2025 Update: "CA license, but no board cert. How to get life back on track with a baby?"

[tofoo]

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To recap: Back in November 2017, I was living in Korea as a new father and was desperate to get back into medicine. I thought my best bet would be to get back into residency but that didn't fan out. In September 2018, I began working for a corporation that provides wound care services to patients in nursing homes. In June of 2019, I started my own private practice. Things were going well, then COVID happened. For more detail, I would refer you to the following posts:

First post on 11/30/17: CA license, but no board cert. How to get life back on track with a baby?
Second post on 7/15/19: Re: CA license, but no board cert. How to get life back on track with a baby?
Third post on 8/2/19: Re: CA license, but no board cert. How to get life back on track with a baby?
Fourth post on 2/21/20: Second update to "CA license, but no board cert. How to get life back on track with a baby?
Fifth post on 8/4/21: 3rd update: "CA license, but no board cert. How to get life back on track with a baby?"
Sixth post on 11/25/2022: 2022 Update: "CA license, but no board cert. How to get life back on track with a baby?"
Seventh post on 5/20/2023: 2023 Update: "CA license, but no board cert. How to get life back on track with a baby?"

----
Hi, how are you? I hope those of you who have been around from the beginning of this saga are doing well. I can't believe it's already been 7-8 years since the first post.

Since my last update in 2023, I've been on a soul searching journey about life and have come to realize who I am and what I do best in life.

Let me get to the medical career aspect of this story.

Private equity: I have been approached by 4 private equity groups in the past 1.5 years. I did not entertain the idea of trading what I have for money. I am content with life. I want to keep doing what it is I do well.

Academia: I've been invited to a couple of academic meetings where I gave presentations on the type of things that I am doing. I am embarrassed to talk about it because what I do is not really academic (I'm not doing any studies in private practice) but it's truly been a terrifying honor to be talking about my passion for wounds in front of reconstructive surgeons. My next presentation will be back in Seoul this November.

Wound care for street medicine: Back in 2023, I've alluded to volunteering to care for the unsheltered population. Since then, it has become a major part of my mission. This year, I had been invited for wound/debridement seminar for the county health department and the city fire department. Our practice won an award for a street medicine consultation program from a major academic institution in California, and the street medicine department has been instrumental in further developing our mission into that of educator/hub for other street medicine teams. I will be putting together a class for a street medicine symposium next year at the invitation of the organizers. I believe I can make a meaningful impact in this context. Pumped.

Because of the street medicine situation, I'm starting a nonprofit foundation that would make it easier for the mission to grow faster than the practice itself.

------

Personally, I am doing well. I have a great work/life balance. I sometimes push myself too much but then I have room and support in my personal and professional life to be able to recover when I need to. A great family and a great team, I am thankful for.

My family is larger. We're a Brady bunch. We're happy because we can work through things. We're all healing and finding purpose and meaning.

Few years ago, my brother got in trouble with the law. When he hit rock bottom, I took him in. Gave him a job, help him pay off his debt to his friends and the family. He's rebuilding his life again. Quit smoking. Goes to gym every day.

My boy is 8 years old. He is polite and loving to everyone. Has a six pack with a kind heart. I can't be more proud. We've been going to Yosemite every year.

He asked me to catch a trout and cook it for him when he was 5. I was fishing conventional reels and that didn't work out for a couple of years. It took me a few years to get to this point, but I picked up fly fishing. I've fished in Eastern Sierra, local waters, Wyoming, and Korea.

Now, fly fishing has me contributing to conservation work - whether with money or time.

-------

This message is to strangers out there who are struggling with trying to figure out what it is that you want to do with life.

I have learned that the outcomes of one's life is determined by luck as much as by our own attitude and effort. No one can have more information about me than I do for myself. No one can be responsible for the choices that I make. No one can face the consequences of my own actions. All I can do is make the best educated choice and work hard to persevere until I find what it is that I'm searching for. That's what we all have been doing since the moment we left our childhood behind.

Have a philosophy - to love wisdom as life give it to you. What is important to you? What makes you move? Do words like integrity, honesty, courage, justice, fairness, respect, dignity, and love ring something true in your heart? Let those values guide you until a time when the world recognizes that you have been true and authentic to yourself. Then you'll find your true purpose.

