What can you do with an MD and steps I-III completed while waiting for residency?

[honordac]

Hello,

I'm a new member and I was wondering what type of things you can do while waiting for residency when you have an MD with all the steps completed. I read on similar threads on what you can do with an MD with no residency, but it doesn't mention anything about situations when you have passed all USMLE (1,2, and 3). Is the situation the same?

I was recommended by a family medicine physician to apply for state licensure as a general practitioner so that I would work under a physician with limitation of practice, but still having the opportunity to work in the medical field. My search has shown so far that you need at least 1 year of residency and it could be his recommendation may have been based on older state laws when they allowed you to practice with no residency, but having steps 1, 2 and 3 completed. I've also looked into the Florida board of medical education where I was recommended to look into applying for medical faculty certification or house officer certification where it required to be accepted in a job position. However looking into it further in the Florida bylaws says that it requires a 1 year residency. I'm wondering if anyone have any experience or heard whether this is true or not?

Other than that, these are the recommendations that I was given from several people to do in the meantime that may help stay close to the medical field and hopefully improve my chances for residency(and may help others who may be in the situation I'm in).

working for CDC as a Medical Officer(currently no job positions offered last I checked a week ago)
General Medical Officer for the military for 1-2 years
Limited scope radiology tech(requiring self studying and passing the exam)
Medical Scribe(requiring 1-2 month training then requiring 1-2 years working for them)
Medical Assistant
Apply for research positions in CDC, NIH, universities, or apply to fellowship research positions
applying for MPH
Externships(done)
Observerships
Teacher or Professor in science field
Any other jobs
volunteer

Applying for outside residencies(directly or by passing their exam) or directly get accepted to work as a GP, from what I read, Australia, New Zealand, Dubai, Israel, UAE and Qatar

From the MD without a residency from what I saw they recommended:

Medical writer
working for a pharmaceutical
medical consultant


Any help will be appreciated and any additional suggestions would be appreciated

A little bit of my background that may be helpful on giving suggestions for me.

US Citizen
Passed all Steps, fail CK once
Went to Caribbean School
ECFMG certified
Graduated 2012

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[J-Rad]

You can't be a General Medical Officer in the military. They require an unrestricted medical license and this requires at least completion of a PGY-1.

 

[NotAProgDirector]

There are no clinical options that I know of -- you can't practice as a physician in any state. The rest of the things on your list are possible. Chances are you wouldn't need any training to be a clinical scribe. One important question is what you want from all of this. If it's an income, then you could do any of the above (some will have very small incomes), or you could simply get a non-medical job. If it's something to improve your application, then a research position is probably the best option (although a medical assistant position, depending on the clinical experience you get, might be good also)

 

[quique2]

The state of Florida has a "House Physician" license separate from the training license for residency, but they seem to be essentially equivalent, e.g. requiring supervision. I know an IMG or two who had no postgraduate training, yet worked under this license in small community hospitals, but I don't know how to find these jobs or apply to them.
http://www.flboardofmedicine.gov/licensing/resident-physicians-interns-fellows-and-house-physicians/

I don't know if other states have something similar.

 

[Jubears09]

The state of Florida has a "House Physician" license separate from the training license for residency, but they seem to be essentially equivalent, e.g. requiring supervision. I know an IMG or two who had no postgraduate training, yet worked under this license in small community hospitals, but I don't know how to find these jobs or apply to them.
http://www.flboardofmedicine.gov/licensing/resident-physicians-interns-fellows-and-house-physicians/

I don't know if other states have something similar.

Do you mean no postgraduate training in the US or no GME training at all? My hospital has several "house physicians" who never completed a residency in the US, but they all had a lot of experience, even subspecialty training in their home countries and found their jobs based on connections with people in their field.

