge you for this provisional license (maybe $60 on top of the regular application fee), others just do it as part of the application process.
- Full license
This is where the money is. Cost for this license is anywhere between $120 and $900 depending on the state (don't ask me why). Usually you have to provide a whole slew of documents. Also, the medical boards go back to your medical school and residency hospitals to confirm that you graduated/showed up. You have to provide personal references and statements regarding your conduct in medical school and residency. You also have to provide reports from the 'national practicioner database' the 'healthcare integrity database' and the 'board action database' as well as 'confirmation of licensure' letters from every state you ever had a license in.
There are of course infinite opportunities for snags in the obtaining of all this paperwork. After all the stuff is in, different states have different ways of dealing with it. Some just send out the license at that point (e.g. CT), others wait anywhere from 2 weeks to several months for it (again, don't ask me why it is so variable).