Licensing

[Lostin_space]

Not sure where or who to ask about this, so here we go.

What exactly do we do for licensing states that ask for "chronological timing" of everything we have done since med school? One state even asks since high school!
Anywho, I have a gap in training since I graduated off cycle due to a second degree and then I started a PGY-2 residency program over a year later after I completed my internship. What do I call this time - gap year? I did not really do anything to be honest, I took the time off since I had been in school for what seemed ages.

I'm trying to be as straightforward and transparent as possible with the licensing bodies but not sure what to say - just say gap time/year?

Also why do they even care? I mean many states do a criminal background check, have your finger prints, they check transcripts, board scores, medical education, and post graduate training. Why does it matter what we did since high school/med school graduation? I personally can't even remember that far back!

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[gutonc]

They want to know if you were in jail or rehab. Seriously...that's it.

Account for your time honestly and move on. If you literally did nothing but play COD 14 hours a day for a year, tell them that. They'll get a good laugh while approving your application.

If you spent time in jail or rehab, tell them that. They'll get a good laugh while throwing your application in the trash.

 

[Lostin_space]

They want to know if you were in jail or rehab. Seriously...that's it.

Account for your time honestly and move on. If you literally did nothing but play COD 14 hours a day for a year, tell them that. They'll get a good laugh while approving your application.

If you spent time in jail or rehab, tell them that. They'll get a good laugh while throwing your application in the trash.

Wouldn't they get that info from my finger prints/background check? I pretty much did nothing other than leisurely things honestly - traveled, went to the spa, explored restaurants, hang out with my pups, etc. It kind of stresses me out that I obviously have forgotten specifics - like I don't remember the exact days/months of certain things, some of it has been soo long ago that I cannot really remember accurately, and I don't want that to be taken as me "lying." I have 0 intent to lie about anything, but don't know how to label it. So stressful.

 

[gutonc]

You are incredibly neurotic.

Account for your time (pick the first day of the month as the start and the last day of the month as the end) and move on.

 

[Lostin_space]

You are incredibly neurotic.

Account for your time (pick the first day of the month as the start and the last day of the month as the end) and move on.

This is what multiple degrees, countless years of education and residency, and getting chewed up for any minimal mishap, including having to meet with my advisor for stupid comments that nurses are allowed to make like my hair being too frissy as being "unprofessional" that has led me to be this way. Blame it on non-stop, countless evals about anything and everything from everyone.

 

[michaelrack]

I recently had to account for the time between med school graduation and start of internship (I said I was waiting for internship to start after finishing med school, and the med board of arkansas accepted that)

 

[Lostin_space]

I recently had to account for the time between med school graduation and start of internship (I said I was waiting for internship to start after finishing med school, and the med board of arkansas accepted that)

Haha, that's awsome. Good job. i like that!

 

[rokshana]

This is what multiple degrees, countless years of education and residency, and getting chewed up for any minimal mishap, including having to meet with my advisor for stupid comments that nurses are allowed to make like my hair being too frissy as being "unprofessional" that has led me to be this way. Blame it on non-stop, countless evals about anything and everything from everyone.

welcome to the world of credentialing...you will have to fill out the same information over and over...and over...

 

[Lostin_space]

welcome to the world of credentialing...you will have to fill out the same information over and over...and over...

Yay, great. It's not so much that I don't want to provide information, but it's so asinine to have to provide a chronological account of my life since HS! That's many many years. So pointless. Why can't we have a national licensing agency!? One application - you are licensed in all states. Voila!

 

[Raryn]

When I got credentialed at my hospital *for fellowship*, they wanted every single day accounted for since I started college. Seriously, they made me list May X - June Y 2013 Vacation & preparation for residency training and the same for May X - August Y 2009 Vacation and preparation for medical school.

Most asinine thing ever. They didn't ask any questions after I filled it out though.

 

[Lostin_space]

When I got credentialed at my hospital *for fellowship*, they wanted every single day accounted for since I started college. Seriously, they made me list May X - June Y 2013 Vacation & preparation for residency training and the same for May X - August Y 2009 Vacation and preparation for medical school.

Most asinine thing ever. They didn't ask any questions after I filled it out though.

I think you guys have given me some good thoughts. *preparing/waiting for stuff*
I agree with you, super asinine and absurd.

 

[smq123]

Yay, great. It's not so much that I don't want to provide information, but it's so asinine to have to provide a chronological account of my life since HS! That's many many years. So pointless. Why can't we have a national licensing agency!? One application - you are licensed in all states. Voila!