"Integrity is one of several paths. It distinguishes itself from the others because it is the right path and the only one upon which you will never get lost." - M.H. McKee

It is hard for one's destiny to speak on the journey itself. It is the journey that reveals the truth of "who am I?" and "what have I done?"

I know I've been a fool. I know I've done wrong. It's only through the Grace of God I'm still here today. I hope you find the truth in your journey thru this crazy thing called life.

May we all find peace and purpose in this changing times.

Catch you again in another couple of years.

 

[DrMetal]

Wound care for street medicine: Back in 2023, I've alluded to volunteering to care for the unsheltered population.

Doing what exactly? Wound care? With a medical license, but no formal residency training? Ahh hell, why not, I guess you're no worse than a mid-level.

Grace of God I'm still here today.

It's interesting how God graces some and not others. I wonder how He makes that determination.

 

[shaggybill]

Thanks for the update. Always good to see these periodic check-ins and I'm glad to hear you're still thriving. Hope you see the cantankerous response above mine for what it is.

 

[tofoo]

Doing what exactly? Wound care? With a medical license, but no formal residency training? Ahh hell, why not, I guess you're no worse than a mid-level.

It’s funny you should mention this. I signed a contract with a FQHC organization where I couldn’t see patients in their clinic because of my non board certified status. So our NPs ended up staffing the clinic. I thought that was pretty dumb but I digress.

Btw, was my internship and second year of residency considered an informal training?

It's interesting how God graces some and not others. I wonder how He makes that determination.

When I say Grace of God, I don’t mean I was chosen over anyone else.

What I mean is that I don’t deserve all the good things in my life, and yet here I am — alive, years after I almost died off that cliff. I carry that with humility and gratitude. For me, grace isn’t about favoritism; it’s about recognizing the gift of time we’ve been given and deciding how to use it.

That’s why I keep showing up — not because I fit the traditional mold, but because patients need care. If I can provide competent, compassionate treatment where others aren’t willing or able to go, then I consider that the best use of the time and grace I’ve been given.

I’ve had 14 years of life since the day I fell off the cliff. I try to greet every morning with gratitude for yet another day I get to live.

Hope that clears up any misunderstanding.

Hope you have a wonderful day full of healing patients!

 

[tofoo]

Thanks for the update. Always good to see these periodic check-ins and I'm glad to hear you're still thriving. Hope you see the cantankerous response above mine for what it is.

Thank you!

I liked the opportunity he/she gave me to clarify what I meant.

“There but for the Grace of God go I” is a famous quote about humility and gratitude. It expresses a combination of sympathy for others and a profound realization of one's own shortcomings, acknowledging that any good fortune or escape from hardship is a gift of God's mercy, not one's own merit.

Not that I’m a bible thumper but I feel like to be not paralyzed or dead from the fall is an amazing reason to be humble and grateful. All the more thankful for the life I’m living today and the role I play in our community.

And I also know all of this could be gone in one day. I feel like we all know how ruthless life could be.

More reason to be thankful for today.

 

[DrMetal]

It’s funny you should mention this. I signed a contract with a FQHC organization where I couldn’t see patients in their clinic because of my non board certified status. So our NPs ended up staffing the clinic.

Ahh. So the NPs are just using your license to see patients. Classic NP-mill. [This is where I would rant off, about house physicians are being exploited, about how the medical system has found a way to circumvent physician-based care . . . but why bother? You're not the first to do this, these mid-level mills are now a dime a dozen.]

Btw, was my internship and second year of residency considered an informal training?

Sure, it's formal (but incomplete) training. That's like me trying to argue that my 6 lessons with the local golf pro qualifies me to be on the PGA Tour.

My definition of a trained physician is one who's completed residency + 3-5 years as an Attending (ie experience doing the job in the real world).

I know, semantics, right?

Lest any students/residents reading this thread think so . . . this is not the norm. Pursue and finish your training!

 

[HemeOncHopeful19]

Ahh. So the NPs are just using your license to see patients. Classic NP-mill. [This is where I would rant off, about house physicians are being exploited, about how the medical system has found a way to circumvent physician-based care . . . but why bother? You're not the first to do this, these mid-level mills are now a dime a dozen.]



