Applying for state licensure too late

[WanderingDave]

I'm beginning the process of applying for state licensure 3 months from my projected graduation date. I've only just learned how late this is. I take full responsibility for this mistake.

To make matters worse, mine is an application with red flags. I've never been a picture of mental heath, and suffered a mental breakdown during my third year of residency, requiring two leaves of absence and an extension of my residency training time. I sought help myself -- none of this involved any wrongdoing or disciplinary action -- and have been a compliant enrolee in my state's PHP / PAP with a report recommending full and unrestricted licensure. Still, I've heard that anything shy of a spotless and seamless course from medical school onward can add serious time to the already lengthy licensing process.

Is there really even any point to job hunting now, if I could count on it taking the better part of a year to get licensed? It's stressful, and I'd rather devote my energies to finishing up my residency in good standing, serving my patients, and taking care of my young triplets. Do job sites (outpatient family practice) even want to hear "I'll get my license sometime in 2016," or would most immediately conclude we were wasting each other's time?

And if I wait to job hunt, I'm afraid the dreaded "What were you doing to keep up your clinical skills?" will be yet another big eyebrow-raiser.

What kind of temporary work is available or commonly sought by residency graduates waiting months for their licenses to come through? I certainly can't afford to not work.

I'm really feeling like I'm between a rock and a hard place. Any serious advice would be much appreciated.

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[Dral]

I had a premed blemish on my record and it only took about six weeks for me to get my license. I think it may depend on state.

I'd say you should be looking for a job now.

So you are applying for a license in a state where you are sure you plan to stay?

I'm assuming so.

Anyway...stop and analyze things. People switch jobs. These jobs can be in a different state. They are obviously interviewing before they get their license in that state.

By the same reasoning, you should be applying for a job now, and it is ok as far as the timeline of licensure goes..unless there is some reason you don't want to search for a job...

 

[Pinkertinkle]

If you get a VA job you can work with any state license. Some states give licenses rather quickly.

http://www.medprocentral.com/blog/2..._and_least_expensive_medical_licensing_states

 

[Smurfette]

Once you have a new job, as long as you do the licensing stuff ASAP (and follow up promptly with further inquiries from the board), employers realize it can take time for the state to actually issue a license. We've had some providers who had a delay in getting licensed for various reasons; it delayed their start dates but that's about it. Licensing can be unpredictable. Employers will wait for the process if they want you.

 

[Arcan57]

There are plenty of people who take a couple of months of vacation before starting and plenty of groups that hire people who's licenses are pending. The main problem tends to be coming up with the money for a relocation and living expense when there is a gap of 3-5 months between pay checks. I'd start looking for moonlighting opportunities now to buffer the loss of income while you wait.

 

[gutonc]

You're asking 2 different questions here. The first is, "should I be working on getting my license and applying for jobs right now?". And the answer to that question is "yes". Assuming you know where you want to look for a job, and that there are jobs available there, go for it. It's going to take longer than average for you to get a license, but assuming your PD (and the PHP) are supportive, you will be OK.

The second question is "what can I do while waiting for my license/job to start. The answer is, "anything you could have done as a pre-med waiting for med school to start". Without a license, you can't do anything clinical. And you're unlikely to find a job outside of food service/retail/freelancing that will take you on a super short term basis.

Another thing to keep in mind is credentialing. Due to a series of issues (and lies) unrelated to me, it took me 2 months to get an actual job offer at my home institution. This came around in late June. It then took 4 months to get my credentialing at that same hospital, despite the fact that it was the only place I'd ever worked as an MD (residency and fellowship). So even though I could moonlight on June 30th (I actually worked on 6/29), once July 1 rolled around, I was unable to work clinically until my credentials cleared.

Bottom line, I don't know if you can start the credentialing process without an active license, but if you can, you definitely should. Your training license (assuming your state has those), should be good through the end of the year (academic or calendar, depending on your state) and may be enough to start the process with any job you may take.

TL;DR - Yes, get licensed and start the job search now.

 

[medrest]

Getting license takes time-less in some and more in others. It's not easy to get jobs in VA as it may take time for a vacant spot to be available. Which state do you want to work in? Any preference? If you want to apply for Texas, you can use this http://www.becomeahospitalist.com/steps-in-applying-for-texas-physician-full-license/

 

[WanderingDave]

I really appreciate the advice, guys. I live in New Jersey, which from my research and asking around is one of the slowest states to get licensed in, by one of the most scrutinizing Boards. I've been quoted wait times of 4~5mo MINIMUM -- a clock that starts ticking only once the board has received every last piece of my initial paperwork, with likely more time added on if you have anything to explain to the Board (which I do). An old post on SDN had people talking about wait times of 8mo for NJ licensure.