If you only had to fill stuff out once, how would they ever manage to make money off of you??

(/Sarcasm)

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[Lostin_space]

If you only had to fill stuff out once, how would they ever manage to make money off of you??

(/Sarcasm)

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I would rather pay a yearly fee to have the federal gov than have to do this. It's interesting because at a number of boards the board doesn't even see the applications but rather random specialists look at the apps and they are non medical people. How ironic is that!

 

[VA Hopeful Dr]

Seriously, you're way over-thinking this. Like gutonc said, its just to make sure your off time wasn't spent in prison/rehab/so drunk you don't remember.

Remember the over-arching purpose of medical boards - to protect the public from bad/impaired physicians. They just want to make sure you're not going to get licensed, write yourself eleventy billion percocet and kill someone. You could have spent that off year going to every furry convention in the country and as long as you weren't arrested they won't care.

 

[Lostin_space]

Seriously, you're way over-thinking this. Like gutonc said, its just to make sure your off time wasn't spent in prison/rehab/so drunk you don't remember.

Remember the over-arching purpose of medical boards - to protect the public from bad/impaired physicians. They just want to make sure you're not going to get licensed, write yourself eleventy billion percocet and kill someone. You could have spent that off year going to every furry convention in the country and as long as you weren't arrested they won't care.

hopefully! Some boards are notoriously difficult for non-sensical stuff. When I got my MA training license I wrote that I had taken a bit of time off to study for step 1. They come back and say - why did you take the time off? Me: to study for step 1. that's not sufficient. Elaborate more. So I had to say the same thing - the time off was needed for step 1 studying. I was like really? Even my school confirmed it - took time off for step 1. I wanted to hit my head against the wall. I think that if a medical school confers your degree (and there are plenty of ways you can screw up med school), you can do an internship and a residency and possibly a fellowship - do we really need this level of nonsensical scrutiny?

 

[Raryn]

hopefully! Some boards are notoriously difficult for non-sensical stuff. When I got my MA training license I wrote that I had taken a bit of time off to study for step 1. They come back and say - why did you take the time off? Me: to study for step 1. that's not sufficient. Elaborate more. So I had to say the same thing - the time off was needed for step 1 studying. I was like really? Even my school confirmed it - took time off for step 1. I wanted to hit my head against the wall. I think that if a medical school confers your degree (and there are plenty of ways you can screw up med school), you can do an internship and a residency and possibly a fellowship - do we really need this level of nonsensical scrutiny?

Trust me, hospital credentialing is a lot worse.

I'm getting credentialed for moonlighting right now. I'm a licensed, board certified internist. I'm also in fellowship so there's no previous jobs to confirm or anything. In a world that makes sense, they would confirm my license on the state medical boards website, ask for a note from my PD that I'm in good standing, get a single signature with my permission for a background check, and that's probably it.

I had to fill out a dozen forms and they're working to get confirmation I went to medical school, residency, three peer evaluation from my coresidents, etc etc et. All pretty much useless information.

 

[Lostin_space]

Trust me, hospital credentialing is a lot worse.

I'm getting credentialed for moonlighting right now. I'm a licensed, board certified internist. I'm also in fellowship so there's no previous jobs to confirm or anything. In a world that makes sense, they would confirm my license on the state medical boards website, ask for a note from my PD that I'm in good standing, get a single signature with my permission for a background check, and that's probably it.

I had to fill out a dozen forms and they're working to get confirmation I went to medical school, residency, three peer evaluation from my coresidents, etc etc et. All pretty much useless information.

Peer evals from co-residents? That's absurd. For what?

 

[Raryn]

Peer evals from co-residents? That's absurd. For what?

I've filled out a few for my coresidents. The hospital asks basically if so-and-so is a nice person to work with. And if you'd trust them to care for a member of your family. And if you feel their procedural skills are up to par.

It's stupid. I'm the one who picked who is getting the peer evals. So even if I was dumb as a rock, I'd choose my closest friends in the program to fill it out. I suppose it can help identify the people who made few friends.

 

[Psai]

hopefully! Some boards are notoriously difficult for non-sensical stuff. When I got my MA training license I wrote that I had taken a bit of time off to study for step 1. They come back and say - why did you take the time off? Me: to study for step 1. that's not sufficient. Elaborate more. So I had to say the same thing - the time off was needed for step 1 studying. I was like really? Even my school confirmed it - took time off for step 1. I wanted to hit my head against the wall. I think that if a medical school confers your degree (and there are plenty of ways you can screw up med school), you can do an internship and a residency and possibly a fellowship - do we really need this level of nonsensical scrutiny?