 

[honordac]

J-rad -
thanks for correcting me, I think I was mistaking with students under HPSP scholarship and Uniform Service University would have to go into that if not entered into residency. I could be mistaken about that as well.

aProgDirector -
Thanks for the advice, I was recommended to get a job in a medically related field since I have little job experience, and I think research experience may help since I haven't done any of that.

quique and Jbears09 -
I'll look into house officer again in more detail when I was on the phone with the attendant I was told to look at the requirements for house officer on 458.345. I was told to go to resources found on this link http://www.flboardofmedicine.gov/resources/. Then click on 458.345 tound on this link: http://www.leg.state.fl.us/statutes...ng=&URL=0400-0499/0458/Sections/0458.345.html. So as I was reading it states the requirements as:

(a) Is at least 21 years of age.
(b) Has not committed any act or offense within or without the state which would constitute the basis for refusal to certify an application for licensure pursuant to s. 458.331.
(c) Is a graduate of a medical school or college as specified in s. 458.311(1)(f).

And when I went into 458.311 found on this link: http://www.leg.state.fl.us/statutes...ng=&URL=0400-0499/0458/Sections/0458.311.html and on 1.f says:

(f) Meets one of the following medical education and postgraduate training requirements: which states the 1 year residency. After I read that I didn't look any further. But with your link, It could be possibly that I may have misread it since reading it again states (c) state is a graduate from medical school or college and ignores stating the postgraduate training portion for 1.f, and the attendant stated that I could possibly apply for house officer license or medical faculty certificate as long I gain acceptance to work there.

I just spoke with my brother who was doing rotations and he said that there are many house officers at the hospital where all they do is see the patient taking the history and physical exam, write notes, and look up labs. And then the supervising physician would make the decision. I will head over there to see if I can possibly get in contact with them and look what they did to do that and look into your link further.

 

[quique2]

Do you mean no postgraduate training in the US or no GME training at all? My hospital has several "house physicians" who never completed a residency in the US, but they all had a lot of experience, even subspecialty training in their home countries and found their jobs based on connections with people in their field.

(f)  Meets one of the following medical education and postgraduate training requirements: which states the 1 year residency. After I read that I didn't look any further. But with your link, It could be possibly that I may have misread it since reading it again states (c) state is a graduate from medical school or college and ignores stating the postgraduate training portion for 1.f, and the attendant stated that I could possibly apply for house officer license or medical faculty certificate as long I gain acceptance to work there.

The people I know had no US postgraduate training. I'm not quite sure whether they had any training in other countries, but I highly doubt it.

However, these rules change frequently on a state-by-state basis. It might have been different a few years ago, when the people I know held these positions. I was just pointing out that the current Florida legislation includes this "house physician" license, which from what I understand would seem to fit medical graduates with no accredited US/Canadian/whatever training and allows them to work (menial scut, but work is work)

 

[honordac]

Hello, just want to give everyone a small update. I've gone to several hospitals this week looking into House Physicians and scribes. So the House Physician is confirmed that you don't need residency, depending on the hospital they'll put you anywhere where you are needed or you'll be at a specific department on where they hire you. I was told that you have to get a job position first and then apply for licensure, which they will cover the cost or you can start the application and pay the fee to get an application number to speed up the process. In my state, I only found 1 so far and the other hospitals stated that they are full since many are medical doctors like me waiting for residency. So they said that positions usually open up in February and March since that is when the DOs and MDs respectively find out if they're accepted into residency, and that is the best time to call.

Outside of FL, I found some house physician positions, but specifically for surgery, and they require some years of experience in surgery. I'm not sure the laws for that state, but I think it is cater to people work or train as surgeons for several years outside the US.

As for the scribe in FL, I haven't found a hospital that hire independent scribes, so far they only hire through a contract with a company. Looking into it many only focus on ER, but there are a few that train you for any department. However they require a 1 year commitment. So I'll be contacting them to see if I can negotiate with them by working full time or over time to reduce the time period commitment. Outside of FL there are several scribes, but many are part time or through a scribe company with the same requirements. There are a few full time for independent scribes, so I'll be looking into that to see if it would be enough to pay for necessities and to hopefully save money for the next application season if I have to apply again.