Sure, it's formal (but incomplete) training. That's like me trying to argue that my 6 lessons with the local golf pro qualifies me to be on the PGA Tour.

My definition of a trained physician is one who's completed residency + 3-5 years as an Attending (ie experience doing the job in the real world).

I know, semantics, right?

Lest any students/residents reading this thread think so . . . this is not the norm. Pursue and finish your training!

I dunno I mean I’ve never actually heard of a specific wound care residency/fellowship and the two wound care docs I personally know of are IM and FM trained, respectively, which don’t really get any true formal training in wound care either. It seems to be a largely self taught discipline either way.

If you read OP’s actual original story they were severely injured in residency and seemingly pushed out of Gen Surg. I agree had they asked for advice at the time we all would have said “try to switch into anything you can and complete a residency” but I applaud them for making lemonade out of lemons or whatever

 

[tofoo]

Ahh. So the NPs are just using your license to see patients. Classic NP-mill. [This is where I would rant off, about house physicians are being exploited, about how the medical system has found a way to circumvent physician-based care . . . but why bother? You're not the first to do this, these mid-level mills are now a dime a dozen.]



Sure, it's formal (but incomplete) training. That's like me trying to argue that my 6 lessons with the local golf pro qualifies me to be on the PGA Tour.

My definition of a trained physician is one who's completed residency + 3-5 years as an Attending (ie experience doing the job in the real world).

I know, semantics, right?

Lest any students/residents reading this thread think so . . . this is not the norm. Pursue and finish your training!

1. Yeah, I gave them 90 day notice 3 months ago. Our contract with them is done next week.
2. Well, it's really not just semantics. You made it sounds like I had zero formal training, and that's just not the case. Now the new question is a moved goalpost "was it enough?" I am not the objective source to answer that question. I just let the patients, the local doctors, and the healthcare market answer that question for me, as I have detailed in these updates.
3. This is where I agree with you. I am an extreme outlier. The main reason I write these things out is to chronicle my professional life in a place that I can go back to, with the wisdom of audience to provide feedback on how I'm understanding myself (which is what you are helping me do).

I know my story cannot be replicated. There's just too much luck involved.

Even my medical license was grandfathered in. I would not qualify for medical license in these days California because the requirement has gone up to 3 years of postgrad training.

Another would be... hospital privilege for a non-board certified doctor. I don't see that happening again to anybody. If anybody in California under 50 years has hospital privilege without board certification, I'd like to buy that person a drink and get to know them. Seriously, if you are one or know someone else like that, please DM me.

I would have LOVED to gone down the traditional path, and that what I was planning to do when I first got back to the US. That I didn't have to go thru another residency to get to where I am today was such a crazy gamble. I don't think anybody should attempt this.

I do want people to understand that a lot of times your mind can only gather and analyze data to a limited degree. Sometimes the only way you can truly find the answer you're looking for is to make the daring choice and face the consequences. Or don't.

Knowing what I know now and if I could go back to medical school years, I'd tell my younger self to do whatever it takes to go into plastic surgery. Finish it, and go into nursing homes as wound care provider and find all the referrals straight from the source.

Anyways, I digress. Thanks Dr. Metal for your input. I understand where you are coming from. We don't always have to agree on things in life for us to be kind to another. And I probably have more in common with you than most of my relatives.

So cheers.

 

[tofoo]

I dunno I mean I’ve never actually heard of a specific wound care residency/fellowship and the two wound care docs I personally know of are IM and FM trained, respectively, which don’t really get any true formal training in wound care either. It seems to be a largely self taught discipline either way.

HemeOnc, you're 100% correct about this. There are certain certifications that requires you to study a decent amount, but most of the things you learn are very much from the experience.

If you read OP’s actual original story they were severely injured in residency and seemingly pushed out of Gen Surg. I agree had they asked for advice at the time we all would have said “try to switch into anything you can and complete a residency” but I applaud them for making lemonade out of lemons or whatever

I did actually asked for advice at the time but in another section of the forum. Like you said you would have, they told me I should do x and y and z to get into a position to be able to apply. I was in the process of applying for preventive medicine residency when I started doing wound care in second half of 2018.