It can't possibly be the first time that they've seen someone take time off to study for step 1. It's not like every single doctor in the country had to do it or anything.

 

[nlax30]

Peer evals from co-residents? That's absurd. For what?

I think that's pretty common. I've done several peer evals for previous residency classmates when they were applying for jobs/credentialing.

 

[Lostin_space]

It can't possibly be the first time that they've seen someone take time off to study for step 1. It's not like every single doctor in the country had to do it or anything.

You would think that taking some time off for studying is not that earth shattering but alas it was a back and forth for quite a while. It was incredibly frustrating.

 

[Winged Scapula]

You would think that taking some time off for studying is not that earth shattering but alas it was a back and forth for quite a while. It was incredibly frustrating.

Remember these are just clipboard toting administrative bureaucrats, not physicians. While the purpose of credentialing/licensing is to protect the public, they get carried away with it, as only bureaucrats can, in an effort to protect their job.

This isn't about you. Its about them. Just do what they say and you'll be fine.

 

[Psai]

Remember these are just clipboard toting administrative bureaucrats, not physicians. While the purpose of credentialing/licensing is to protect the public, they get carried away with it, as only bureaucrats can, in an effort to protect their job.

This isn't about you. Its about them. Just do what they say and you'll be fine.

So their role is to be obstructionist to physicians. What are they being paid for again?

 

[Winged Scapula]

So their role is to be obstructionist to physicians. What are they being paid for again?

By being obstructionist they think they are protecting the public from this huge onslaught of fraudulent misanthropic physicians who would otherwise harm people.


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[Lostin_space]

Remember these are just clipboard toting administrative bureaucrats, not physicians. While the purpose of credentialing/licensing is to protect the public, they get carried away with it, as only bureaucrats can, in an effort to protect their job.

This isn't about you. Its about them. Just do what they say and you'll be fine.

Yes, I realize this. But it's still frustrating. I think one of my all time favorites when I was inquiring about licensing in Wisconsin - I see that there is some sort of oral test. So I call and inquire. The woman on the phone tells me - yeah most people don't have to take it, but some do, it's really up to the person who reviews the file and how they feel about it. There's no set criteria. I was like what! Like that's not opening the board up for a massive lawsuit. It's like saying - we like you, you don't have to do that. You not so much so you get to do EXTRA stuff!

Same thing as if we said well some docs don't have to go through the USMLE steps, but some do. Criteria has to be the same for all. I don't find that acceptable!

 

[RadOncDoc21]

How are you able to 'do nothing' for a year? Congrats on building up your savings...I probably would have had to work at Footlocker or sell drugs.

 

[rokshana]

Yes, I realize this. But it's still frustrating. I think one of my all time favorites when I was inquiring about licensing in Wisconsin - I see that there is some sort of oral test. So I call and inquire. The woman on the phone tells me - yeah most people don't have to take it, but some do, it's really up to the person who reviews the file and how they feel about it. There's no set criteria. I was like what! Like that's not opening the board up for a massive lawsuit. It's like saying - we like you, you don't have to do that. You not so much so you get to do EXTRA stuff!

Same thing as if we said well some docs don't have to go through the USMLE steps, but some do. Criteria has to be the same for all. I don't find that acceptable!

dude....you are gonna blow a gasket if you are worrying about little things like this...licensing is nothing like credentialing for privileges...

you do realize that the oral test is to see if you can speak English, right?

 

[Lostin_space]

How are you able to 'do nothing' for a year? Congrats on building up your savings...I probably would have had to work at Footlocker or sell drugs.

Well I worked for a little bit after college, I am a whiz with finances, have been able to work through part of med school on/off with markets, lived at home during most of med school so I did not take an astronomical amount of money out (only for tuition/fees), went to undergrad on a full ride and got a bunch of merit scholarships so had some $ that I had when I went in to med school, side business has been good, etc. I also paid off all my med school loans few months after graduation since I had saved up through above. Married as well and spouse works.

 

[Lostin_space]

dude....you are gonna blow a gasket if you are worrying about little things like this...licensing is nothing like credentialing for privileges...

you do realize that the oral test is to see if you can speak English, right?

That's not what the woman said. And I would imagine if you can get through a residency you should be able to speak sufficient English no?

