Licensing

[Chickenandwaffles]

So I have noticed that many states require evaluation forms for post-graduate training filled out prior to a license being given, which I don't quite understand why that would be necessary.

I also wonder, for how long are these types of forms needed? If I'm practicing for 10 years, and then I decide to go to another state, I need my old program director to fill out a form? How does that make sense? Not only are skills in residency/recent grads not compatible with how a doctor is doing years after residency, given that you will gain experience, become better, etc. but old PD's may pass away, may no longer be PDs, programs may close, and however a resident did 10 years ago is completely irrelevant to the present. How does that work?

Or are those evaluations only required for a certain period of time?

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[Winged Scapula]

Does it make sense? No.

How long does it go on for? I thought it was 5 years, but I've been out of residency for almost 8 years and just recently got privileges at a new hospital and yes, they wanted my residency and fellowship PDs to complete some paperwork.

 

[Chickenandwaffles]

Does it make sense? No.

How long does it go on for? I thought it was 5 years, but I've been out of residency for almost 8 years and just recently got privileges at a new hospital and yes, they wanted my residency and fellowship PDs to complete some paperwork.

Perhaps it would make sense to change this. Who comes up with these arbitrary rules? Perhaps it makes sense if/when getting a license shortly after training, but it seems absurd to have to do that years out. How can a PD make really even remember anything accurately, and who cares what they think/thought of you back then?I would hope that so many years out, you'd be a pro at whatever you do. It's like if med school professors fill out evals for licensing - it's pointless.

 

[rokshana]

and it would make sense that once you do the paperwork and run through the hoops of getting a license in one state that there would be reciprocity in the other states…if they wanna make money, fine….charge me a fee to grant me reciprocity but to have to give the same information over and over and OVER is silly…but of course that would make too much sense.

 

[Chickenandwaffles]

and it would make sense that once you do the paperwork and run through the hoops of getting a license in one state that there would be reciprocity in the other states…if they wanna make money, fine….charge me a fee to grant me reciprocity but to have to give the same information over and over and OVER is silly…but of course that would make too much sense.

Agreed about this. I mean profiles won't change much from years to years. Why do things need to be explained each and every single time? Or having a federal license. Submit all documents, ONCE, and be done with it. And pay a license fee per state, fine but not having to reapply all over again.

 

[Raryn]

It doesn't necessarily go to your old program director, it goes to whomever the current PD is of your old program. Basically it entails them opening your old file and copying whatever is in the summative eval your PD filled out at the end of residency.

Not sure what happens if your old program ever closes down.

 

[Doctor Bob]

Agreed about this. I mean profiles won't change much from years to years. Why do things need to be explained each and every single time? Or having a federal license. Submit all documents, ONCE, and be done with it. And pay a license fee per state, fine but not having to reapply all over again.

FCVS does this to some degree.
If you foresee that you will move around and get multiple state licenses in your life, the cost/time of setting up an FCVS profile is worth it. Most state boards will accept an FCVS packet which has verified transcripts, diplomas, board scores, references, etc.
Saves you trouble of hunting down these forms each time you apply for a license.

 

[mcl]

It's forever. I just got a residency verification request for someone who graduated in 1980. It's due diligence on behalf of the state boards and other credentialing bodies. I would not expect the practice to change any time soon.

 

[Winged Scapula]

It's forever. I just got a residency verification request for someone who graduated in 1980. It's due diligence on behalf of the state boards and other credentialing bodies. I would not expect the practice to change any time soon.

Bleh.... after my recent experience reapplying for privileges at the hospital where I left them lapse, I can see why they say never to let this happen.

 

[BlondeDocteur]

It protects the public against fraud. It's a good thing.

 

[Chickenandwaffles]

It protects the public against fraud. It's a good thing.

I disagree. If you get a medical degree, get through internship, residency, etc. that should be sufficient. If you are good to get the end point, then you should be good enough to practice. For example, for people who have been on probation in med school - if they got the degree, does it matter? (and no, i have NEVER been on probation or have had any negative record) so I'm not talking from experience. If the medical school deemed they were good enough to graduate, why should any random state decide otherwise? Or if someone did not do well in a particular residency, does that mean they should not practice or be FBI type questioned about it? Some people are not good fits, some people enter the wrong field, some people are in malignant programs, etc. Tons of things happen. Why should a state determine whether someone should get a license based on random facts?

Things and life happen. Doesn't mean things should haunt people for the rest of their lives.

