April, 2008 Archive

A new state license?! Where do I start?

rsutton — Mon, 07 Apr 2008 00:00:00 -0600

Your first step is understanding your eligibility, which varies by state, and is based on:
• Whether you are an American or international medical school graduate and, in some states whether your medical school is approved by the state. VISTA’s team will research a state medical board’s website or utilize the WHO Directory of Medical Schools or the ECFMG FAIMER Directory to determine if a school is acceptable.
• The length of post graduate training you have completed. International graduates are commonly required to complete three years of PGT; American grads may meet eligibility with one or two years of training after graduation.
• Limitations on licensure examination, e.g., some states do not accept a “state” exam—these were the norm prior to NBME, FLEX and USMLE.
• The status of your original license. Some states require that your first license remain active.
• When you took the USMLE; USMLE failure rate on each of the steps; weighted score of the exam.
• How long it’s been since you took a licensure exam along with ABMS certification. Some states invoke “The 10-year Rule,” which states that if a physician has not taken a licensure exam within 10 years of application and is NOT board certified, he or she may be required to take the SPEX Exam.

VISTA’s recruiters review all locum tenens candidates’ applications and work with our licensing specialists to determine whether these requirements will impact your ability to qualify for a new state license. This is an important step in assessing locum tenens opportunities.

Once we help you determine your eligibility, a Licensing Specialist will walk you through the steps required to apply for the license. It is important to decide if you can meet the requirements, especially if you may be required to take the SPEX or obtain ABME certification. It is also important to know up front if a state will require an on-site interview or exam.

Once you have worked through the above, you must complete and certify the application for licensure and an FCVS profile application, if required by the board. Additionally, for those states that require an associated controlled substance certificate, you must complete a separate application and meet specific requirements.

The VISTA Licensing Specialist then begins requesting primary source verification of your credentials, which always include:

• Medical Education- all schools attended
• Post Graduate Training
• Licensing Exam Scores
• All state licensure – active, inactive, and training
• Professional’s statement regarding history of malpractice experience, discipline, and mental health issues that could affect or limit his/her ability to provide competent medical care.
• ECFMG for all international graduates

These additional verifications and requirements are requested by most states and processed by the Licensing Specialist:

• AMA or AOA Profile
• Federation of State Medical Board Clearance
• NPDB
• Transcripts
• Practice experience – this varies by state in terms of how far back your work history needs to be verified.
• Liability insurance coverage
• Certified birth certificate
• Legal proof of name change, if applicable
• Fingerprinting and background checks
• CME required for licensure- FL
• Passport photos
• Referencing – many states have their own forms; others require a statement

The Licensing Specialist contacts primary sources and then follows up to assure a response to the board is completed.

Once the application and all requirements for verification and documents are received by the board, the Licensing Specialist will stay in contact with you and the board until a decision is made.

If at any time during the application, you experience an unusual negative experience, even something like a traffic ticket (yes, just for speeding) you must notify VISTA and fully disclose the circumstances to the board you are petitioning for licensure.

The how-to on licensure renewal

rsutton — Mon, 14 Apr 2008 09:40:00 -0600

State medical license renewal applications are much simpler than initial applications and re-licensure applications. The vast majority of state medical boards now offer on-line renewal.

The process generally requires the following:

• Verifying personal data
• Answering questions regarding discipline, criminal matters and mental health conditions
• Certifying completion of mandatory CME for the prior one- or two-year registration period

CME requirements range from 12 hours per registration year in Alabama to 50 per registration year in Illinois, Maine, Washington, Massachusetts, Pennsylvania, New Hampshire, New Jersey, and North Carolina. Specific class content may be required such as risk management, palliative care, and ethics.

Additionally, a certain percentage of your CME must be designated Category I. Make sure to keep your CME certificates, because boards often conduct audits and may request proof of CME. You may also want to apply for the AMA Physician’s Recognition Award, which measures Category I CME content. This certificate is accepted as an equivalent for licensure renewal by more than 75 percent of state medical boards.

You will usually receive your renewed license certificate in 15 to 30 days after the application is submitted.

Hospital credentialing for locum tenens physicians - a few important changes you should know about

rsimmons — Mon, 21 Apr 2008 00:00:00 -0600

A lot has changed over the past three years in regards to getting physicians credentialed and ready for locum tenens assignments. Applications are longer, medical staff offices are understaffed and require more time to process applications, and the types of documents required have changed significantly.

In the past the focus was on the written word and the ability of your peers to express their ideas and opinions about their professional interaction with you in a simple reference letter. This “Letter of Reference” actually served two purposes: 1. As an introduction to a client. 2. As a professional reference to fulfill hospital by-laws.

Today the Letter of Reference has shed some of its responsibilities. Your locum tenens recruiter will still need it, along with your CV and any supporting documents, to assess your fit with locum tenens work. However, from a hospital credentialing point of view the letters are outdated. These days we find that medical staff offices prefer their own version of the Letter of Reference: A Reference Questionnaire or Evaluation that is specific to each facility. These are usually one to two pages and consist mainly of a handful of questions that rate your performance in a number of areas, followed by a few questions that allow your colleague can elaborate in a more general form. So far the response has been hit or miss, as it does alleviate the need to type out a letter and the forms usually only take a minute or two to complete by hand. However, it is another piece of correspondence in a physician’s busy schedule.

A good rule as you move forward as a locum tenens physician is to keep your references current. I suggest that new doctors gather up a few references prior to leaving their practice, residency or fellowship and current assignment. Basically keep a running list of their work address, phone, fax and email address. This way, you’ll give outdated references a bit of relief and improve the odd of getting the newer references to respond in a timely manner.

Another change that is just as significant as your references is the Procedure Log. Almost anyone who is going to work in a hospital setting or perform any type of procedures is going to be asked to provide a copy of their Procedure Log for the past 24 months when applying for privileges. This includes new residents and fellows. The Procedure Log is basically a running tally of specific procedures and the number of times you performed them. Most modern hospitals and clinics have these readily available and can usually print them out on request. Again, I would suggest asking for a copy of your Procedure Log before you leave your training program or current assignment. Hang on to them for at least two years. It will save you a lot of time and effort trying to track them down after you leave.

Lastly, the UPIN number and all the paperwork and headache it took to get this number are all but gone. The number still shows up on credentialing applications that have not been revised, but the focus is now on the NPI number. Instead of three months, the new NPI number application takes five to 10 minutes to complete online. You are emailed a confirmation letter with your NPI number that you will use for the rest of your career. But that’s not the end of it. Hospitals now require that confirmation letter as part of your credentialing, so please don’t delete that email. Keep a copy handy.

The good news in all of this is that when you work locum tenens assignments through VISTA, we help you make sense and keep track of all of this.