15 days short of licensure

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For licensure, I passed step 3 and I have 23.5 months of residency and most states want 24 months. how do I get these extra 15 days of post graduate training? any easy way? anyone know of any nonacgme or acgme programs that may accept me for a short time just so i can get my license? if you can't write it on here, please pm me.

Thanks in advance!

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Get a license somewhere that only requires 12 months, practice there for a while, then request licensure in the state that's asking for 24 months. If they allow licensure by reciprocity, you're set. If not, they might allow it anyway based on training + practice time.
 
Your question is much more complicated than you suggest, based upon your posting history. If I remember correctly, some of your training was non-ACGME. If so, it won't count towards licensure in most states. To answer your question directly, there is no way to get 15 days of training. No program will be willing to do this, and then "sign off" that you are competent to practice medicine. How could they assess that in 15 days?

Given your problems in prior programs, you might find that medical boards won't give you a license without a clear track record of satisfactory performance in a residency program.
 
Agree (as usual) with aPD. The training length is a requirement, not a guarantee of a license. Given your prior difficulties, even if you had the full required 24 months, you would likely need to appear in front of the licensing board to explain your gaps and changes in training.
 
I don't think any state or US jurisdiction allows licensure by reciprocity.

Not true. I know of at least one state that will grant a permanent license to someone whose training wouldn't otherwise qualify, based on licensure elsewhere (although you still have to provide documentation of education, training and test scores). And another state will grant temporary licensure with an incomplete application based licensure elsewhere. I'm sure there are others, but those are the only two states I've checked.
 
However, you're correct, it's not reciprocity in the strictest sense--you wouldn't have to maintain your license in the original state for it to remain active in your new state.
 
Samoa,

Which 2 states are you talking about? if you cant mention, please pm me.

The state I applied to accepts nonACGME training FYI.

my performance was satisfactory enough.
 
Yeah, I'm wondering which are those two states or jurisdictions, too.

"Reciprocity", strictly, means I have a license in South Carolina, and Hawai'i gives me one simply because I have one in SC, and that is irrespective of maintenance of the first state license. That didn't happen. Nurses do get that in some states due to some "compact of agreement" or something. They show up with a license from state "X" and state "Y" issues them a license. If you have to fill out all of the forms and provide all your paperwork, then that's not really reciprocity, although the consideration given is similar.
 
The state I applied to accepts nonACGME training FYI.

my performance was satisfactory enough.

TB, congrats on passing Step 3, hope this helps you to have new beginnings and opportunities.

Just curious as to which state accepts non-ACGME training, you can PM me if you wish.

Good luck.
 
Samoa,

Which 2 states are you talking about? if you cant mention, please pm me.

The state I applied to accepts nonACGME training FYI.

my performance was satisfactory enough.
In that case, perhaps you have several options. It depends on what "nonACGME" training means. For example, you could try to convince any physician to let you volunteer (or pay you $1 as a salary) to "work" with them. That work could be anything, and they could call it a "residency". So you could work with someone for 3 months and get a letter saying so, calling it residency training, and be able to get a license. AGain I'd suggest focusing on something more than 15 days, as although that might meet the letter of the law, you'd probably be better off with some "extra".

If this state has specific rules about non-ACGME training, then it would depend on what those rules are.
 
In that case, perhaps you have several options. It depends on what "nonACGME" training means. For example, you could try to convince any physician to let you volunteer (or pay you $1 as a salary) to "work" with them. That work could be anything, and they could call it a "residency". So you could work with someone for 3 months and get a letter saying so, calling it residency training, and be able to get a license. AGain I'd suggest focusing on something more than 15 days, as although that might meet the letter of the law, you'd probably be better off with some "extra".

If this state has specific rules about non-ACGME training, then it would depend on what those rules are.

Thanks for the great idea aPD. I will try it. I am asking around if doing an elective with a doctor is considered post graduate training. Hopefully I will hear a good answer.

aPD, would you be willing to offer me a short nonACGME elective? please! :D with a cherry on top? maybe i could pay you if you want.or you could pay me $1 if that's the rule. i wouldn't mind that at all. maybe even just a month would suffice. free labor. any takers?

if you can't, could you hook me up to any PD's that would do this? I have been asking around to some PD's I know and they don't want any part of it.
:(

thanks.
 