 

[colbgw02]

I disagree. If you get a medical degree, get through internship, residency, etc. that should be sufficient. If you are good to get the end point, then you should be good enough to practice. For example, for people who have been on probation in med school - if they got the degree, does it matter? (and no, i have NEVER been on probation or have had any negative record) so I'm not talking from experience. If the medical school deemed they were good enough to graduate, why should any random state decide otherwise? Or if someone did not do well in a particular residency, does that mean they should not practice or be FBI type questioned about it? Some people are not good fits, some people enter the wrong field, some people are in malignant programs, etc. Tons of things happen. Why should a state determine whether someone should get a license based on random facts?

Things and life happen. Doesn't mean things should haunt people for the rest of their lives.

I'm not sure what you think he/she meant by "fraud", but it's not what you're describing. These verifications are to make sure you are who you say you are and you did what you claim to have done, not for a licensing board to decide if your medical school or residency were correct in allowing you to matriculate.

Would a nationalized or federal system be more efficient? Sure, but this is a money maker for the states, so don't look for it to change any time soon.

 

[Chickenandwaffles]

I'm not sure what you think he/she meant by "fraud", but it's not what you're describing. These verifications are to make sure you are who you say you are and you did what you claim to have done, not for a licensing board to decide if your medical school or residency were correct in allowing you to matriculate.

Would a nationalized or federal system be more efficient? Sure, but this is a money maker for the states, so don't look for it to change any time soon.

I did not mention fraud at all. That was a different poster. And they are not just verifying that you are who you are, and did what you did. They care about the most pointless things. For example, some states require transcripts and copy of med school diploma. Fine. But who cares if you took longer to study for a step, or took time off, or did research and took longer or whatever? Unless there is a criminal history, or serious academic issues, or serious disciplinary issues, the non-important stuff should be irrelevant.

Many states have random licensing people who decide licenses, not physicians. How does it make sense that random people decide whether we can practice? Also if the medical school decided you were ok to graduate, who are they to say whether that will prevent you from practicing? I have read that some states can prevent you from getting a license because of academic difficulty or things like that. Again not my case just examples. How are they to say that you should not practice? Makes no sense.

I think most of us would be ok with paying the states a fee, but going through this every time is insanity.

 

[colbgw02]

Dude, you quoted a brief post about fraud and then said "I disagree" as your first comment. I made a pretty reasonable conclusion.

I hold many state licenses, so I'd like to see some proof that non-physicians are deciding who gets a medical license and who doesn't, as it doesn't fit with my experiences.

Who are they? Well, to be precise, they are the institution charged by the State to ensure the safety of the populace by regulating the practice of medicine. I understand better than most people that it's frustrating, considering the number of different licensing agencies I have to deal with. However, it's not our choice to decide what is important and what is not. They hold the responsibility to ensure proper licensure, so they make the rules. Personally, I'm glad that there isn't more government oversight. It's pretty amazing to me that vast majority of the regulation of physician training is handled by private organizations, beginning with AAMC and ending with the hospital committees that grant privileges.

If you want a more efficient system, awesome. Make that your calling in life. We'll all be very thankful if you succeed. Just understand that the government's intrusion into a physician's ability to practice is just a small fraction of what it could be.

 

[rokshana]

I hold many state licenses, so I'd like to see some proof that non-physicians are deciding who gets a medical license and who doesn't, as it doesn't fit with my experiences..

actually many boards have citizen members that have no medical credentials…they certainly don't make up the majority of boards, but they do,, i imagine, have some input.

 

[Chickenandwaffles]

Dude, you quoted a brief post about fraud and then said "I disagree" as your first comment. I made a pretty reasonable conclusion.

I hold many state licenses, so I'd like to see some proof that non-physicians are deciding who gets a medical license and who doesn't, as it doesn't fit with my experiences.

Who are they? Well, to be precise, they are the institution charged by the State to ensure the safety of the populace by regulating the practice of medicine. I understand better than most people that it's frustrating, considering the number of different licensing agencies I have to deal with. However, it's not our choice to decide what is important and what is not. They hold the responsibility to ensure proper licensure, so they make the rules. Personally, I'm glad that there isn't more government oversight. It's pretty amazing to me that vast majority of the regulation of physician training is handled by private organizations, beginning with AAMC and ending with the hospital committees that grant privileges.

If you want a more efficient system, awesome. Make that your calling in life. We'll all be very thankful if you succeed. Just understand that the government's intrusion into a physician's ability to practice is just a small fraction of what it could be.

