License Question

[alphaholic06]

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When a resident obtains a full unrestricted license, does he still practice under a trainee's license as a resident in his program, or does he practice under his own license?

 

[gutonc]

When a resident obtains a full unrestricted license, does he still practice under a trainee's license as a resident in his program, or does he practice under his own license?

Yes, you practice under your own license...but...you don't have privileges at your training hospital. Therefore you still practice under the supervision (and license) of your attending.

So if you're going to massively screw up, do it on your training license. Otherwise you screw yourself AND your attending.

The legal implications are way more complex than I outline them here, but the basics are more or less correct.

 

[colbgw02]

I think it depends. My wife's residency never required her to obtain an unrestricted license, and since they didn't permit moonlighting, she had no reason to get one until right before her residency ended. In that case, she was obviously still practicing under someone else's license. I, on the other hand, had to get a license by the end of my PGY-2 year and submit it, so I suppose that I could have been practicing under my own license, not that it really matters for reasons already explained.

 

[Smurfette]

We were REQUIRED to get our permanent licenses after finishing PGY2. We couldn't work as a PGY3+ under a training license in my institution.

For malpractice purposes, if something happens while you are a resident, it is irrelevant if it is your trainee or permanent license. Residents with trainee licenses can be sued too. Otherwise you wouldn't need malpractice coverage. Obviously there are different caveats with this given a specific patient scenario, but the attending is the one with the brunt of responsibility and the residents involved are usually dismissed from the case. This is why as a resident, it is important to document that you discussed the plan with the attending.

If you are moonlighting and therefore not working as a trainee, then YOU are the primary individual responsible; you are acting as an attending in that capacity. This is also why you need a permanent license to moonlight---if you had a "trainee" license, someone would have to supervise you.

 

[michaelrack]

When a resident obtains a full unrestricted license, does he still practice under a trainee's license as a resident in his program, or does he practice under his own license?

A doctor only has one medical license (per state) at a time, and he practices under it whether it is a training license or an unrestricted license. The training license is generally only valid within a specified training program- if a doctor practices outside that setting with a training license, he is practicing medicine without a license or violating the terms of his training license, depending on the state.

(there may be some slight variation state to state)

 

[Winged Scapula]

The training license is generally only valid within a specified training program- if a doctor practices outside that setting with a training license, he is practicing medicine without a license or violating the terms of his training license, depending on the state.

Agreed.

(there may be some slight variation state to state)

Yes, for example in Pennsylvania you are required to have a training license as long as you are in residency, even if you also have an unrestricted medical license. Probably a revenue source (even if only $15, that adds up when you consider all the residents).

 

[michaelrack]

Winged Scapula,

that's interesting- I wasn't aware that licensing was handled that way in some states

 

[Winged Scapula]

Winged Scapula,

that's interesting- I wasn't aware that licensing was handled that way in some states

Given the malpractice crisis in PA, it would nice if some of the funds went to deflecting costs of litigation. 🙄