What state do I get a license in?

[BigNavyPedsGuy]

I have to register for Step 3 VERY soon. I don't know what state to choose.

1) What state(s) are cheap? I really don't know where I'm going to be after residency. I'm currently in CA and it's very expensive.

2) Has anyone gone through the process of switching state license after seperation? How easy/difficult was it? I want to do a fellowship after seperation (in 7 years), but I can't reasonably know where I'll end up.

3) What's the advantage of being licensed in state ___________?

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[orbitsurgMD]

I have to register for Step 3 VERY soon. I don't know what state to choose.

1) What state(s) are cheap? I really don't know where I'm going to be after residency. I'm currently in CA and it's very expensive.

2) Has anyone gone through the process of switching state license after seperation? How easy/difficult was it? I want to do a fellowship after seperation (in 7 years), but I can't reasonably know where I'll end up.

3) What's the advantage of being licensed in state ___________?

Indiana had a pretty cheap fee, although it has gone up from the $40 they charged a few years ago.

My recommendation is that you get a license in the state you someday want to settle in or, where you would like to moonlight at your soonest opportunity. If you think you want to go back to the state you think of as "home," that is not a bad way to go either.

Some states are ridiculous, I'll admit. Texas requires you take some dopey jurisprudence exam (I can only guess what constituentcy thought of that) and California has been infamous for requiring that you ship your diploma in the original with your application (beats me why, I doubt they have any sort of real expertise in forensic document authentication.)

All the same, you might as well have a license where you would someday like to live, PITA requirements or not.

 

[hammena1]

You needn't worry yet. Putting a state as in intent to pursue licensure does not obligate you to file their. Just put anything on your step 3 application. Nebraska will only cost 50 dollars if you apply after January 2008 since it will be an even year. Also, it has a one time $25 inactivation fee.

 

[BigNavyPedsGuy]

bump

 

[navdoc47]

I am licensed with Indiana. Took less than 3 weeks to receive my license. Cost is very reasonable - $200 for first year, then $200 every two years thereafter. The big savings is the fact that they have ZERO CME requirements - saves both time and money.

I agree that if you have any moonlighting aspirations, then get a license in the state you reside.

 

[Capt_Mac]

Nebraska is quick, painless and costs 200$ for the initial registration. After that they have free renewals for military and you have to renew every 2 years. CME is not a big deal during residency. You also have to pick a state that will allow you to license after only having completed internship.

Me, I have my license in Nebraska. Before I finish residency, I will get my Texas license. (The process of which is a kin to entering the 5th circle of hell.)

 

[runningmom]

Do military patients ever try to take their Rx to outside non-military pharmacies?

Can't speak to the physician side of this, but anecdotally - I take almost all of my family's Rxs to outside pharmacies.

Here's why: Tricare cover most major chains (I use CVS because it is close). It is $3 co-pay for most items, but I can drop off the paper copy at the drive through and come back later (again in the drive through) rather than playing the "wait-for-my-number-to-be-called" game. 45 minute+ waits with 3 children aren't exactly my idea of fun. My sanity is well worth the co-pay. Even for the occassional $9 co-pay (non-formulary items I guess?)

I haven't had an issue with getting them filled so far. Though I do get a funny look occasionally when I ask for a paper Rx rather than having it put into CHCS/ALTHA.

Which reminds me, at least here (Bethesda) if you do have a patient who wants to get something filled out in town, don't put it in CHCS. It makes it complicated to get filled because HealthNet will show it as already dispensed and as such won't approve it for reimbursement.

So I've completely hijacked the thread - sorry. My point was - some people do get their Rx filled out in town and it doesn't seem to be an issue.

 

[almostfamous]

In case anyone was curious, the fee for a Maryland license is $819, compared to the $200 for Nebraska. And no, the military will not reimburse you. They will cover Step 3, but not licensure fees (only know this because of the email I got from GME yesterday).

Please confirm the covering for Step 3... we were told by GME and by last yrs interns that it is not covered. Is it Bethesda's GME specifically?

Seems like if the DoD wanted us to be licensed so damn bad, then they should encourage us with reimbursement.

 

[runningmom]

Do you have residents writing the prescriptions? Are their Rx's good at the outside pharmacies, even though most probably don't have Maryland licenses?

I have had both residents and attendings prescribe - but I have no idea who was licensed where. Nothing like hijaking a thread and having no real info to provide!! I just like listening to myself talk!! Errr... you know what I mean....

 

[LexiLuthor]

Just wanted to chime in- When I had TRICARE I usually took my RXes to CVS and just paid the copay. I went to military medical clinics in VA and MD. Never had a problem filling them in VA, although I have no idea where the doctors I saw were licensed.

 

[The White Coat Investor]

Seems like if the DoD wanted us to be licensed so damn bad, then they should encourage us with reimbursement.

There's some weird law somewhere that doesn't let the government pay licensing fees for individuals. No kidding.

 

[Capt_Mac]

If GME is covering STEP 3 now I will be pissed off. That cost me some serious coin and at least 3 years ago they didn't cover it. Once they have sunk their hooks into you that is the last of the niceties. No text books, no PDA's, nothing that the civilians guys get. Only a swift kick in the arse and a bi-annual PT test.

 

[runningmom]

As the title states.... if GME fees aren't covered, can you use your GI Bill? (For those that have it of course.....) Anyone know/have experience with this? Based on the website it looks like it would be covered.

 

[i want out]

Just wanted to chime in- When I had TRICARE I usually took my RXes to CVS and just paid the copay. I went to military medical clinics in VA and MD. Never had a problem filling them in VA, although I have no idea where the doctors I saw were licensed.

Never had any problem with scrips coming back when they were sent out in town, and in some cases, they were easier to get filled.

I didn't have a license in the state I was practicing in either.

i want out

one other thing you may want to consider, is getting a license in a state that you don't mind keeping one in for several years. Like the rest of the time you plan to practice. If you get a license, and then let it lapse, you will have to explain the reason in writing on pretty much every professional document for the rest of your life. May seem like a simple enough thing to you, but medical boards and credentialing offices see it as a red flag, and tend to look deeper.

 

[NavyFP]

There's some weird law somewhere that doesn't let the government pay licensing fees for individuals. No kidding.

The military pays for parts I and II because they are typically requirements to graduate from medical school. Part III is needed for licensure only. Since licensure is a requirement for practice and all of the lovely bonuses it becomes a function of the job and not covered. (they don't pay for your license either.) Oddly, specialty boards are covered. I don't get the reasoning, but it is what it is.