Actually, many states, including IL, Tx, and I believe NY and MA all have non-medical people looking at licensing, and some of those states provide licenses without medical professionals being involved in the licensing process for "regular" applications, that are straight forward. For those that are more complicated, then they may be presented in front of a board with medical members, but not if the applications are straight forward.

 

[colbgw02]

Many states have random licensing people who decide licenses, not physicians. How does it make sense that random people decide whether we can practice?

actually many boards have citizen members that have no medical credentials…they certainly don't make up the majority of boards, but they do,, i imagine, have some input.

I would submit that those people are not "random", as was originally asserted. I also highly doubt that these non-physicians are somehow trumping the physicians' opinion when it comes to deciding who gets a medical license.

Actually, many states, including IL, Tx, and I believe NY and MA all have non-medical people looking at licensing, and some of those states provide licenses without medical professionals being involved in the licensing process for "regular" applications, that are straight forward. For those that are more complicated, then they may be presented in front of a board with medical members, but not if the applications are straight forward.

Okay, so non-medical people are in charge of giving out licenses but are not empowered to reject an application. How, exactly, does that fit into your view that "random people decide whether we can practice?"

We can split hairs all day long, but the bottom line is this: state licensing boards are not filled with droves of unqualified personnel and they aren't rejecting applications on a whim. As I've said, the process is frustrating and often onerous, but they're not out to get you. They want you to be licensed, as it's a revenue producer for the state. Now, you've clearly encountered a snag, and that stinks, but it's not because there are shadowy non-physicians waiting around every corner just waiting for a chance to deny your chance to practice.

 

[rokshana]

I would submit that those people are not "random", as was originally asserted. I also highly doubt that these non-physicians are somehow trumping the physicians' opinion when it comes to deciding who gets a medical license.



Okay, so non-medical people are in charge of giving out licenses but are not empowered to reject an application. How, exactly, does that fit into your view that "random people decide whether we can practice?"

We can split hairs all day long, but the bottom line is this: state licensing boards are not filled with droves of unqualified personnel and they aren't rejecting applications on a whim. As I've said, the process is frustrating and often onerous, but they're not out to get you. They want you to be licensed, as it's a revenue producer for the state. Now, you've clearly encountered a snag, and that stinks, but it's not because there are shadowy non-physicians waiting around every corner just waiting for a chance to deny your chance to practice.

i don't think that they are random by any means, they obviously have an interest or they wouldn't give their time to serve on a states' medical board but they still don't have medical degrees…your contention was that non medical people didn't serve on the boards in the states that you got a license.

I too have a few licenses and it is a bit annoying to fill out the same information over and over and over to different boards..surely if one state has verified a person's med school, internship, residency, credentials at hospitals once, it should be enough for another state to take that to be valid. Sure if there is NEW information that should be verified (new degree, new privileges, etc) but it would be nice if the states could have a centralized clearinghouse to verify the basics.

Does it really mean much to have a PD of a program verify that someone did their residency at his program probably long before the PD was even born?

And the idea of reciprocity is not a new one….back in the day when states had their own licensing exams, reciprocity was granted based on passing another state requirements (i.e. passing FLEX i believe gave you reciprocity in 48 of the 50 states back in the 60-70s).

 

[colbgw02]

i don't think that they are random by any means, they obviously have an interest or they wouldn't give their time to serve on a states' medical board but they still don't have medical degrees…your contention was that non medical people didn't serve on the boards in the states that you got a license.

Well, I actually contended that non-physicians weren't "deciding" who gets a license and who doesn't, but, yes, I'm splitting hairs and clearly they have input in some states.

I too have a few licenses and it is a bit annoying to fill out the same information over and over and over to different boards..surely if one state has verified a person's med school, internship, residency, credentials at hospitals once, it should be enough for another state to take that to be valid. Sure if there is NEW information that should be verified (new degree, new privileges, etc) but it would be nice if the states could have a centralized clearinghouse to verify the basics.

Does it really mean much to have a PD of a program verify that someone did their residency at his program probably long before the PD was even born?

And the idea of reciprocity is not a new one….back in the day when states had their own licensing exams, reciprocity was granted based on passing another state requirements (i.e. passing FLEX i believe gave you reciprocity in 48 of the 50 states back in the 60-70s).

I don't disagree with any of this. In fact, reciprocity is a much better idea in my mind than a federal license. FCVS ought to function as the clearinghouse, but I've found it to be lacking, largely due to borderline incompetence. And it doesn't help that the documents provided by FCVS, while necessary for licensure, are not sufficient, requiring you to fill out the state's own paperwork on top of it.