So I did try to follow the advice here. But I began solidifying my position in the wound care market in this city and it became very hard to work away from it.

Think about it this way. Let's say you were in my shoes in late 2019. You see that you could buy a house for your family in 6 months or you can go find a spot into a residency in midwest where you and your family would scrimp on resident salary for 3-5 more years and no guarantee you could come back to the city you want to call him. What would you choose?

At a certain point, going to a residency became the more risky choice. This happened so quickly for me that there was no time to really deliberate on decisions.

 

[The Sangin Chupacabra]

To recap: Back in November 2017, I was living in Korea as a new father and was desperate to get back into medicine. I thought my best bet would be to get back into residency but that didn't fan out. In September 2018, I began working for a corporation that provides wound care services to patients in nursing homes. In June of 2019, I started my own private practice. Things were going well, then COVID happened. For more detail, I would refer you to the following posts:

First post on 11/30/17: CA license, but no board cert. How to get life back on track with a baby?
Second post on 7/15/19: Re: CA license, but no board cert. How to get life back on track with a baby?
Third post on 8/2/19: Re: CA license, but no board cert. How to get life back on track with a baby?
Fourth post on 2/21/20: Second update to "CA license, but no board cert. How to get life back on track with a baby?
Fifth post on 8/4/21: 3rd update: "CA license, but no board cert. How to get life back on track with a baby?"
Sixth post on 11/25/2022: 2022 Update: "CA license, but no board cert. How to get life back on track with a baby?"
Seventh post on 5/20/2023: 2023 Update: "CA license, but no board cert. How to get life back on track with a baby?"

----
Hi, how are you? I hope those of you who have been around from the beginning of this saga are doing well. I can't believe it's already been 7-8 years since the first post.

Since my last update in 2023, I've been on a soul searching journey about life and have come to realize who I am and what I do best in life.

Let me get to the medical career aspect of this story.

Private equity: I have been approached by 4 private equity groups in the past 1.5 years. I did not entertain the idea of trading what I have for money. I am content with life. I want to keep doing what it is I do well.

Academia: I've been invited to a couple of academic meetings where I gave presentations on the type of things that I am doing. I am embarrassed to talk about it because what I do is not really academic (I'm not doing any studies in private practice) but it's truly been a terrifying honor to be talking about my passion for wounds in front of reconstructive surgeons. My next presentation will be back in Seoul this November.

Wound care for street medicine: Back in 2023, I've alluded to volunteering to care for the unsheltered population. Since then, it has become a major part of my mission. This year, I had been invited for wound/debridement seminar for the county health department and the city fire department. Our practice won an award for a street medicine consultation program from a major academic institution in California, and the street medicine department has been instrumental in further developing our mission into that of educator/hub for other street medicine teams. I will be putting together a class for a street medicine symposium next year at the invitation of the organizers. I believe I can make a meaningful impact in this context. Pumped.

Because of the street medicine situation, I'm starting a nonprofit foundation that would make it easier for the mission to grow faster than the practice itself.

------

Personally, I am doing well. I have a great work/life balance. I sometimes push myself too much but then I have room and support in my personal and professional life to be able to recover when I need to. A great family and a great team, I am thankful for.

My family is larger. We're a Brady bunch. We're happy because we can work through things. We're all healing and finding purpose and meaning.

Few years ago, my brother got in trouble with the law. When he hit rock bottom, I took him in. Gave him a job, help him pay off his debt to his friends and the family. He's rebuilding his life again. Quit smoking. Goes to gym every day.

My boy is 8 years old. He is polite and loving to everyone. Has a six pack with a kind heart. I can't be more proud. We've been going to Yosemite every year.

He asked me to catch a trout and cook it for him when he was 5. I was fishing conventional reels and that didn't work out for a couple of years. It took me a few years to get to this point, but I picked up fly fishing. I've fished in Eastern Sierra, local waters, Wyoming, and Korea.

Now, fly fishing has me contributing to conservation work - whether with money or time.

-------

This message is to strangers out there who are struggling with trying to figure out what it is that you want to do with life.