So we'll see how it goes, I'll be still looking into several hospitals since I haven't finish searching the area and see what I can find out. And hopefully I'll be able to get the house physician position and match for the upcoming residency.

 

[pvn76]

There are no clinical options that I know of -- you can't practice as a physician in any state. The rest of the things on your list are possible. Chances are you wouldn't need any training to be a clinical scribe. One important question is what you want from all of this. If it's an income, then you could do any of the above (some will have very small incomes), or you could simply get a non-medical job. If it's something to improve your application, then a research position is probably the best option (although a medical assistant position, depending on the clinical experience you get, might be good also)

Florida State has an special restricted license for IMG (http://flboardofmedicine.gov/licensing/resident-physicians-interns-fellows-and-house-physicians/). Currently I am a foreign graduated physician working like House Physician and we are performing physical exams, and clinical interventions. We are a code blue and rapid response leader under ACLS protocol, performs intubations of critical patients, manages mechanical ventilation settings, determines use and need for administration of antiarrhythmic and vasopressors medications, offers strong clinical support and assists nursing staff in critical circumstances with unstable patients, jugular iv access, arterial blood gases draws and interpretation, difficult nasogastric, feeding, and urinary tubes placement. Every procedure under hospital protocols. This kind of job you could find in south Florida (Miami), mainly in Tenet Corp. Hospitals. The most of house physicians in IM residencies becomes chiefs residents based in the experience under this license. The point is to work full time required by this position and get high scores working and studying at the same time.

 

[Law2Doc]

Florida State has an special restricted license for IMG (http://flboardofmedicine.gov/licensing/resident-physicians-interns-fellows-and-house-physicians/). Currently I am a foreign graduated physician working like House Physician and we are performing physical exams, and clinical interventions. We are a code blue and rapid response leader under ACLS protocol, performs intubations of critical patients, manages mechanical ventilation settings, determines use and need for administration of antiarrhythmic and vasopressors medications, offers strong clinical support and assists nursing staff in critical circumstances with unstable patients, jugular iv access, arterial blood gases draws and interpretation, difficult nasogastric, feeding, and urinary tubes placement. Every procedure under hospital protocols. This kind of job you could find in south Florida (Miami), mainly in Tenet Corp. Hospitals. The most of house physicians in IM residencies becomes chiefs residents based in the experience under this license. The point is to work full time required by this position and get high scores working and studying at the same time.

You are bumping a several year old post-- you should mention that so as not to let people respond to posters who may not even be on SDN any longer.

 

[Raryn]

Please sign the petition asking the legislature to allow medical graduates without residency training to work in medically underserved areas: https://www.change.org/p/texas-legislature-and-governor-help-end-the-doctor-shortage

Can I sign a petition for them to not allow this?

 

[Doctor Bob]

Can I sign a petition for them to not allow this?

Some of the comments on the page were highly amusing.
This was my favorite: I'm signing this because this would be a better option than the federal, state or local governments bringing in foreigners to take the jobs.

All I could think of was that SouthPark episode...
https://www.change.org/p/texas-legislature-and-governor-help-end-the-doctor-shortage/c/334505818

 

[NotAProgDirector]

Can I sign a petition for them to not allow this?

Perhaps we should recommend to the site a way to "counter sign" petitions if you don't agree with them? That would be fun!

 

[j4pac]

Please sign the petition asking the legislature to allow medical graduates without residency training to work in medically underserved areas: https://www.change.org/p/texas-legislature-and-governor-help-end-the-doctor-shortage

Sadly, this is likely going to be our countries answer to the doctor shortage...hire unqualified people to treat (and potentially harm) our countries poor and underserved. Considering that I have family members in both pools...I pray that never happens...even if that means you never get a job.