Yeah, I'm wondering which are those two states or jurisdictions, too.

"Reciprocity", strictly, means I have a license in South Carolina, and Hawai'i gives me one simply because I have one in SC, and that is irrespective of maintenance of the first state license. That didn't happen. Nurses do get that in some states due to some "compact of agreement" or something. They show up with a license from state "X" and state "Y" issues them a license. If you have to fill out all of the forms and provide all your paperwork, then that's not really reciprocity, although the consideration given is similar.

I have actual experience with licensure by reciprocity in a different profession, although you're always welcome to argue that your opinion is more valid than my experience.
 
I have actual experience with licensure by reciprocity in a different profession, although you're always welcome to argue that your opinion is more valid than my experience.

Do you really need to be snarky and sarcastic? First, you say you know of "two states", and extrapolate that others will be the same, but don't say what are those two states. Then, you say "a different profession", but don't say which it is: was it paramedical, or some other licensed profession? Electrician? Plumber? And I have experience with 3 state medical boards (NC, SC, and HI). But I'm not playing 'tit for tat'. If you can provide something specific instead of vague "I know", I would be happy to read it. I really, honestly, truly have no issue with you; I do not know why you choose to take a combative approach.
 
Do you really need to be snarky and sarcastic? First, you say you know of "two states", and extrapolate that others will be the same, but don't say what are those two states. Then, you say "a different profession", but don't say which it is: was it paramedical, or some other licensed profession? Electrician? Plumber? And I have experience with 3 state medical boards (NC, SC, and HI). But I'm not playing 'tit for tat'. If you can provide something specific instead of vague "I know", I would be happy to read it. I really, honestly, truly have no issue with you; I do not know why you choose to take a combative approach.

Samoa was/is a pharmacist before med school.

But let's not quibble. The common understanding is that reciprocity is the automatic issuance of another license based on already being licensed somewhere else. You send a copy of your license and a fee, and you get licensed somewhere else.

It's like that with Florida and concealed weapons permits.
 
Thanks for the great idea aPD. I will try it. I am asking around if doing an elective with a doctor is considered post graduate training. Hopefully I will hear a good answer.

aPD, would you be willing to offer me a short nonACGME elective? please! :D with a cherry on top? maybe i could pay you if you want.or you could pay me $1 if that's the rule. i wouldn't mind that at all. maybe even just a month would suffice. free labor. any takers?

if you can't, could you hook me up to any PD's that would do this? I have been asking around to some PD's I know and they don't want any part of it.
:(

thanks.
No, I can't offer you a non-ACGME elective. Honestly, I have no idea what that means. In order to give you "residency training" I'd need to hire you, via the GME office, etc. And there's no way I would do that for anyone for 15 days. Not to mention that I'd forever be "responsible" for your future performance -- if there were problems, people would come looking to me for explanations.

Trying to get ACGME programs to give you 15 days of training seems pointless. Your best option would seem to be the program that gave you non-ACGME training in the past. If they really liked you / felt you did well and you explained that you needed 15 more days to get licensed, I expect they would help you out. Especially if you offer to do it for free, with no benefits.

I still remain skeptical that a state medical board is going to count non-ACGME / non-AOA accredited training towards licensure. That being said, there are many boards and I certainly don't know all of their rules.
 
For weapons or medical licenses?

Pick one.

Actually, I think the system of medical licensing we have is ridiculous. Why we have a national exam series but individual state licenses (other than each state wanting it's piece of the fee pie) is beyond me.

I don't personally know of anybody denied a medical license after moving to a different state but I know plenty of people who have had to put off starting their new job because State C can't just call up States A and B and ask "any problems with Dr. Jones? No...OK, we'll give her a license here too." They have to re-invent the wheel every time.
 
