States licenses, reciprocal agreements?

[dr_ahmedja]

I am towards the end of my residency and it's crazy how difficult to get a new license at other states like California...Basically you are starting from scratch like it's your first license. I wonder if there are states that have reciprocal agreements with other states where you can just move from one state to another with using transition and they account for the other state license for a smooth transition

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[LucidSplash]

I am towards the end of my residency and it's crazy how difficult to get a new license at other states like California...Basically you are starting from scratch like it's your first license. I wonder if there are states that have reciprocal agreements with other states where you can just move from one state to another with using transition and they account for the other state license for a smooth transition

Not completely but there is the IMLC where if you have a standard license in a member state, and go through credentialing with the IMLC, you can easily get a license in another member state. However the licenses through the compact can have shorter expiration dates. If you move to another state, you need to redesignate your state of principal licensure which means you need to go through the standard process of getting a license in that state. So it really is only meant for locums and other short term positions. Physician Information | Interstate Medical Licensure Compact

Otherwise, there are not reciprocity agreements for regular permanent licenses. Medical licensing is miserable in many states and yes, you have to start over every time almost. Many states use FCVS, so it is worth it to pay for them to keep your info in perpetuity to use in the future. It actually gets slightly more difficult every time you get a new license because some states will want a continuous record of everywhere you’ve worked since finishing training, explain all gaps of >1 month, and want letters of good standing from everywhere you currently, or have previously, held a license.

Also, every state has different CME requirements on a different timeline/schedule.

Welcome to life as an attending!

 

[rokshana]

Hold 13 licenses…and yes from scratch with every one…so review or retire them…do t let them lapse…because you start all over again.

 

[dr_ahmedja]

Not completely but there is the IMLC where if you have a standard license in a member state, and go through credentialing with the IMLC, you can easily get a license in another member state. However the licenses through the compact can have shorter expiration dates. If you move to another state, you need to redesignate your state of principal licensure which means you need to go through the standard process of getting a license in that state. So it really is only meant for locums and other short term positions. Physician Information | Interstate Medical Licensure Compact

Otherwise, there are not reciprocity agreements for regular permanent licenses. Medical licensing is miserable in many states and yes, you have to start over every time almost. Many states use FCVS, so it is worth it to pay for them to keep your info in perpetuity to use in the future. It actually gets slightly more difficult every time you get a new license because some states will want a continuous record of everywhere you’ve worked since finishing training, explain all gaps of >1 month, and want letters of good standing from everywhere you currently, or have previously, held a license.

Also, every state has different CME requirements on a different timeline/schedule.

Welcome to life as an attending!

Thanks. Is FCVS really worth it? It appears only saving your diploma and can send some verifications like USMLE/ECFMG. But does not save you from having your med school sending stuff again from scratch to the new state, does it?

 

[dr_ahmedja]

Hold 13 licenses…and yes from scratch with every one…so review or retire them…do t let them lapse…because you start all over again.

This is a lot!! This is at least $3K for 13. So you tell me if you freeze (don't renew) you will have to start from scratch again? I thought you just need to pay renewal fee and this is it.

 

[rokshana]

This is a lot!! This is at least $3K for 13. So you tell me if you freeze (don't renew) you will have to start from scratch again? I thought you just need to pay renewal fee and this is it.

That is only if you are still current or some states within 30 days, will they let you just renew…otherwise yep.

 

[Apollyon]

That is only if you are still current or some states within 30 days, will they let you just renew…otherwise yep.

Hawaii gives you a year (maybe it's two).

 

[LucidSplash]

Thanks. Is FCVS really worth it? It appears only saving your diploma and can send some verifications like USMLE/ECFMG. But does not save you from having your med school sending stuff again from scratch to the new state, does it?

It also saves residency/fellowship verification. I believe it can also directly request letters of good standing from everywhere you’ve held a license, which some states require. Some states will require FCVS for licensing. Some states it is optional. I had to use it for my first post-training state license and now am using it for another state license that requires using it. If you have to use it any point, it makes sense to pay to keep it going forward.

 

[LucidSplash]

This is a lot!! This is at least $3K for 13. So you tell me if you freeze (don't renew) you will have to start from scratch again? I thought you just need to pay renewal fee and this is it.

Some states will let you go “inactive” which has a lower fee than active status, instead of expired. But most do not. You have to pay to keep the license up (including the CME requirements) or you let it expire and then go through it again. A few have a re-entry pathway which might be a tiny bit easier for a certain period of time but that is rare. You have to gauge the trouble. I had a full TN license when I was a resident which I used for moonlighting as a chief. But I let it lapse intentionally because TN charges a yearly professional privilege tax of over $400 just for having the license, which is separate from the license renewal fees. I decided if I ever moved back to TN I’d rather reapply than pay $400 a year for a license I wasn’t using.

My IMLC licenses I will let lapse once I am not doing locums anymore, as they don’t count as permanent licenses anyway. But this Pennsylvania license - whew. It is miserable and once I go through this I’m never going through it again. Same for my TX license which had a lot of extra requirements too and took several months.

