licensing in another state

[hazlet]

Hey, if you do residency in one state, can you get your license in another state before you get your license in the state you're doing residency in?

The reason I ask is that I'm likely going to just do an intern year and try to get out of medicine. Many states now require 2 or 3 years of residency before getting a license and most of the places I've interviewed at fall in that category. If I were to do just intern year in one of those places, would I be able to get a license in a state that allows licenses after an intern year? Or do I need to have a license in the state I'm doing residency first?

The reason I'm asking is if there's no way I can get a license after an intern year, I have to reorder my entire rank list.

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[ThoracicGuy]

Hey, if you do residency in one state, can you get your license in another state before you get your license in the state you're doing residency in?

The reason I ask is that I'm likely going to just do an intern year and try to get out of medicine. Many states now require 2 or 3 years of residency before getting a license and most of the places I've interviewed at fall in that category. If I were to do just intern year in one of those places, would I be able to get a license in a state that allows licenses after an intern year? Or do I need to have a license in the state I'm doing residency first?

The reason I'm asking is if there's no way I can get a license after an intern year, I have to reorder my entire rank list.

If you want to have a chance to repay your loans, it would be better to finish residency training. Just having one year won't really help you all that much...

 

[hazlet]

If you want to have a chance to repay your loans, it would be better to finish residency training. Just having one year won't really help you all that much...

I agree, but that wasn't my question. Do you know about the licensing rules?

 

[hamstergang]

I don't believe any state requires that you do your training there in order to get your first license there. But every state is allowed to make their own rules.

 

[W19]

If you want to have a chance to repay your loans, it would be better to finish residency training. Just having one year won't really help you all that much...

Wrong! I know a few GP who are making 160-180k/year... One of the them got 25k/year in loan repayment.

As for OP's question, I am not sure there is a requirement to do the 1-year intern at the state you want to be license... If a state requires 1-year post grad to get a license, they don't really care where you do that year... I am also planning to do only 1-year intern and then get a license... I contacted a few states and they said it's ok... I am just a MS2 now; things might change when I am ready to do that..

 

[ThoracicGuy]

I agree, but that wasn't my question. Do you know about the licensing rules?

As long as you fulfill the state licensing requirements, you can get a license. For a US MD grad, that is one year of residency training along with passing all three Step exams.

 

[ThoracicGuy]

Wrong! I know a few GP who are making 160-180k/year... One of the them got 25k/year in loan repayment.

As for OP's question, I am not sure there is a requirement to do the 1-year intern at the state you want to be license... If a state requires 1-year post grad to get a license, they don't really care where you do that year... I am also planning to do only 1-year intern and then get a license... I contacted a few states and they said it's ok... I am just a MS2 now; things might change when I am ready to do that..

Can someone get a job as a GP with one year of training? Of course. Is that common? Not really. Is that a good thing for patients? Probably not. Just because it's possible doesn't mean someone should see it as a viable option.

Why do you only want to do a 1 year internship and quit? You do realize that residency is not the same as medical school. You also realize that you will have a difficult time finding a job as a physician with only one year of training. Typically it will be hard to get on insurance plans as they typically want to see board certification. This can also be a problem for getting hospital privileges. I hope you think real long and hard and have some mentors at your school that you can have honest discussions about this idea before you do it.

 

[hazlet]

Can someone get a job as a GP with one year of training? Of course. Is that common? Not really. Is that a good thing for patients? Probably not. Just because it's possible doesn't mean someone should see it as a viable option.

Why do you only want to do a 1 year internship and quit? You do realize that residency is not the same as medical school. You also realize that you will have a difficult time finding a job as a physician with only one year of training. Typically it will be hard to get on insurance plans as they typically want to see board certification. This can also be a problem for getting hospital privileges. I hope you think real long and hard and have some mentors at your school that you can have honest discussions about this idea before you do it.

I don't want to work as a physician. I dislike clinical work. I have looked into other opportunities, and there are pharmaceutical and research positions that only require a MD that possesses an unrestricted license. If that doesn't work out, I will complete residency and find something administrative. I abhor patient care, but have too many red flags to secure a radiology or pathology residency (I tried).

