R2's and beyond: license in which state?

[zoolander]

To anyone who's taken Step 3: Which state are you all applying for licensure in?

Any prelims going from one state to another and having to decide on a state license to apply for?

Anyone looking at a position post-training in a different state after residency and applying for a second license before you get a job?

Anyone in the NYC/Tri-State area choosing CT or NJ licenses to save $? Lots of R3's at the local county hospital recommended CT in particular b/c of the low fees.

For Step 3, the licensure process needs to be rolling. NY is steep around $735, CA less around $550 and other states $325 or less. On top of NBME transmittal fee, notary, transcript copies, etc. Not a king's ransom but a large chunk on a resident's salary.

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[AJM]

I guess I'm confused about the question. You have to be licensed in the state that you're practicing medicine in. I don't really think you get a choice as to which state. Granted, some states have different rules than others: for example, in MA residents can get a cheaper limited license rather than a full license, but you have to have a license from the start of internship; while in CA you don't get a license as an intern, but you have to get a full license when you start your second year of residency.

BTW - the CA initial licensure fee is actually more than $550. They just don't tell you about it all up front...

 

[G'ville Nole]

True, you have to be licensed in the state you are doing your internship. However, most places cover you under a "training license" for the duration of your residency. At any time after you complete step three, you can apply for a full license (they're referred to as "medical examiner" licenses in FL) in pretty much any state you choose, and this is where all of the fees and such come into play.

I'm having a similar dilemma right now. Namely, I'm going out-of-state after this year, and though it's pretty likely I'll return, I am also entertaining the possibility of moonlighting during my residency. So I guess my specific question would be this: can moonlighting be done with a "training" license, or must I obtain full licensure in the state I will be moonlighting in? This would be a little problematic for me, as I ultimately would likely seek full licensure again once my residency is done. Anyone with insights on the subject?

Thanks in advance!

 

[edmadison]

To anyone who's taken Step 3: Which state are you all applying for licensure in?

Any prelims going from one state to another and having to decide on a state license to apply for?

Anyone looking at a position post-training in a different state after residency and applying for a second license before you get a job?

Anyone in the NYC/Tri-State area choosing CT or NJ licenses to save $? Lots of R3's at the local county hospital recommended CT in particular b/c of the low fees.

For Step 3, the licensure process needs to be rolling. NY is steep around $735, CA less around $550 and other states $325 or less. On top of NBME transmittal fee, notary, transcript copies, etc. Not a king's ransom but a large chunk on a resident's salary.

Connecticut to save money? Conn has a professional occupational tax of $450 per year (at least that what it used to be).

Ed

 

[zoolander]

Connecticut to save money? Conn has a professional occupational tax of $450 per year (at least that what it used to be).

Ed

Is there a way to take Step 3 as an intern, then apply for a license (or more specifically pay for it) later?

The fees are all pretty brutal, those $s to start but increases quickly. Some folks said the NY one is about $1200 all in, not sure if that includes the extra 100's for a DEA # or not. Not really part of the average urban resident budget.

The CT route's been recommended this summer by senior co-residents. A friend of mine has a CT license and is now moonlighting in Manhattan. Never heard of the occupational tax for residents but it's possible...

 

[Bobblehead]

Generally moonlighting requires that you have a full license as you'll be unsupervised and as acting as a full-fledged physician.

 

[Apollyon]

Generally moonlighting requires that you have a full license as you'll be unsupervised and as acting as a full-fledged physician.

You can always find a deal somewhere, though. I knew an FMG who was a heme/onc fellow, that only had a limited permit in NY. He would moonlight in the ED, and see patients independently, and the attending would cosign his charts (in real time - not retrospectively). Of course, that means you need a fully licensed doc who trusts you.

But you're absolutely right - generally, you need a full license.

 

[AJM]

Is there a way to take Step 3 as an intern, then apply for a license (or more specifically pay for it) later?

The fees are all pretty brutal, those $s to start but increases quickly. Some folks said the NY one is about $1200 all in, not sure if that includes the extra 100's for a DEA # or not. Not really part of the average urban resident budget.

The CT route's been recommended this summer by senior co-residents. A friend of mine has a CT license and is now moonlighting in Manhattan. Never heard of the occupational tax for residents but it's possible...