Your best option would seem to be the program that gave you non-ACGME training in the past. If they really liked you / felt you did well and you explained that you needed 15 more days to get licensed, I expect they would help you out. Especially if you offer to do it for free, with no benefits.

That does seem to be the best option.

I think doing a "mini-residency" with a PP physician, outside of an academic institution, is not going to work. She is also willing to pony up for her own malpractice insurance. Even medical students are required to have it; she cannot work as a physician, licensed or not, without it...I know I certainly would not be willing to take a student or resident without it nor would I be willing to pay for it.
 
Pick one.

Actually, I think the system of medical licensing we have is ridiculous. Why we have a national exam series but individual state licenses (other than each state wanting it's piece of the fee pie) is beyond me.

I don't personally know of anybody denied a medical license after moving to a different state but I know plenty of people who have had to put off starting their new job because State C can't just call up States A and B and ask "any problems with Dr. Jones? No...OK, we'll give her a license here too." They have to re-invent the wheel every time.

So automatic reciprocity is a good idea, then.
 
So automatic reciprocity is a good idea, then.

To be honest, I actually go back and forth on it although I don't think automatic reicprocity is a great idea (witness the OP) because then you'd have the same situation you do in law (people in the DC area often pick one jurisdiction to pass the Bar in - MD I think - where it's easiest to pass, and get reciprocity throughout the area (DC and VA) or the banking industry (where companies moved their statutory HQ to SD or DE which have lax regulatory oversight and minimal consumer protection laws).

Either we need a US Medical License (to go along with the US Medical Licensing Exams) or there needs to be a more streamlined procedure when someone with an active, unblemished license in one state goes to get one in another state. With the NPDB and HIPDB, checking a physician's record should take about 15 minutes. Fingerprinting/background check (if required by the state as mine does) should take a couple of days. Any state specific examinations (again, mine has 2) can be done online and scored instantaneously. The whole thing should take at most 2 weeks (and really, could probably be done in 48-72 hours). Why should I have to round up yet another copy of my diploma, my internship, residency and fellowship completion certificates, my birth certificate, my marriage license or divorce decree (if my name changed in the interim) and ship them off to some bureaucratic black hole, just because I move to a different town for a job?

When I got my first license, it took about 6 weeks from "application complete" to "license granted." When our new division chief moved here (a guy who is first author on several NEJM and JCO articles and a Dept Chair at a prior institution) it took him almost 6 months because he had licenses in 4 other states. That's crazy talk! I'm a bigger risk (as a new licensee with minimal background) to patient safety than he is. 4 quick phone calls/emails/DB searches and the stuff I mentioned above should have been enough to secure him a license.
 
I'm a bigger risk (as a new licensee with minimal background) to patient safety than he is. 4 quick phone calls/emails/DB searches and the stuff I mentioned above should have been enough to secure him a license.

This is not necessarily true. As a new grad, you have a minimal trail to review. Most of the disasters in credentialing are when someone has had poor performance in one state, and then moves to another. There is no easy "person to call" who would know about their performance.

On the other hand, I agree that our current system is a real disaster. A national physician license does make much sense -- until you lose it and can't work anywhere. There are certainly stories of physicians getting screwed in one state who are at least able to set up shop somewhere else -- of course balanced by the stories of the disaster docs who move from state to state creating havoc. Pick your poison.
 
Which makes the idea of automatic reciprocity seem like a really bad idea.

Florida participates along with 31 or 32 other states in a concealed weapons permit reciprocity program (Nevada recently dropped out...) Basically, a concealed weapons license from any of those states can help you get a license if you move to the other states much more easily... and, if I understand the law correctly, allows you to carry a gun with a license from any of those other states within a reciprocity state, if you're only a visitor and not a permanent resident. (I.E. you can take your gun with you on vacation but if you move there you gotta get a new permit.)