I have learned that the outcomes of one's life is determined by luck as much as by our own attitude and effort. No one can have more information about me than I do for myself. No one can be responsible for the choices that I make. No one can face the consequences of my own actions. All I can do is make the best educated choice and work hard to persevere until I find what it is that I'm searching for. That's what we all have been doing since the moment we left our childhood behind.

Have a philosophy - to love wisdom as life give it to you. What is important to you? What makes you move? Do words like integrity, honesty, courage, justice, fairness, respect, dignity, and love ring something true in your heart? Let those values guide you until a time when the world recognizes that you have been true and authentic to yourself. Then you'll find your true purpose.

"Integrity is one of several paths. It distinguishes itself from the others because it is the right path and the only one upon which you will never get lost." - M.H. McKee

It is hard for one's destiny to speak on the journey itself. It is the journey that reveals the truth of "who am I?" and "what have I done?"

I know I've been a fool. I know I've done wrong. It's only through the Grace of God I'm still here today. I hope you find the truth in your journey thru this crazy thing called life.

May we all find peace and purpose in this changing times.

Catch you again in another couple of years.

We actually have the wound care since 2017 and two years of residency in common.

I left the Navy to go into a non-categorical residency. About halfway through my family life imploded. Not worth going into the details. I started working wound care, at first out of desperation to keep my family afloat while my now ex-wife was starting up her own practice. I was leaving the state of Nevada to see patients, every week I would drive to Phoenix then San Bernadino the back to Vegas. All the while crossing my fingers that her practice would work out and that I would be able to get back into residency.

Then the divorce hit, I was trapped in the web of child support. I was trapped in a position where she claimed to be making 400 dollars a month and where I was making much more. I attempted to get a restricted license so I wouldn't have to do the drive anymore. I received an unsolicited phone call from someone claiming to work for the NSMB, urging me to apply for a license by endorsement. I did, I was invited to present my case to the board. When I sat down, it felt like a complete ambush. I was accused of trying to manipulate the law, which was shocking because I was operating under the impression that it was the board who had told me to reapply for licensure in this fashion. The last thing they said to me was that it was against the law to practice medicine without a license...I guess some physicians are either ignorant of the law or have criminal egos that tell them that the law doesn't apply to them.

In my head I was pretty devastated with the whole ordeal. Plainly thinking about it now, I wonder if it was in-fact someone working for the board who had called me. After all, why would they invite me to do something and then criticize me for doing it? For all I know it could have been my children’s mother triangulating someone to call me or just an entry level office worker who could read the requirements for endorsement and was simply trying to help me out. I continued my route until I burnt out.

7 years of staying in hotel rooms and only having my children to talk to. After that drive, I basically needed two days to recover. I helped desperate people. I healed people. I took a terminally ill man's deathbed confession of being a former car thief, I went into heroin dens to perform I&Ds, I was invited to prayer -- I took care of a man's wounds who was suffering from hemibalismus inside a church, testified in court for court ordered treatment, I bought patients wound supplies when they couldn't afford to. I did what not a whole lot of doctors would do and with only two years of residency and a tour in Afganistan for training.

I was a good doctor. I am going to be applying for a restricted medical license again. I graduated from medical school 14 years ago, and 12 of those years I was practicing independently. I'm applying to law school now, maybe by the time I'm done with law school I will have completed the required time to get full licensure in a state that I had never intended to live in. 🫡

on .

 

[hallowmann]

To recap: Back in November 2017, I was living in Korea as a new father and was desperate to get back into medicine. I thought my best bet would be to get back into residency but that didn't fan out. In September 2018, I began working for a corporation that provides wound care services to patients in nursing homes. In June of 2019, I started my own private practice. Things were going well, then COVID happened. For more detail, I would refer you to the following posts:

First post on 11/30/17: CA license, but no board cert. How to get life back on track with a baby?
Second post on 7/15/19: Re: CA license, but no board cert. How to get life back on track with a baby?
Third post on 8/2/19: Re: CA license, but no board cert. How to get life back on track with a baby?
Fourth post on 2/21/20: Second update to "CA license, but no board cert. How to get life back on track with a baby?
Fifth post on 8/4/21: 3rd update: "CA license, but no board cert. How to get life back on track with a baby?"
Sixth post on 11/25/2022: 2022 Update: "CA license, but no board cert. How to get life back on track with a baby?"
Seventh post on 5/20/2023: 2023 Update: "CA license, but no board cert. How to get life back on track with a baby?"

