License in multiple states

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justwondering

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Just wondering how difficult it would be to get my license in multiple states. I'm not sure where I will end up after residency, but I would like to be licensed so that I can start working ASAP once my husband knows where he will need to move. In addition to my own state, I'm thinking of possibly working in CA, NY, or IL. Is one license good enough to get me through working a few months in any of those states (ie can I get my TX license here, and then work several months in another state while waiting for licensure in the new state)? Is it different for locums jobs?
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you can work in any state without a license... it's not advisable, but you can do it. seeing as how can and should are two different words.

so yes, you can do it. no, you should not.

with that being said, assuming you want to work legally without problems as a physician, you need to get a license before working as an attending. that can take weeks to months. some states will wait until you finish residency before granting you a license- those states typically have a different license for those in training, and those not in training.

locum jobs may have a person that specializes in licensing/credentialing, and knows what forms/papers/etc. is needed for the various states in which they have clients.

with all of that being said, once you have a license, you then need to get privileges in various hospitals within the state. again, having a licensing/credentialing person is key, as they'll know deadlines and committee meeting dates.

in the end, a license may not be enough, depending on what you plan to do. work in urgent care, just a license. want to work at a specific hospital, need the license and privileges to work there.

winged scapula may chime in, but from my experience it can be about a 9-12 month process when it's all said and done.

i was an internal medicine resident, signed a contract to come to vegas oct 07, finished residency june 08, got a nevada license july 08 (had to wait to finish residency as their are separate licenses for those still in training), credentials/privileges to start sept 08.

fwiw, i carry a cali and nevada medical license.
 
As elwademd notes, there is a LOT more to working than just having a license and it is different for locums jobs.

In most cases, locums jobs don't require you to apply for hospital privileges and they will fast track a temporary state license for you if you are not licensed in that state.

Working in the VA facilities is easier because any unrestricted state license is fine.

You can apply for any state license you wish - I currently have 3 (from residency, fellowship and now where I actually practice). The length of time to get that license varies WILDLY from state to state. Unfortunately, California and Texas can be the most length; recall in Texas you have to take the Jurisprudence exam to be licensed. New Jersey took me nearly 6 months but I got my Arizona license within 3-4 weeks after submitting my FCVS app to them.

BUT...and this is a big one. Just because you have a license doesn't mean you can work. Most hospitals will require you to go through a credentialing process and if you are not going to be an employee but rather a contracted practitioner who is required to be on insurance, you will also have to apply to be a provider.

These things can take months...it took me nearly a year to get on United Healthcare and most hospitals took 2-3 months to credential me (lets not start on the frustration of them requiring you to submit all the same information you had to submit to the state licensing board, or if you are in a state like Arizona which has a centralized credentialing board but not every hospital uses it...so you have to reinvent the wheel each time).

So don't make the mistake of just thinking you can find some job to start right after residency is over UNLESS like elwademd you know exactly where you are going to be after residency and can start the process MONTHS before you graduate. Locums work is easier in terms of setting it up, but finding something in the geographic area you want, in the specialty you want and for the length of time you want can be difficult.
 
group_theory said:
Wouldn't it also be expensive to maintain licensure in multiple states?

And the CME requirements for those multiple states would also be a nightmare to management
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My dad is licensed in 3 states (each has a different fee and a different schedule for paying), and he does CME for the most stringent one. He told me never give up a license once you get it somewhere.
 
You need to get a license BEFORE you start working in any state, in general...there might be some exceptions such as getting a "short track" license or temporary one. My current state license it took me only a couple of months to get, and it wasn't that much trouble. As far as I know, California does not do temporary licenses and they definitely have to process to speed up the application, no matter how much the applicant might want that. They specifically warned us about that fact. I have a license in another state and currently am working on getting a California one. I've been working on it for 3 months, but currently still waiting...I have heard 4.5 months or so is average for getting one from there, so you really need to get on that at least 6 months prior, or more if you can, if you are thinking of moving there. It will cost you about $1200 all told to get a license in California. There is an applicant fee of about $400 and then a license fee of $830.

Some people say to never give up a license once you have it, but as mentioned above it can be expensive and time consuming to maintain all those. The CME in general is not a big deal...you can do it online, at professional meetings, etc. Mainly I would not want to pay to maintain multiple state medical licenses if I am not using them. Some states have a "retired" license process where I think you can retire it temporarily, and ask to get it back (and repay the yearly fee) if you want it back later.

OP, my advice is if you are thinking of staying in your current state where you are doing residency, then definitely go for that state license first. Also, need to discuss with your spouse where you two plan to live, and what are your future plans...I seriously think it's too expensive and too much trouble to take out 3 or 4 different state licenses at this point in your career.

Also, as mentioned by the attendings above, you'll have to get hospital privileges at any hospital you end up working in, and that can take a couple of months. I am filling out paperwork now for hospital privileges @ a California hospital and they basically want copies of all my credentials (med school and residency diplomas, ACLS card, driver's license, social security card, internal medicine board certification, personal references, the works...).
 
group_theory said:
Wouldn't it also be expensive to maintain licensure in multiple states?
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Depends on the cost of each state license. The renewals are less expensive because you don't have all the upfront costs...plus many states will let you put a license on inactive status which doesn't cost you anything but makes it easier to reinstate. As others have noted, never let go a license once you have it.