 

[ThoracicGuy]

I don't want to work as a physician. I have looked into other opportunities, and there are pharmaceutical and clinical research related positions that only require a MD that possesses an unrestricted license.

Be aware that many of these positions still prefer board certified physicians. You could probably find clinical research positions easier, but they will pay peanuts. I'm sure you have alot of loans, so you may need to suck it up and get through residency just to be able to make money to pay them back.

Another thing to consider if you want to get boarded but still have a reasonable personal life and lifestyle is looking at Preventative Medicine. You need an intern year in something and then I believe it's two years for preventative medicine. Then you can work in clinics at workplaces or as occupational medicine and have a 9-5 day with no weekends and no call. Something to consider...

 

[W19]

Can someone get a job as a GP with one year of training? Of course. Is that common? Not really. Is that a good thing for patients? Probably not. Just because it's possible doesn't mean someone should see it as a viable option.

Why do you only want to do a 1 year internship and quit? You do realize that residency is not the same as medical school. You also realize that you will have a difficult time finding a job as a physician with only one year of training. Typically it will be hard to get on insurance plans as they typically want to see board certification. This can also be a problem for getting hospital privileges. I hope you think real long and hard and have some mentors at your school that you can have honest discussions about this idea before you do it.

I don't know if the landscape will change in south FL, but I know of many GP who had no problem finding jobs at county department of health, 'migrant' clinics, clinics for low income individuals, jail etc... in south FL. These are 9-5 M-F jobs with no calls... Of course they don't have hospital privilege. Not interested in that anyway... They probably don't make the average salary of FM/IM BC/BE physicians, but they make enough to pay the bills.

 

[ThoracicGuy]

I don't know if the landscape will change in south FL, but I know of many GP who had no problem finding jobs at county department of health, 'migrant' clinics, clinics for low income individuals, jail etc... in south FL. These are 9-5 M-F jobs with no calls... Of course they don't have hospital privilege. Not interested in that anyway... They probably don't make the average salary of FM/IM BC/BE physicians, but they make enough to pay the bills.

And likely giving substandard care, unfortunately. When you get to be a chief resident, you'll look back at your intern year and realize how clueless you really were. Now you want to go out just finishing intern year and start a practice? Just to skip two years of training? That just doesn't make any sense.

 

[W19]

And likely giving substandard care, unfortunately. When you get to be a chief resident, you'll look back at your intern year and realize how clueless you really were. Now you want to go out just finishing intern year and start a practice? Just to skip two years of training? That just doesn't make any sense.

That's an opinion though, and I am not sure why you think so. There is no outrage about PA/NP giving substandard care, so I am not sure why you think that would be the case for a 1-year postgrad MD that has more training...

Again, it's something that I am considering. There will be other variables to consider before I make that decision.

 

[IslandStyle808]

Can someone get a job as a GP with one year of training? Of course. Is that common? Not really. Is that a good thing for patients? Probably not. Just because it's possible doesn't mean someone should see it as a viable option.

Why do you only want to do a 1 year internship and quit? You do realize that residency is not the same as medical school. You also realize that you will have a difficult time finding a job as a physician with only one year of training. Typically it will be hard to get on insurance plans as they typically want to see board certification. This can also be a problem for getting hospital privileges. I hope you think real long and hard and have some mentors at your school that you can have honest discussions about this idea before you do it.

Had a question about the preventative medicine residency. I only see two programs on the NRMP report (yet I know there are a whole bunch). Do they all use the NRMP or an independent matching service like urology?

 

[ThoracicGuy]

That's an opinion though, and I am not sure why you think so. There is no outrage about PA/NP giving substandard care, so I am not sure why you think that would be the case for a 1-year postgrad MD that has more training...

Again, it's something that I am considering. There will be other variables to consider before I make that decision.

