Key Points
- More opportunities come with multiple licenses.
- You may wait months to get licensed in larger states.
- Be detail-oriented when completing applications.
Much like obtaining staff privileges at hospitals, the process of getting state medical licenses is becoming more arduous
for physicians as medical boards tighten standards. As you consider your locum tenens career, think strategically about which
licenses you will need. The more places you are licensed, the more choices you will have, but that does not mean you need
a license in dozens of states. Depending on the size of the primary states in which you practice—the larger the state, the
more opportunities typically available—five to eight is probably about right.
STATE PREFERENCES
Your locum tenens agency can help you apply for licenses, either in anticipation of a contract or based on geographic location.
When deciding where to become licensed, factor in both your personal preferences and the level of demand for your specialty.
You may also want to consider positions in government facilities because they often accept any valid state license.
It seems that no two states process medical licenses in exactly the same way. Some medical boards will turn around an application
in a matter of weeks. In others —especially large states like California, Texas, Florida, and New York—you can expect to wait
months for your license. A handful of states grant temporary licenses, but that is the exception rather than the rule. Initial
application fees also vary significantly, ranging from less than $100 to well over $1,000. All states tend to request the
same basic information to verify your education, training, and practice history, but depending on the board, you may also
have to be fingerprinted, take a written exam, or even go before a board for an in-person interview. ORGANIZE DOCUMENTATION
The more organized you are with paperwork, the easier the application process will be. Maintain a file that includes photocopies
of everything that licensing boards routinely ask for such as diplomas, certificates, CME records, malpractice history, and
licenses from other states. Be meticulous when completing application forms. Attach copies of every item that is requested
and provide exact dates for training and practice history. Offer as much detail as possible for each verification or reference,
including the name, address, and telephone number for credentialing office staff in hospitals where you have practiced and
at programs where you trained.
If time is of the essence, contact your peer references and hospital credentials office staff when you submit your application
to alert them that a verification request is coming their way. Politely ask if they can expedite the request when it arrives.
This is especially helpful in the case of international schools.
Follow-up will likely be necessary to move the application process along. Most locum tenens agencies have staff dedicated
to helping physicians with the paperwork, including obtaining licenses. Some licensing boards will only speak with physicians
about the status of a pending application, but many will talk to a locum tenens representative who has the applicant's authorization.
Be sure to ask your recruiter if the latter is a possibility.
Visit the Federation of State Medical Boards (FSMB) website ( http://www.fsmb.org/) to find a directory of licensing boards and corresponding links. The Federation Credentials Verification Service (FCVS),
affiliated with FSMB, can serve as primary source verification for credentials that do not change, such as exam scores and
where you completed medical school, residency, and fellowship. This service costs a few hundred dollars but may be worth the
investment, especially for international graduates and physicians who anticipate applying for several licenses. A few states
require that applicants use FCVS; if you are applying in a state that does, plan for additional lead-time to complete this
step.
BE PROACTIVE
Once you have a license, keep it active. Most boards will require you to start the process all over if you should ever re-apply.
Also, a lapsed license will raise a red flag during future credentials checks and when you apply for additional state licenses.
Notify every state in which you hold a license if you change your address, name, or other contact information. If you choose
not to renew a license, proactively notify the state medical board.
Check with your NALTO ( http://www.nalto.org/) agency recruiter if you have questions about state licensing. Member companies have experienced staff who will help guide
you through the process.
Karen Childress is a Colorado-based freelance healthcare writer currently crafting a series of articles on behalf of NALTO.