Whether you can wait to apply for a license depends on the state. Most states do not require that you have applied for a license in order to take Step 3. I know many residents who have taken Step 3, but have not yet gotten full licenses. My recommendation is that if you don't have to get a license, don't get one. I would recommend checking with the NY state medical board to find out what the specific rules are for NY.

If you want to moonlight, you pretty much have to get a full license in the state that you're moonlighting in. If you moonlight with just a training license (which is illegal), you are asking for trouble. You put yourself at risk for potentially getting arrested for practicing medicine without a license (a training license only covers you for duties directly related to your residency program). You also would not be able to be covered by malpractice insurance, so would be screwed if someone brought a malpractice suit against you. Getting notes cosigned by an attending is not sufficient to protect you, since you are working outside the bounds of your residency program.

The other thing is that states tend not to honor licences obtained in other states. If you are moving around from state to state, you will need to get a different license at each state that you are working. (although if you are a resident who is not moonlighting, then you may be exempt from the licensure, depending on the state). I personally have already had to get two different full state medical licenses, which is very expensive, but can be easily paid for with extra moonlighting shifts.

I'd be careful about getting a CT license if you are planning on moonlighting in NY -- NY may not honor the license. You should check with your state medical board to see if the CT license would be sufficient before you go ahead and pay for one.

 

[Bobblehead]

Another thing to keep in mind is some states want verification of your license from any state you've EVER been licensed in. This can after some years get to be significantly annoying as your application keeps getting longer and more involved with each step in training.

 

[Snoopy]

Well, I just sent all my paperwork to New York state and FCVS for my medical license so I can try to address some of the New York concerns.

Step 3: When I took Step 3, I applied to take the exam under Florida state rules. Florida only requires that you graduate from medical school to sit for the exam. Many other states have similar requirements. The fact that I reside in another state and have no plans on ever becoming licensed in Florida has nothing to do with my eligibilty to take Step 3 under Florida rules--you can apply to any state board to sponsor you for the exam. I then took the test in Ohio. You can physically take the test anywhere in the country, regardless of which state sponsors you. For more details about state requirements, go to www.fsmb.org. Cost now is around $600.

NYS License: Now that I have completed one year of residency and passed all 3 steps I am eligible for licensure. I just completed all of my paperwork and mailed my application today. Cost is $735.

DEA: You can apply for this after you have a license. Cost is $320.

FCVS: There has been a lot of debate at my residency program as to whether this service is worth it. I was going to deal with collecting all the paperwork myself and save some money but then I discovered that the state of Ohio (where I may want to practice) requires that applicants use FCVS. After seeing that I realized that there are probably other states that require or will require that applicants use this service so I bit the bullet and started a file with them. Cost is $340 initially and about $100 for additional profiles to other states.

Moonlighting: It has always been my understanding that in order to moonlight you must hold your own license in each state in which you wish to moonlight.

If there are other questions about NY or about the above, I'd be happy to try to answer them.

 

[zoolander]

Well, I just sent all my paperwork to New York state and FCVS for my medical license so I can try to address some of the New York concerns.

Step 3: When I took Step 3, I applied to take the exam under Florida state rules. Florida only requires that you graduate from medical school to sit for the exam. Many other states have similar requirements. The fact that I reside in another state and have no plans on ever becoming licensed in Florida has nothing to do with my eligibilty to take Step 3 under Florida rules--you can apply to any state board to sponsor you for the exam. I then took the test in Ohio. You can physically take the test anywhere in the country, regardless of which state sponsors you. For more details about state requirements, go to www.fsmb.org. Cost now is around $600.

NYS License: Now that I have completed one year of residency and passed all 3 steps I am eligible for licensure. I just completed all of my paperwork and mailed my application today. Cost is $735.

DEA: You can apply for this after you have a license. Cost is $320.

FCVS: There has been a lot of debate at my residency program as to whether this service is worth it. I was going to deal with collecting all the paperwork myself and save some money but then I discovered that the state of Ohio (where I may want to practice) requires that applicants use FCVS. After seeing that I realized that there are probably other states that require or will require that applicants use this service so I bit the bullet and started a file with them. Cost is $340 initially and about $100 for additional profiles to other states.

Moonlighting: It has always been my understanding that in order to moonlight you must hold your own license in each state in which you wish to moonlight.

If there are other questions about NY or about the above, I'd be happy to try to answer them.

Hey Snoopy- that was dead-on.

No moonlighting til PGY-4 in my (long) program, think I'll defer that NY State check til then.