I'm about to interview at job sites in NH and upstate NY, plus we live right near PA, so these are other states I'm looking into getting licensed. From my research, PA is one of the quickest and easiest states to get licensed in, albeit with the extra hurdle of getting my intern year approved by the Osteopathic Board. NH isn't quick or easy, but they do grant a temporary license good for 3~6mo, to anyone with an active license in any other state. If I decide on the NH job, I think I might apply for licensure in PA, then for the temp one in NH. NY is somewhere in between in terms of time, I hear.

Can anyone speak about license expediating agencies, or recommend any good ones? Most of the ones I've found on Google charge a flat fee of anywhere between $400~900 to track down and file all the forms for any state medical Board, and then hassle the Board about getting it processed. They claim to shave off some amount of time in getting licenses issued, or at least avoid any unnecessary delays.

Also, one of you guys mentioned moonlighting. I'm pretty sure I need a full (not training) license to do that in most states. If indeed my training license is still good for another few months after I graduate, is there any precedent for a practice taking me on temporarily (or as a locum) under direct supervision, as if I were a resident or mid-level?

 

[NotAProgDirector]

Also, one of you guys mentioned moonlighting. I'm pretty sure I need a full (not training) license to do that in most states. If indeed my training license is still good for another few months after I graduate, is there any precedent for a practice taking me on temporarily (or as a locum) under direct supervision, as if I were a resident or mid-level?

Your training license will likely expire the day you complete residency. In any case, you can't work on a training license unless enrolled in a residency program. You need a full license.

 

[Dral]

I really appreciate the advice, guys. I live in New Jersey, which from my research and asking around is one of the slowest states to get licensed in, by one of the most scrutinizing Boards. I've been quoted wait times of 4~5mo MINIMUM -- a clock that starts ticking only once the board has received every last piece of my initial paperwork, with likely more time added on if you have anything to explain to the Board (which I do). An old post on SDN had people talking about wait times of 8mo for NJ licensure.

I'm about to interview at job sites in NH and upstate NY, plus we live right near PA, so these are other states I'm looking into getting licensed. From my research, PA is one of the quickest and easiest states to get licensed in, albeit with the extra hurdle of getting my intern year approved by the Osteopathic Board. NH isn't quick or easy, but they do grant a temporary license good for 3~6mo, to anyone with an active license in any other state. If I decide on the NH job, I think I might apply for licensure in PA, then for the temp one in NH. NY is somewhere in between in terms of time, I hear.

Can anyone speak about license expediating agencies, or recommend any good ones? Most of the ones I've found on Google charge a flat fee of anywhere between $400~900 to track down and file all the forms for any state medical Board, and then hassle the Board about getting it processed. They claim to shave off some amount of time in getting licenses issued, or at least avoid any unnecessary delays.

Also, one of you guys mentioned moonlighting. I'm pretty sure I need a full (not training) license to do that in most states. If indeed my training license is still good for another few months after I graduate, is there any precedent for a practice taking me on temporarily (or as a locum) under direct supervision, as if I were a resident or mid-level?

The license that took 6 weeks for me to get was PA. So yeah, it's pretty fast. It's relatively cheap as well. My DEA only took about a month.

PA makes you go through an extra background check or two, but I can't complain about their licensing process.

 

[Raryn]

If you're looking at different states, I wouldn't even bother applying for a license until I had a job lined up. Why would you maintain a NJ license if you're going to get a job in NY?

 

[koikisi]

There are plenty of people who take a couple of months of vacation before starting and plenty of groups that hire people who's licenses are pending. The main problem tends to be coming up with the money for a relocation and living expense when there is a gap of 3-5 months between pay checks. I'd start looking for moonlighting opportunities now to buffer the loss of income while you wait.

How can he be looking at moonlighting opportunities when he doesn't have a license at this time?

 

[Arcan57]

How can he be looking at moonlighting opportunities when he doesn't have a license at this time?

Missed that. Thought he has looking for an out of state license but already had one from the state where he trained.

 

[rokshana]

talk to a locums company as well...some states (Maine comes to mind) have a locums license that can be done in as little as 2 weeks...this way you can work locums while awaiting the longer timeframe for NJ if NJ is where you want to stay...but yea, Pa is pretty quick and painless in the licensing processing...