GP license after 1 yr?

[ama33]

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i'm finishing up my first year of IM and realizing i don't want to practice it. i'm thinking of taking my step 3, applying for my general practitioner license, and doing only cosmesis procedures--botox,sclerotherapy, laser...is this possible? people around me are saying that it's not. anyone know of anyone who has gotten a gp license after their first year of residency? anyone know of anyone doing cosmesis?

 

[frank51]

Its definitely possible, for a couple of states you need to have 3 years of post graduate training, everywhere else is 1 year. Starting your own practice, and attracting customers will be very difficult though.

 

[tkim]

No such thing as a 'GP license'. There's the unrestricted medical license that you can get after step III and 1-3 years postgrad training. The individual state's requirements are here:

http://www.fsmb.org/usmle_eliinitial.html

You can certainly open up a practice after getting your license, but without completing a residency, most health insurance will not reimburse you, and you will have to work on a cash-only basis. Might be a tough thing to swing as a solo office practice without an established patient base.

 

[Good Solutions]

If there are independent NPs out there practicing, you should be able to do just fine as a GP. Insurance might not like you, but who cares. Formulate a business plan and take the appropriate steps to make it happen. Medicare is on the verge of collapse and less people are able to afford insurance any ways. If anything you'll have a head start on the new medical economy that involves cash and any one who can wield an Rx. It's going to be the wild west out there.

In addition to cosmetic botox, don't forget to learn trigger point injections. Lots of myofascial pain especially cervico thoracic. Occipital nerve blocks for headaches. Botox for cervico thoracic pain and muscle spasms refractory to relaxants, antidepressants, trigger points, PT, etc. You can fill a whole practice being a needle jocky. Good luck.

 

[NotAProgDirector]

In addition to cosmetic botox, don't forget to learn trigger point injections. Lots of myofascial pain especially cervico thoracic. Occipital nerve blocks for headaches. Botox for cervico thoracic pain and muscle spasms refractory to relaxants, antidepressants, trigger points, PT, etc. You can fill a whole practice being a needle jocky. Good luck.

This is reasonable advice. Personally, I think it will be difficult to establish a practice without completing a pain fellowship, or derm, etc. You'll need to get people to refer to you, or try direct marketing to patients. You may find it hard to convince patients to pay out of pocket for healthcare.

However, you should be aware that from a malpractice standpoint, you may be held to the standard of someone who has completed a pain / derm cosmetic fellowship

In the long run, my best advice is to finish a residency. Many people who have not finished residency are now finding it very difficult to find a job at all, and impossible to find a residency program that is willing to take them back.

 

[gutonc]

In the long run, my best advice is to finish a residency. Many people who have not finished residency are now finding it very difficult to find a job at all, and impossible to find a residency program that is willing to take them back.

And this, I think, is the key. You are in a training program now. If you bail out because you want to go push Botox and dermabrasions and then decide that you hate dealing with rich, vain people all day long, you'll be hard pressed to find anything other than a malignant IMG mill to take you back and let you finish your training. Finish it now and then go do cosmetics if that's what you want to do but, if you leave now and ever decide you want back in (which I know you may not) it will be an uphill slog.

 

[psymed]

I agree with gutonc. I have worked in Dermatology and the cosmetic patients are the worst. They are needy, hard to satisfy and they will not hesitate to file a complaint against you if they are not happy.

A lot of these patients are body dysmorphic too. They will want stuff done when they do not really need it. Really think about it before you drop out of your residency. Everyone is different but I did not find working with cosmetic patients gratifying at all. Just my opinion.

 

[frank51]

I think the important issue is not working with those patients, if a lot of people had issues working with those patients Dermatology would not have been this competitive. The issue here is having the ability to do it with just one year of internship and succeeding, especially with this economy. If however, the OP has connections and is able to bring a lot of patients and establish his practice by all means he should do it, if not, which is the more likely scenario he should finish his residency.

 

[Law2Doc]

...
However, you should be aware that from a malpractice standpoint, you may be held to the standard of someone who has completed a pain / derm cosmetic fellowship...

Not only this, but you may have a difficult time getting medmal coverage without a full residency, and if you can find some, the premiums will likely be sky high. The insurance issues are what makes OP's plan unrealistic.