 

[guytakingboards]

Not completely but there is the IMLC where if you have a standard license in a member state, and go through credentialing with the IMLC, you can easily get a license in another member state. However the licenses through the compact can have shorter expiration dates. If you move to another state, you need to redesignate your state of principal licensure which means you need to go through the standard process of getting a license in that state. So it really is only meant for locums and other short term positions. Physician Information | Interstate Medical Licensure Compact

Otherwise, there are not reciprocity agreements for regular permanent licenses. Medical licensing is miserable in many states and yes, you have to start over every time almost. Many states use FCVS, so it is worth it to pay for them to keep your info in perpetuity to use in the future. It actually gets slightly more difficult every time you get a new license because some states will want a continuous record of everywhere you’ve worked since finishing training, explain all gaps of >1 month, and want letters of good standing from everywhere you currently, or have previously, held a license.

Also, every state has different CME requirements on a different timeline/schedule.

Welcome to life as an attending!

A notable addition tidbit about the IMLC is that you also have to be board certified to be approved. Once you get approved, it can be super quick to get those additional licenses. I got my CO license in 2 weeks.

 

[LucidSplash]

A notable addition tidbit about the IMLC is that you also have to be board certified to be approved. Once you get approved, it can be super quick to get those additional licenses. I got my CO license in 2 weeks.

All of my IMLC licenses have been <48 hours after the initial IMLC credentialing, including CO. Like magic.

 

[dr_ahmedja]

Thank you all. Any of you guys have dealt with California License? This one seems the real mess

 

[dozitgetchahi]

Not completely but there is the IMLC where if you have a standard license in a member state, and go through credentialing with the IMLC, you can easily get a license in another member state. However the licenses through the compact can have shorter expiration dates. If you move to another state, you need to redesignate your state of principal licensure which means you need to go through the standard process of getting a license in that state. So it really is only meant for locums and other short term positions. Physician Information | Interstate Medical Licensure Compact

Otherwise, there are not reciprocity agreements for regular permanent licenses. Medical licensing is miserable in many states and yes, you have to start over every time almost. Many states use FCVS, so it is worth it to pay for them to keep your info in perpetuity to use in the future. It actually gets slightly more difficult every time you get a new license because some states will want a continuous record of everywhere you’ve worked since finishing training, explain all gaps of >1 month, and want letters of good standing from everywhere you currently, or have previously, held a license.

Also, every state has different CME requirements on a different timeline/schedule.

Welcome to life as an attending!

The bit about “redesignating your SPL (state of primary licensure)” is not entirely true.

Redesignating the SPL doesn’t require you to start from scratch with a full license application process. I got an IMLC license in my current state (IL) with my SPL originally being AL. Redesignating my SPL to IL involved filling out a short form online with the IMLC, certifying that I had a residential address in IL, and sending a copy of my drivers license. Took 30 minutes and they switched my SPL status to IL a week later.

IMLC licenses are real, unrestricted, genuine medical licenses…not some sort of temp license you can only use for locums. At least in AL and IL, the renewal dates on these licenses are identical to those of non-IMLC licenses. It is a really good solution for having licenses in multiple states and I wish I had started with it earlier.

 

[LucidSplash]

The bit about “redesignating your SPL (state of primary licensure)” is not entirely true.

Redesignating the SPL doesn’t require you to start from scratch with a full license application process. I got an IMLC license in my current state (IL) with my SPL originally being AL. Redesignating my SPL to IL involved filling out a short form online with the IMLC, certifying that I had a residential address in IL, and sending a copy of my drivers license. Took 30 minutes and they switched my SPL status to IL a week later.

IMLC licenses are real medical licenses…not some sort of temp license you can only use for locums. It is a really good solution for having licenses in multiple states and I wish I had started with it earlier.

Thanks for clarifying based on your experience. I haven’t actually redesignated my SPL yet though anticípate doing so maybe next year, and my interpretation of the instructions was not accurate based on your experience. Cheers!

 

[gutonc]

IMLC licenses are real, unrestricted, genuine medical licenses…not some sort of temp license you can only use for locums. At least in AL and IL, the renewal dates on these licenses are identical to those of non-IMLC licenses. It is a really good solution for having licenses in multiple states and I wish I had started with it earlier.

A bit OT here, but I can't for the life of me understand why every state doesn't go in on this (I happen to work in a non-IMLC state). It's not like they still don't get their pound of flesh from the fee. And they have to do much less work on most of them. Seems like a win-win.

 

[LucidSplash]

A bit OT here, but I can't for the life of me understand why every state doesn't go in on this (I happen to work in a non-IMLC state). It's not like they still don't get their pound of flesh from the fee. And they have to do much less work on most of them. Seems like a win-win.

While I agree with you, the current political environment with regard to what constitutes medical care, and the fact that it varies from state to state is playing a role.

https://www.imlcc.org/wp-content/uploads/2022/09/Comments-Rule-Chapter-6-American-Medical-Association.pdf

But in reality the compact is now up to 41 states which have passed legislation to be part of it. But a decent number have delayed or yet to implement it. Like PA. So I am going through the standard process. Miserable.