----
Hi, how are you? I hope those of you who have been around from the beginning of this saga are doing well. I can't believe it's already been 7-8 years since the first post.

Since my last update in 2023, I've been on a soul searching journey about life and have come to realize who I am and what I do best in life.

Let me get to the medical career aspect of this story.

Private equity: I have been approached by 4 private equity groups in the past 1.5 years. I did not entertain the idea of trading what I have for money. I am content with life. I want to keep doing what it is I do well.

Academia: I've been invited to a couple of academic meetings where I gave presentations on the type of things that I am doing. I am embarrassed to talk about it because what I do is not really academic (I'm not doing any studies in private practice) but it's truly been a terrifying honor to be talking about my passion for wounds in front of reconstructive surgeons. My next presentation will be back in Seoul this November.

Wound care for street medicine: Back in 2023, I've alluded to volunteering to care for the unsheltered population. Since then, it has become a major part of my mission. This year, I had been invited for wound/debridement seminar for the county health department and the city fire department. Our practice won an award for a street medicine consultation program from a major academic institution in California, and the street medicine department has been instrumental in further developing our mission into that of educator/hub for other street medicine teams. I will be putting together a class for a street medicine symposium next year at the invitation of the organizers. I believe I can make a meaningful impact in this context. Pumped.

Because of the street medicine situation, I'm starting a nonprofit foundation that would make it easier for the mission to grow faster than the practice itself.

------

Personally, I am doing well. I have a great work/life balance. I sometimes push myself too much but then I have room and support in my personal and professional life to be able to recover when I need to. A great family and a great team, I am thankful for.

My family is larger. We're a Brady bunch. We're happy because we can work through things. We're all healing and finding purpose and meaning.

Few years ago, my brother got in trouble with the law. When he hit rock bottom, I took him in. Gave him a job, help him pay off his debt to his friends and the family. He's rebuilding his life again. Quit smoking. Goes to gym every day.

My boy is 8 years old. He is polite and loving to everyone. Has a six pack with a kind heart. I can't be more proud. We've been going to Yosemite every year.

He asked me to catch a trout and cook it for him when he was 5. I was fishing conventional reels and that didn't work out for a couple of years. It took me a few years to get to this point, but I picked up fly fishing. I've fished in Eastern Sierra, local waters, Wyoming, and Korea.

Now, fly fishing has me contributing to conservation work - whether with money or time.

-------

This message is to strangers out there who are struggling with trying to figure out what it is that you want to do with life.

I have learned that the outcomes of one's life is determined by luck as much as by our own attitude and effort. No one can have more information about me than I do for myself. No one can be responsible for the choices that I make. No one can face the consequences of my own actions. All I can do is make the best educated choice and work hard to persevere until I find what it is that I'm searching for. That's what we all have been doing since the moment we left our childhood behind.

Have a philosophy - to love wisdom as life give it to you. What is important to you? What makes you move? Do words like integrity, honesty, courage, justice, fairness, respect, dignity, and love ring something true in your heart? Let those values guide you until a time when the world recognizes that you have been true and authentic to yourself. Then you'll find your true purpose.

"Integrity is one of several paths. It distinguishes itself from the others because it is the right path and the only one upon which you will never get lost." - M.H. McKee

It is hard for one's destiny to speak on the journey itself. It is the journey that reveals the truth of "who am I?" and "what have I done?"

I know I've been a fool. I know I've done wrong. It's only through the Grace of God I'm still here today. I hope you find the truth in your journey thru this crazy thing called life.

May we all find peace and purpose in this changing times.

Catch you again in another couple of years.

Congratulations for everything and this well-balanced life!!! I'm glad things are going well.

I think I may have heard you talk, and I'll be at that symposium if its the one I think it is. I'm doing more on the addiction and MH side, but we share the same patient population, just in different areas. Good luck with everything and great to see all the updates!