 

[Raryn]

Yes, I realize this. But it's still frustrating. I think one of my all time favorites when I was inquiring about licensing in Wisconsin - I see that there is some sort of oral test. So I call and inquire. The woman on the phone tells me - yeah most people don't have to take it, but some do, it's really up to the person who reviews the file and how they feel about it. There's no set criteria. I was like what! Like that's not opening the board up for a massive lawsuit. It's like saying - we like you, you don't have to do that. You not so much so you get to do EXTRA stuff!

Same thing as if we said well some docs don't have to go through the USMLE steps, but some do. Criteria has to be the same for all. I don't find that acceptable!

WI oral test is basically if something doesn't jive with your application, they call you before a subset of the board to try to explain it. If you can't explain it sufficiently or you seem sketchy, they reserve the right to deny you your license despite you potentially meeting the qualifications on paper. It really only matters to people with red flags (or at least grayish flags that might be red flags).

 

[NotAProgDirector]

They will tell you they are trying to protect you against this guy: http://www.nbcnews.com/news/us-news...cia-found-guilty-four-revenge-murders-n673386

Lots of employers bury problems in order to avoid being sued. Bad docs can move from one place to another. The system is designed to try and stop this. Sadly, it doesn't really work and is just a pain for the rest of us.

 

[Lostin_space]

They will tell you they are trying to protect you against this guy: http://www.nbcnews.com/news/us-news...cia-found-guilty-four-revenge-murders-n673386

Lots of employers bury problems in order to avoid being sued. Bad docs can move from one place to another. The system is designed to try and stop this. Sadly, it doesn't really work and is just a pain for the rest of us.

Yeah I saw that recently. But it is rare I will say that someone who has gone through undergrad, med school, +/- grad school, internship, residency, +/- fellowship can just randomly get through and be a socio path. Sure it happens but it's very very rare. You get cases like that one 19yo kid who was practicing as a Cardiologist I think in like Michigan or something. Now THAT's a blunder. But someone like me, I'm so squeaky clean it's kinda sad. Yet I have to have a 2 week back and forth because I took like a month to study for step 1. Yikes I say!

 

[smq123]

Yeah I saw that recently. But it is rare I will say that someone who has gone through undergrad, med school, +/- grad school, internship, residency, +/- fellowship can just randomly get through and be a socio path. Sure it happens but it's very very rare. You get cases like that one 19yo kid who was practicing as a Cardiologist I think in like Michigan or something. Now THAT's a blunder. But someone like me, I'm so squeaky clean it's kinda sad. Yet I have to have a 2 week back and forth because I took like a month to study for step 1. Yikes I say!

I agree with rokshana...it's frustrating, but (in the grand scheme of things) not THAT frustrating. It only gets worse from here...

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[Lostin_space]

I agree with rokshana...it's frustrating, but (in the grand scheme of things) not THAT frustrating. It only gets worse from here...

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Point taken. I will let things take their course I guess.

 

[chocomorsel]

Lostinspace, there are lots of narcissistic sociopaths in medicine. Haven't you realized that yet?

 

[Lostin_space]

Lostinspace, there are lots of narcissistic sociopaths in medicine. Haven't you realized that yet?

I have.

 

[mvenus929]

Bumping an old thread, sorry.

For those of you with experience with the credentialing process, I am currently working on credentialling for multiple hospitals as a condition of my employment next year. They all ask about previous criminal history, but the wording is a little different each time. I remember when I applied for a job in a hospital before medical school, they told me that if I didn't list everything, including minor traffic violations, and something was discovered on my background check, it could be grounds for dismissal.

So, question is... how deep do they dig? If you don't have any misdemeanors or felonies, do they care if you don't disclose it? Obviously, it's not going to prevent me from being credentialled because of the ticket itself, but I don't know if they'll get up in arms about not disclosing something that they don't really care about.

 

[ThoracicGuy]

Bumping an old thread, sorry.

For those of you with experience with the credentialing process, I am currently working on credentialling for multiple hospitals as a condition of my employment next year. They all ask about previous criminal history, but the wording is a little different each time. I remember when I applied for a job in a hospital before medical school, they told me that if I didn't list everything, including minor traffic violations, and something was discovered on my background check, it could be grounds for dismissal.

So, question is... how deep do they dig? If you don't have any misdemeanors or felonies, do they care?

I doubt they will care about speeding tickets. Unless it specifically includes that in your application, I wouldn't worry.

 

[JJ JJ]

When they say that it is required to finish the USMLE exams within 10 years, and someone finishes the USMLE's within 10 years and 2 months, Is that an automatic disqualification? Or they usual let something like this pass for a license?

