licensing question

[sdnstud]

I feel stupid for asking this question, but can someone explain to me how physician licensing work? For example, if i am a CA resident, go to medical school in NY, do my residency training in IL, what do I need to do to pratice in CA? Also, can I be licensed to practice in more than one state?

I am a current applicant, what other tests do i need to take before i am a full fledged doctor? i know there is the step 1 and step 2, are there any other tests after medical school (let's say i wanna be a primary dr)

---

Members don't see this ad.

 

[Pinkertinkle]

USMLE is nationwide, you may practice in any state.

 

[Yellow Snow]

I used to process licenses for physicians on a fee basis.

USMLE can be used in any state. Most states offer, or at one time offered a state test as well. For the most part other states will recognize these but not in all cases. Florida's test is looked down on for some reason and several states will not accept it. For specific information you will have to check with the state you want to be licensed in.

License processing time can take anywhere from a few weeks (PA) to nine months or a year (FL and CA) so it is usually helpful to contact the state you want to work in.

 

[AJM]

All licensing and certification exams are national - so you can get a license in any state you want. You just have to do the application, which is an absolute pain, and send the state lots of money (both for the initial fee, and then for the periodic renewals). You can have a license in more than one state, but most people don't, unless they are actively practicing medicine in more than one place.

To get a medical license, you need to take and pass USMLE steps 1, 2, and 3. Step 1 is taken at the end of the preclinical years, step 2 is taken before finishing medical school, and step 3 is typically taken after internship. You can then apply for a full medical license and practice medicine independently.

Most physicians also get board-certified in their chosen specialty, because they'll be hard-pressed to get a job that compensates well if they are just licensed and not board-certified. The specialty board exams are taken after completion of a full residency in that specialty, which is when you become "board-eligible". So if you want to do family practice, for example, you take USMLE steps 1, 2, and 3, then complete your FP residency, and take the family practice board exam. Then to keep your certification, you usually have to retake the specialty board exam every 10 years or so.

If you want to sub-specialize, there are often more exams. For example, if you want to do cardiology you take the 3 steps of USMLE, do an internal medicine residency, take the IM boards, do a cardiology fellowship, then take the cardiology boards.

 

[AJM]

USMLE can be used in any state. Most states offer, or at one time offered a state test as well. For the most part other states will recognize these but not in all cases. Florida's test is looked down on for some reason and several states will not accept it. For specific information you will have to check with the state you want to be licensed in.

I've never heard of a state exam for any state. If they existed in the past, they don't have them anymore.

 

[Yellow Snow]

You can still take state exams in some states. The Washington Board of Osteopathy will require you to take their state exam unless your licensing examination from a different state specifically covers principles of Osteopathy.


Here is a bit from the Idaho website that specifically mentions they accept state exams but won't accept the FL examination:

"Eligible to apply for a license without examination (by endorsement) are applicants who fulfill all requirements and

are Diplomates of the National Board of Medical Examiners, or USMLE or
are Diplomates of the National Board of Examiners for Osteopathic Physicians and Surgeons, or
hold valid, current licenses, received after examination in a state with standards considered to be equivalent to those of Idaho.

Oral or written examination or reexamination can be required.

Qualified applicants may requwsst expedited licensure. In certain cases, an interview may be required.

Osteopathic physicians and surgeons receiving degrees after January 1, 1963, and fulfilling applicable requirements, can apply for a license by endorsement.

The Florida examination, from July 1969 through 1980, is not endorsed."
http://www.bom.state.id.us/licensees/general.html

 

[bgreet]

So is it after completing usmle step 3 that you can officially perscribe on your own?

 

[Yellow Snow]

Just completing USMLE step 3 doesn't mean you are licensed. You have to apply for licensure in the state you work in. I am pretty sure that a license is needed to prescribe.

 

[MadameLULU]

Just completing USMLE step 3 doesn't mean you are licensed. You have to apply for licensure in the state you work in. I am pretty sure that a license is needed to prescribe.

Very true. I know that pharmacists in TX have access to records of all licenced physicians in TX. They will not fill a prescription for a physician who isn't licensed by the state of TX.

 

[bgreet]

Very true. I know that pharmacists in TX have access to records of all licenced physicians in TX. They will not fill a prescription for a physician who isn't licensed by the state of TX.

Really? I live in NJ and out of state doctors can write perscriptions here with no problems. So when you are in residency, I assume you have full perscribing rights then?

 

[AJM]

You can still take state exams in some states. The Washington Board of Osteopathy will require you to take their state exam unless your licensing examination from a different state specifically covers principles of Osteopathy.


Here is a bit from the Idaho website that specifically mentions they accept state exams but won't accept the FL examination:

"Eligible to apply for a license without examination (by endorsement) are applicants who fulfill all requirements and

are Diplomates of the National Board of Medical Examiners, or USMLE or
are Diplomates of the National Board of Examiners for Osteopathic Physicians and Surgeons, or
hold valid, current licenses, received after examination in a state with standards considered to be equivalent to those of Idaho.

Oral or written examination or reexamination can be required.

Qualified applicants may requwsst expedited licensure. In certain cases, an interview may be required.

Osteopathic physicians and surgeons receiving degrees after January 1, 1963, and fulfilling applicable requirements, can apply for a license by endorsement.

The Florida examination, from July 1969 through 1980, is not endorsed."
http://www.bom.state.id.us/licensees/general.html

1. I wasn't talking about osteopathic physicians. They have a separate licensing process and may very well have other exams (I don't know anything about that process).

2. The Florida exam that you're talking about has not existed since 1980 (see your last sentence of your post)

3. The Idaho statement of the 3rd group of physicians they will accept applications from, those who "hold valid, current licenses, received after examination in a state with standards considered to be equivalent to those of Idaho," refers to older physicians who obtained out-of-state licenses before the USMLE existed. Every new physician who wants to be licensed in the US must take either the USMLE or the national osteopathic exam. The third group has to be mentioned because older physicians have never taken the USMLE, yet many may want to change state licenses. The possibility for re-examination, again, is for this group of older physicians.

If you want more information on individual state licensing requirements, go to http://www.fsmb.org/ This site has links to all the state medical boards.

FYI - out of curiosity, I looked up Florida's licensing requirement, and you do not need to take a state exam if you've graduated from a US accredited med school and passed the USMLE. If you don't believe me, look at this link: http://ww2.doh.state.fl.us/LASNET/Modules.aspx?ProjectID=DOHMED

 

[AJM]

Really? I live in NJ and out of state doctors can write perscriptions here with no problems. So when you are in residency, I assume you have full perscribing rights then?

You need a medical license in order to prescribe medications. Most states require the license to be from their own state, however there is variability, as each state makes it's own rules on licensure and what they will accept.

As far as the question on whether you have full prescribing rights in residency, that's not entirely true. In order to prescribe medications in residency, you need to have a medical license. Many states offer a limited license for residents so that residents can practice medicine, but under the umbrella of their training institution. They do not have full practice rights, because they can only practice within the scope of their training program. These residents may not moonlight. To practice outside the scope of your residency program, ie to make more money, residents must get a full medical license, which has stricter requirements than the limited license.

There was recently a thread on the nuances of the licensure process in the General Residency forum. It can be a confusing process, and one that is hugely variable depending on the state you are in, so I think this is getting beyond the scope of this thread/forum.

Hope that helps...