It seems this wouldn't be a terribly bad way to approach medical licensing (with the exception of the vacation part.)
 
is there a way to change the system? it has changed over the years, so i know that change is possible. the way it is, it just isn't fair. i mean most people who aren't in my shoes would never understand or care about the predicament a person like i am in, where I went to medical school for nothing. why throw people away in one instant? why can't we be able to show improvement and progress rather than hit a wall and live a life of fuitility? why are usmle scores set in stone, why cant we retake them and do better if criteria aren't going to change? i mean things like that are what make this system really unfair to a lot of people, not just me. there are thousands out there just like me who went to medical school and never going to practice medicine again all because of a few measly months. maybe we weren't well during those months, or had some family problem going on during that time, but the programs don't seem to care or understand that at all and move on through like a thoughtless plow, with around a thousand plus lives in ruins every year.
 
is there a way to change the system? it has changed over the years, so i know that change is possible. the way it is, it just isn't fair. i mean most people who aren't in my shoes would never understand or care about the predicament a person like i am in, where I went to medical school for nothing. why throw people away in one instant? why can't we be able to show improvement and progress rather than hit a wall and live a life of fuitility? why are usmle scores set in stone, why cant we retake them and do better if criteria aren't going to change? i mean things like that are what make this system really unfair to a lot of people, not just me. there are thousands out there just like me who went to medical school and never going to practice medicine again all because of a few measly months. maybe we weren't well during those months, or had some family problem going on during that time, but the programs don't seem to care or understand that at all and move on through like a thoughtless plow, with around a thousand plus lives in ruins every year.


I understand your frustration but I think that you have to realize the system is not going to change to help the outliers. The vast majority of residents make it through without these difficulties. Further, many residents I've encountered at various institutions who have had problems, had programs that guided them through their residencies or facilitated a switch to a new specialty/institution. While it sucks that you are left out in the cold, it seems you are unwilling to take responsibility for the actions that put you there in the first place. Based on reading your previous posts my suggestion to you would be to improve the areas of your CV that you can. You can't retake the USMLE's and thats good. It shouldnt be a test that you can take over and over like the MCAT's. You score what you score. What you can do is to go for an MPH or do research and spend time shadowing and getting involved with a small community program. Work hard for them, show them that you are dedicated and then reapply hoping that they will take you. I don't see a lot of hope for you simply reapplying and going through ERAS otherwise as the programs need to get to know you so they can get beyond the transgressions/problems on your application.

Best of luck.
 
The system is always changing and evolving albeit slow as molassess sometimes but still changing. Look at the change in work hours, for example which is still changing. Plenty of people aren't happy with the system and the status quo, and when that happens they make waves and things happen. Of course those people who tend to make those waves are usually treated like crap by others in the profession for trying to change what's "old tried and true" and considered troublemakers, weak etc. But people can only persevere for so long and when they no longer can take it, they sue the heck out of someone/some system, collect their research and lobby, go on the news, internet; whistleblow and eventually they system slowly changes as more people are made aware of the problems that people are facing.

It's probably not going to change in a fast enough time for you, but I agree that they residency system is unfair. While in the real world you can get a job without having your previous employer contacted, in the small medicine community that doesn't happen. Plenty of people don't want to give you a second chance if for whatever reason you blew it the first time, or were mistreated and what have you. I don't understand why myself at all and I think it's a screwed up system but it is what it is, and somewhere down the line I bet it will change as well.

Good luck in your struggles and hopefully someone down the line will attempt to see both sides of the story and give you a second chance. If you didn't endanger patient's lives, physically assault someone, weren't abusing drugs, weren't a complete and total screw up globally, you should be given a second chance. We are human after all and prone to make mistakes.
 
i have a few questions regarding termination:

does termination really make you a less likely candidate for getting another residency? can it prevent you from getting licensed?

what about voluntarily resigning during probation in lieu of the threat of ACGME trial? will that affect your chances of ever getting residency again? when a PD asks for the reason for resigning, can you just say to a PD you were having family problems and decided to leave instead of going into other details?

How do these people get back into residency? or are they forced to find another job?

are there any statistics on how many terminated became residents again?

PS i thought i posted this under a different thread i think called 'terminating residents'. i don't know how it got on this thread...??? o well...
 