I think independent NPs and PAs usually give substandard care too. There are a few practices that are independent NP based in my town. You wouldn't believe the ridiculous consults and haphazard management I've seen sent to my clinic from those groups. I don't like those practices and I certainly don't like the idea of a fresh PGY2 resident being in independent practice. I've been through residency. I've seen how poorly those residents can perform. Now imagine you only have that one year of experience and you are going out there and practicing on people that either don't know you never finished your training or can't afford to go elsewhere. You are practicing on those people to get your skills up to an acceptable level and there is no backup for you. I spent 10 years in training and my first few years out in practice I have several times when I'm not comfortable with things. I can't imagine how it would be if you had 1 year and had to make decisions.

I see you and a few others ALWAYS go back to the "but but but NP/PAs!" as an argument on why it should be ok for MDs to just go out with one year of practice. Two wrongs don't make a right...

 

[ThoracicGuy]

Had a question about the preventative medicine residency. I only see two programs on the NRMP report (yet I know there are a whole bunch). Do they all use the NRMP or an independent matching service like urology?

I don't know much about them. Maybe @fantasty could weigh in on it.

 

[fantasty]

I don't know much about them. Maybe @fantasty could weigh in on it.

Prev Med programs do not use the match, for the most part. There may be some that do, particularly if they are combined with other specialties (like IM/PM or Family/PM). A lot of the programs still use ERAS for applications though. PM is a slightly different application process because you usually need to complete at least 1 year of another clinical residency before you apply (although you can do a full residency too, of course, if you want to be dual-boarded).

I recently typed a longer synopsis of applying to PM in this thread: http://forums.studentdoctor.net/threads/preventive-medicine.482167/

(skip down to #48 if you want the recent stuff - the thread is a little old, and that's part of why I posted such a long response).

But, also, the basic for applying to PM residencies is available on the ACPM website: http://www.acpm.org/?page=GME_Home

 

[fantasty]

Had a question about the preventative medicine residency. I only see two programs on the NRMP report (yet I know there are a whole bunch). Do they all use the NRMP or an independent matching service like urology?

And, oh yeah... getting back to your original question.... Because there are relatively few programs (compared to most other specialties) and the fact that you need to apply after/during your PGY-1 year anyhow, they don't really do a match. It's more like rolling admissions for med school. I believe some of the programs have discussed trying to make more uniform application, interview, and offer deadlines, but I don't think they've come to a consensus yet. So, some programs will still have spots relatively "late" in the year. The ACPM annual meeting is this week (although I'm not attending this year), but residency programs often are still interviewing at the meeting and I know several people who secured July 1 spots well after Feb.

 

[IslandStyle808]

And, oh yeah... getting back to your original question.... Because there are relatively few programs (compared to most other specialties) and the fact that you need to apply after/during your PGY-1 year anyhow, they don't really do a match. It's more like rolling admissions for med school. I believe some of the programs have discussed trying to make more uniform application, interview, and offer deadlines, but I don't think they've come to a consensus yet. So, some programs will still have spots relatively "late" in the year. The ACPM annual meeting is this week (although I'm not attending this year), but residency programs often are still interviewing at the meeting and I know several people who secured July 1 spots well after Feb.

Very interesting to know. Thank you for your input.

 

[fantasty]

That's an opinion though, and I am not sure why you think so. There is no outrage about PA/NP giving substandard care, so I am not sure why you think that would be the case for a 1-year postgrad MD that has more training...

Again, it's something that I am considering. There will be other variables to consider before I make that decision.

Weighing in on that... I'm siding with @ThoracicGuy . "Midlevels" generally aren't practicing independently. And, I also think rules will be changing as far as urgent care work. So, yes - it definitely is possible to practice as a GP generalist with an unrestricted medical license. But, not being boarded is severely limiting. I can tell you that even when it comes to "moonlighting" and other positions that may have been easier to do in the past.

I don't know where this stands, but Missouri was talking about allowing MD's to practice without a residency if they were supervised by another physician, but I don't think that's in effect yet.

Some places will consider GP's for limited responsibilities (like you said, corrections, some governmental clinics that have high demand for providers, or very limited scope of practice), but I'm still going to suggest that it's not a good long-term option if you can avoid it. And, really, the county / local health department gigs should be going to those of us boarded in General preventive medicine & public health - that's one of the main focus areas of our training.