 

[Apollyon]

When they say that it is required to finish the USMLE exams within 10 years, and someone finishes the USMLE's within 10 years and 2 months, Is that an automatic disqualification? Or they usual let something like this pass for a license?

To my knowledge, it's kinda like being "a little pregnant" - you can't be. The law is the law. They can't be mellow on that. Not saying it's everything, but very little gets to pass for a license.

 

[JJ JJ]

To my knowledge, it's kinda like being "a little pregnant" - you can't be. The law is the law. They can't be mellow on that. Not saying it's everything, but very little gets to pass for a license.

So, you are saying it would likely be a disqualification?

 

[rokshana]

So, you are saying it would likely be a disqualification?

if a state says 10 years and it took longer than that...then you won't be able to get a license in that state...can you ask them if there are exceptions, sure, but probably not something they waive.

 

[Apollyon]

So, you are saying it would likely be a disqualification?

Yeah, probably a hard stop.

 

[Raryn]

When they say that it is required to finish the USMLE exams within 10 years, and someone finishes the USMLE's within 10 years and 2 months, Is that an automatic disqualification? Or they usual let something like this pass for a license?

This varies from state to state. Some states have a 10 year limit, some have a 7 year limit, some have no limit at all. Some of the states with limits will allow you to get licensed if you fall outside of it if you have previously been licensed in a different state OR if you are ABMS board-certified. You'd be best off calling the state board of your specific state of interest and asking what their exact rules are.

 

[gutonc]

This varies from state to state. Some states have a 10 year limit, some have a 7 year limit, some have no limit at all. Some of the states with limits will allow you to get licensed if you fall outside of it if you have previously been licensed in a different state OR if you are ABMS board-certified. You'd be best off calling the state board of your specific state of interest and asking what their exact rules are.

This is pretty much the correct answer to every licensing related question that has ever been asked on SDN.

 

[Dog_luver]

Yeah, probably a hard stop.

No, not really. There is not only a lot of variation between different states, but lots of exceptions. I took more than 7 years, and have gotten a number of licenses with no problem for example. For the vast majority of states, if you were in training - whether because of various residents, other degrees, etc. they are likely to waive the requirement. If you are board certified, again likely waived. If you have a license in another state, a 7 year state can grant you a license - case in point, Arizona will grant you a license despite > 7 years if you have a license in a non- 7 year state first. If you ask for a waiver for good reason, many states consider that also. I recently called PA for example and they told me that even though they are a 7 year state, most requests for waiver are granted. Of course you have to be reasonable in why you did not take the test within that time frame. If you have a valid, reasonable reason, and no red flags, and/or other licenses/board certification, etc you are likely to be granted a license. Of course I'm not saying this is all the time everywhere but generally.

 

[Apollyon]

No, not really. There is not only a lot of variation between different states, but lots of exceptions. I took more than 7 years, and have gotten a number of licenses with no problem for example. For the vast majority of states, if you were in training - whether because of various residents, other degrees, etc. they are likely to waive the requirement. If you are board certified, again likely waived. If you have a license in another state, a 7 year state can grant you a license - case in point, Arizona will grant you a license despite > 7 years if you have a license in a non- 7 year state first. If you ask for a waiver for good reason, many states consider that also. I recently called PA for example and they told me that even though they are a 7 year state, most requests for waiver are granted. Of course you have to be reasonable in why you did not take the test within that time frame. If you have a valid, reasonable reason, and no red flags, and/or other licenses/board certification, etc you are likely to be granted a license. Of course I'm not saying this is all the time everywhere but generally.

The number of years is set by statute. I can't think of a good reason that is not being in training for taking more than 7 years; I really don't think failing one or more steps would be considered a "good" reason!

 

[Dog_luver]

The number of years is set by statute. I can't think of a good reason that is not being in training for taking more than 7 years; I really don't think failing one or more steps would be considered a "good" reason!

I did not say anything about failing steps and there's numerous reasons people take longer. I know residents who were in their pgy 5 and had not taken step 3! For me I did a dual degree, research, residency switches, etc. not an issue. In most states despite the 7yrs.

 

[Apollyon]

I did not say anything about failing steps and there's numerous reasons people take longer. I know residents who were in their pgy 5 and had not taken step 3! For me I did a dual degree, research, residency switches, etc. not an issue. In most states despite the 7yrs.

My point is that, if I had to guess, the people that are in trouble with time limits are NOT folks like you. I was PGY-4 when I took Step III. I just forgot about it.

I am not looking for an argument, but, I would ask you what other "good" reasons there are besides training/degrees?