And the CME requirements for those multiple states would also be a nightmare to management
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Why?

I simply keep all my CME certificates in a folder and when asked for them, make copies and send them along. Its not like you need separate ones for each state (just differing amounts of credits).
 
dragonfly99 said:
I have a license in another state and currently am working on getting a California one. I've been working on it for 3 months, but currently still waiting...I have heard 4.5 months or so is average for getting one from there, so you really need to get on that at least 6 months prior, or more if you can, if you are thinking of moving there. It will cost you about $1200 all told to get a license in California. There is an applicant fee of about $400 and then a license fee of $830.
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I have an unrestricted NC license and am working on CA too. I'm in the military, so it doesn't matter what state I'm licensed in - I can work in any military hospital in any state. But if I want to moonlight, I need a license in whatever state I'm in.

The Navy just decided to send me to California, so I'm working on that license. $493 application fee and a license fee of $830 (but it looks like I'll get to pay the reduced $427 license fee since I'm presently a resident). They quote 6-9 months on their web site.

I called the board last week to get their special fingerprint cards mailed to me, and the person said there was currently a 90-day backlog to even look at new applications. I don't know if that 90 days is factored into the 6-9 months their web site says. My application has no red flags (ie, no felonies, drug rehab, malpractice suits, etc) so I figure if anyone falls into the 6 month group, it's me ... just hoping to have it in hand by August or September.

I've also heard that DOs have additional hassles to slog through if they want CA licensure.
 
FYI, I just got word that I got my license in California...it was about 3.5 months total wait time...less than 4 I know. They kept saying the finger prints weren't good enough, then all of a sudden they just said the feds accepted them, and I get my license. Woohoo!

I think the 6-9 months on the California web site is a conservative estimate...likely more true for someone with a red flag or perhaps IMG's who have to complete extra paperwork?

I thought DO's have a separate medical licensing board in California...but I might be wrong.
 
It does get expensive. My licenses in CA and NV are $400/ year (actually $800 every 2 years). I haven't touched a patient in CA in 6 years so I've paid $2400 for the privelidge of not going through the initial license process again. That's a bit steep.
 
i have a few medical licenses and depending on which state you will be licensed in its a pain in the arse. the hoops you have to jump through are phenomenal. Ny is easy.. 6 weeks once yyou get your stuff in.. NJ is hard Ca is medium hard Il is medium PA is really really easy va is really easy MA is impossible pain in the ares
 
maceo said:
i have a few medical licenses and depending on which state you will be licensed in its a pain in the arse. the hoops you have to jump through are phenomenal. Ny is easy.. 6 weeks once yyou get your stuff in.. NJ is hard Ca is medium hard Il is medium PA is really really easy va is really easy MA is impossible pain in the ares
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can anyone approximate how long Pennsylvania licensure takes for Caribbean IMGs?
 
I agree on not surrendering a license. I have had mutliple professional health care licenses in 2 states for about 20 years. The requirements for licensure have changed, and if I wanted to be licensed now in those states I would have to meet additional requirements - take a couple of more tests. After taking my USMLE's for this whole MD fiasco I would hate to think of taking more tests for my other licenses.

Licensing requirements tend to get tougher over time, and if you surrender a license you may have a hard time qualifying 20 years down the road.
 
THanks for all the responses!! this is really helpful!
 
Winged Scapula said:
Training or unrestricted license?

Neither takes very long - a few weeks for the former, a couple of months for the latter as long as there isn't anything worrisome in your file.
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Wow, it takes a couple of months to get a Pennsylvania unrestricted medical license, even if you don't use the FCVS service? I was under the impression that PA was a straightforward state.
 
prominence said:
Wow, it takes a couple of months to get a Pennsylvania unrestricted medical license, even if you don't use the FCVS service? I was under the impression that PA was a straightforward state.
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It is, but it is also a big state with lots of residency programs and people applying for licenses. IMHO, 2 months is pretty quick for most states and besides, as an IMG, you have to add in verification of your education, etc which takes time. Its not that straightforward ( for example, you have to have so many weeks of medical education and they won't count any medical school rotations done in the state of Pennsylvania if you are an IMG).
 
prominence said:
Wow, it takes a couple of months to get a Pennsylvania unrestricted medical license, even if you don't use the FCVS service? I was under the impression that PA was a straightforward state.
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straightforward != fast. I think at a bare minimum you can expect 3 months for a license from most states (unless you're in one of the few that still have reciprocity agreements with neighboring states that you already have a license in).
 
I don't know, Guton, I know of at least a couple of states in the South and Midwest where it only takes 2 months...maybe even quicker if you are lucky.
They just don't have as many applicants nor as many licensees/practicing docs to keep track of. I got a license in about 2 months @the end of my residency, and it was super easy...
 
dragonfly99 said:
I don't know, Guton, I know of at least a couple of states in the South and Midwest where it only takes 2 months...maybe even quicker if you are lucky.
They just don't have as many applicants nor as many licensees/practicing docs to keep track of. I got a license in about 2 months @the end of my residency, and it was super easy...
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Sure, shorter is possible. But if you prepare for 3 months or more you won't be disappointed when it takes that long.
 
Why isn't SolaceMed banned? Just curious.
 
DrMom said:
We can't always get to these problematic posts less than 20 minutes after they are posted. 😉
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Well, geez...don't tell me you do other things in life besides surf SDN all day...C'mon.
 
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