Getting state medical license, changing name, attended overseas medical school

[letmeinwillya]

About to graduate from IM residency in July 2019. Don't know where I will get the job but have few places in mind..TX, NC maybe CA. I'm an IMG so a specific concern of mine is needing to reach out to my medical school for any LOR or any other type of information is a big PITA!!

What's the general licensing process like? I understand that it differs from state to state. I've heard from others that FSMB is a good choice for IMGs (who went to medical school overseas, non-Caribbean) as they take care of contacting the medical school for verifying the graduation etc and I can then request FSMB to simply forward the profile information to any state of choice.

Are there states that are tricky/hectic or require extra stuff (have people sit for some exam .. or stuff like that)? Are TX and CA among those?

Currently in NY, is getting credentialed in NY relatively easy and does it benefit to be licensed in one state when applying for medical license in another state?

I'm a US citizen if that matters.

To throw a monkey wrench into this, planning to change my name before graduating from residency program ...would that complicate the maters as far as establishing the identity?

Would appreciate advice from anyone who may have gone through something similar or can point me in the right direction.

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[NotAProgDirector]

FCVS, the Federal Credentialing and Verification Service, is run by the FSMB. It's basically "ERAS for licenses". You complete a single application, have your documents completed / forwarded to them (transcripts, USMLE, etc) and then any time you need a new license, you just send the packet to whatever state you want.

States often have their own applications you must complete in addition, and their own fees.

Some states are slower / more complicated than others. In general, the slower states are MA, CA, TX, FL, and PA. But these fluctuate like the weather.

The only state with an exam, of which I am aware, is TX. There is a jurisprudence exam. There are plenty of threads on SDN about it. It's easy to pass with a small amount of reading / studying.

Each license you have makes the next license slower to get. All states are going to want to know where any other licenses you have are, and then want to request information from that state -- which adds more headaches for you, and slows down the process. Do not get licenses you don't need.

Can't comment on a name change, certainly will add to the paperwork you will need but plenty of people do it and are fine. Certainly won't speed things up.

Timing wise, you're not late to be applying for positions. However, all but one of residents who are graduating this spring into jobs already have contracts -- they are done with interviewing. If you want a job in July, you will be late soon. Licensing and credentialing take 3 months (sometimes faster, but don't count on it). The fact that you don't have any good idea of where you want to work will make it take longer to find a position (more variables, travel, etc). Plus you'll need to work this into your resident schedule.

If you're going into outpatient medicine, you should also consider getting your Bup x-waiver training done now if interested (and not already done in residency). There are free options online.

 

[letmeinwillya]

Thank you aProgDirector!! for your reply and thoughtful feedback! I think the delay in licensing is also a function of how many applications a given state board gets and how inefficient and understaffed they are.

Also TX license seems to be issued for two years, not sure about other states. Reminds me of RI used to issue driver's license for 2 years and I found that to be annoying having to renew every 2 years (DL and Medical license not at the same level but still..)

I looked at the Jurisprudence exam resources online, not many choices and some seem to be outdated. Anyway will look further and see if I can find something useful.

I remember seeing some job descriptions that would accept physicians licensed in ANY state .. can't recall what type of jobs were those.

At this point, also thinking about going for temp. work route if I can't commit to an area other than where I'm currently training. Are there jobs available that you could do on contract/temp basis and don't require a long notice if one needs to leave? Kinda like "at will" employment. An analogy would be "month to month basis" vs "signing a yearly lease".

 

[NotAProgDirector]

Many medical licenses need to be renewed every 2-3 years, but it's easy, you usually just need to submit your CME completion and pay a small fee.

The only physician jobs that allow for a license in ANY state are at the VA, as they are federal property. Otherwise, you will need a license in any state you work.

Locum tenens (temporary physician work) can be done. It can be shift by shift, or it can be a several month assignment. It can be very lucrative for the right person -- if you agree to several months at a location, they will often pay for your lodging also. If you have no rent/mortgage, you'll have very low expenses and can get paid quite well. But these jobs can be in geographically unpopular spots, and your employer isn't really trying to make you happy. And there's potential tax issues if you're paid as an Independent Contractor.

As a new graduate, I worry about doing locums work as your primary source of income. You only learn 50% of what you really need to know in residency. You learn the next 25% in the first 6-12 months of work. You learn the last 25% over the rest of your career. That first 12 months is really important, I think it would be valuable to be in a stable position with good mentorship. But I'm sure it's been done before.

 

[letmeinwillya]

Thank you for your reply! Ah! that's it. I happened to look at a job posting for VA and yes it specifically states being licensed in ANY state would suffice! Good to know that renewals hopefully wouldn't be a big deal in that time consuming process as the first time.

I agree with your assessment of having a stable work environment where one could have experienced peers/senior docs whom one can go to when needed and not being the only doc. in a late night locum position in a remote area.

Keeping that mind, I would think hospitals, medium sized medical groups would be good places to start vs. small clinics where you are the second physician other than the owner physician.

 

[NotAProgDirector]

Correcting my above statement, any federal job requires a license in any state. Most of these are VA based, but working in a federal prison, or the Indian Health Service, would fall under the same rules.

A small clinic can be absolutely fine as a first job. Totally depends upon what you're looking for.