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i have a few questions regarding termination:

does termination really make you a less likely candidate for getting another residency? can it prevent you from getting licensed?

what about voluntarily resigning during probation in lieu of the threat of ACGME trial? will that affect your chances of ever getting residency again? when a PD asks for the reason for resigning, can you just say to a PD you were having family problems and decided to leave instead of going into other details?

How do these people get back into residency? or are they forced to find another job?

are there any statistics on how many terminated became residents again?

PS i thought i posted this under a different thread i think called 'terminating residents'. i don't know how it got on this thread...??? o well...

Here's the deal. Someone who has been terminated or resigned to avoid administrative action is going to have difficulty getting another residency. It doesn't really matter if a PD or essay asks your reasons for resigning -- nobody is going to listen to your version if there are multiple PDs they can call to get the other side. So you can spin it however you want, but if I'm a PD, I'm going to get on the phone and call your prior PD(s) for their take, not just take your word.

For this reason, the only way I can see you getting back on your feet is by endearing yourself to someone with clout and having them make phone calls on your behalf. Your own word and application are pretty meaningless at this point, in the face of such a rough start to your career. A good word from some faculty member/attending who worked with you and will stand behind you might outweigh the not so good word of a prior PD. But that's going to mean networking and finding some context to work with someone, be it as a researcher etc, and develop a longterm positive working relationship with them such that they will jump on the phone and stick their own neck out on your behalf. So it will be a long road, and might not work. The other alternative will be to find a place so desperate for warm bodies that it ignores your back story, but there are folks with less baggage competing for those who will probably get the nod.

I doubt there are statistics for how many terminated residents make it back on top, but statistics are pretty meaningless in such a setting where every story is quite different and driven by individuals actions/personality/networking, etc.
 
Thank you for the great advice Law2doc. I haven't tried that route yet. I have a few contacts I could use that I'm sure would say good things.
 
Thank you for the great advice Law2doc. I haven't tried that route yet. I have a few contacts I could use that I'm sure would say good things.

It would need to be more than just a LOR type contact that would say "good things". You are going to need them to be proactive, and get someone they know on the line at a realistic program to say you've been working with them for X period of time and really sell you. Which is why this is not something everyone is able to do. And certainly not the kind of resource you are going to find on SDN.
 
Realistically, it's never going to happen. Never.

i feel that way sometimes..feel like its the end of the road for me....but you never know...something may come up...i've been praying a lot lately...everyday...hoping something comes my way......
its sad the way the system is...
 
i feel that way sometimes..feel like its the end of the road for me....but you never know...something may come up...i've been praying a lot lately...everyday...hoping something comes my way......
its sad the way the system is...

You should really just move on with your life. Forget medicine. With every year that passes that you don't get another residency, it's that much harder. Your assertion that 'something may come up' and praying will not change the fact that you are medically unemployable, unable to obtain a license and have zero chance of matching again. You've been told this, in so many words, by many other people.
 
There are quite a few large glaring red flags on your application that make this a very difficult uphill battle for you:

*Resigning from your IM internship after 6 months
*Leaving your prelim Surgery year after 10 months (medical reasons?)
*Leaving your non-accredited Surgery externship after 8 months (unclear reasons)
*Low Step scores (all in the 70s with two attempts on Step 2 CK and three attempts on Step 3)
*Graduation date that was 7-8 years ago (IIRC)

Add to this the fact that you were trying to get into tough Medicine/Surgery programs coming from a Caribbean school...
 
You should really just move on with your life. Forget medicine. With every year that passes that you don't get another residency, it's that much harder. Your assertion that 'something may come up' and praying will not change the fact that you are medically unemployable, unable to obtain a license and have zero chance of matching again. You've been told this, in so many words, by many other people.

im getting licensed in at least one state within the next month. and i found a job as a supervising physician, keeping my fingers crossed that i will get it.
does this improve my chances of getting residency?
 
im getting licensed in at least one state within the next month. and i found a job as a supervising physician, keeping my fingers crossed that i will get it.
does this improve my chances of getting residency?

It certainly won't hurt, but I still think the only way to overcome what your prior PDs are going to say about you is to have someone with some equivalent clout make some phone calls on your behalf.

If you get licensed, at least you have an ability to make a living working as a physician, which is better than the way a lot of us were expecting this to play out, so congrats.
 
im getting licensed in at least one state within the next month. and i found a job as a supervising physician, keeping my fingers crossed that i will get it.
does this improve my chances of getting residency?

I sincerely doubt that any of this is based in reality. Sorry.
 
I sincerely doubt that any of this is based in reality. Sorry.
I do not as well. I know I am only a lowly medical student but I hope for the sake of the mid-levels(I am a EM PA prior to going back to med. school) he is supervising they are quite experienced in their respective field and/or they have another Physician in the group they can lean on in the truly difficult cases. I personally would feel uncomfortable asking for advice on a complicated case from a Physician that has so many red flags(nothing to do with him being a IMG have worked with many GREAT ones).

His training currently might be at the level of a Physician Assistant/NP that has done one of the +1 residencies(I know of a few PA EM 1yr residencies that train side by side with the residents for 1 year and come out very strong in training) and that is not fair to either him or his MLP or the general public.
(I noticed in previous post you wanting a short cut for you to become a PA or NP now you want to supervise us that is very disturbing)

If he is getting his license would there not be restrictions on it for not completing a set amount of continous training? Or am I understanding this scenario wrong?
 
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...
If he is getting his license would there not be restrictions on it for not completing a set amount of continuous training? Or am I understanding this scenario wrong?

Someone with a mere license and no completed years of residency would not be able to get board certified in anything so that limits the type of practice one could do. There also would be hurdles to getting insurance with reasonable premiums. But there are a number of physician jobs, like seeing patients in urgent care/clinics, completing and signing off on incomplete H&Ps, doing insurance company physicals, and the like which have been known to allow someone with a mere license to be employed.
 
Someone with a mere license and no completed years of residency would not be able to get board certified in anything so that limits the type of practice one could do. There also would be hurdles to getting insurance with reasonable premiums. But there are a number of physician jobs, like seeing patients in urgent care/clinics, completing and signing off on incomplete H&Ps, doing insurance company physicals, and the like which have been known to allow someone with a mere license to be employed.

:thumbup: exactly..licensed doctors don't have to be BE/BC to get a job....opportunities are limited, but possible.
 
well guess what....my license was approved. i found a license in the mail. they waived the 15 days after saying they were strict on the 2 year rule.....Yippeee! all that praying must have seriously worked.
 
Good for you. I hope you get a descent job that pays for the bills and then some in the meantime. Seems like you've been through a lot and yes, I know you've changed your mind a couple of times but doesn't mean you should get screwed for ever. We are all human and our tastes/plans change all the time. Only in medicine.

Good luck.
 
well guess what....my license was approved. i found a license in the mail. they waived the 15 days after saying they were strict on the 2 year rule.....Yippeee! all that praying must have seriously worked.

Congrats! I've followed your situation on and off for a while now, and I must say that altogether, I'm pleased you now at least have the ability to work. Like Law said, I hope you're able to get some sort of position with the license + intern year, and maybe time and persistence will turn this into either residency opportunities or simply a solid enough career that you can keep doing it.

Regardless, good luck.
 
well guess what....my license was approved. i found a license in the mail. they waived the 15 days after saying they were strict on the 2 year rule.....Yippeee! all that praying must have seriously worked.

TB, I am so happy for you, :). Hope this is the beginning of the end of all your troubles.
 
well guess what....my license was approved. i found a license in the mail. they waived the 15 days after saying they were strict on the 2 year rule.....Yippeee! all that praying must have seriously worked.

can we have the state so I can make sure I never get sick there?
 
well guess what....my license was approved. i found a license in the mail. they waived the 15 days after saying they were strict on the 2 year rule.....Yippeee! all that praying must have seriously worked.

Congratulations!! I´m so glad you can move on with your life now!! Enjoy!! This is your time!! :highfive:
 
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