I decided to start my own practice in March of my last year in residency. As a resident, still training in Illinois, there weren’t too many steps in starting a medical practice I could work on other than obtaining my medical license. Depending on the state, this process can either be a cinch or a total nightmare.
In addition to my California license, I also decided to apply for a permanent license in Illinois as well (I only had a temporary medical license during residency). Illinois’ credentialing process is quite easy. In case my California application took forever to get approved, I thought it would be a good idea to have a medical license in another state rather than no state.
If you are still in residency, you should apply for a permanent license as soon as you are eligible. At least for Illinois, people with temporary medical licenses can obtain their permanent license more easily and quickly. Even if you know for sure that you will not be practicing in the same state as your residency, it’s just nice to have a permanent license somewhere.
For example, you can use any permanent state license to apply for a Medicare number, Medicaid number, or DEA number. The Medicare and Medicaid applications in themselves are massive beasts to tackle, and are notorious for application delays. You don’t want to delay these federal applications even further because you’re still waiting for your state medical license to come through. In addition, you can be licensed in any state if you are considering work at a VA or military institution.
Illinois Medical License
My permanent Illinois license and controlled substance number, which some states require, cost me $305. The application process went smoothly. I submitted my application and all the necessary documents to my residency program’s GME office. Everything came in the mail within 3 weeks. Piece of cake.
California Medical License
My California medical license application, on the other hand, was a bit more cumbersome, and it could have become a nightmare if I didn’t stay on top of things. Because it can be so daunting, some people choose to hire a professional medical licensing service for about $500. I just chose to do everything myself (this will be a common trend by the way), and in all honesty, I don’t think my application process would have gone any smoother had I utilized these services.
In the past, it was not uncommon for it to take 6 to 9 months to get a California license approved. I have heard that management has changed, and that the application process has become faster. I applied for my California license on March 16, 2010, and received approval on May 19, 2010. Needless to say, I was quite shocked at the fast turnaround time! These processing times vary seasonally. I’m not sure when the peak times are, but I would guess them to be early in the calendar year. I have also heard that in-state applications take precedence over out-of-state applications.
The application instructions are self-explanatory on the Medical Board of California website. I won’t bore you with any details that you can obtain by reading the application packet. What I will discuss are the tips and tricks that I believe will give you the best chance of an expeditious approval.
1. Apply EARLY!
The first thing you need to do is to apply super early! The second thing you need to do is APPLY SUPER EARLY! (and don’t talk about Fight Club either 🙂 ) Apply 6 months to 1 year before you plan to practice in California. This application can hit many different dead ends, and you want to be able to afford the time to start over. Especially because when I applied, the Medical Board only accepted paper applications, which also introduced the possibility of things getting lost in transit.
2. Live Scan Your Fingerprints
You have the option of mailing in your fingerprints on a card they send to you, or having your fingerprints physically scanned on a computer through Live Scan. The problem for out-of-staters is that Live Scan is only performed at certified locations physically located in California. This means that you would have to fly to California to get your fingerprints done. Having said that, Live Scan should be your ONLY option. It can take 2 to 3 months for the FBI and DOJ to approve mail-in fingerprints, provided that the quality of your fingerprints are acceptable. If they are not, you have to repeat the whole process again, and you just delayed your opening day by 2 to 3 months. Live Scan, on the other hand, takes only 7 to 10 days to receive approval. The agent will repeatedly scan your fingerprint until he or she gets an acceptable image. Hence, there is absolutely no chance that your fingerprints get rejected because of poor quality.
I flew to California to get my Live Scan. I didn’t even consider the postcard as an option. It worked.
3. Application fee
I paid for the application fee online, and mailed in a printed receipt with my application packet as per the instructions. I thought this option would be more efficient than writing a check or money order. The $493 nonrefundable application fee is ridiculous. The actual license fee is an additional $808. If you’re still in residency, you pay a discounted rate of $416.50. You also have the option to make an additional $25 “Family Physician Training” donation, which I actually chose to contribute. Although there is absolutely no evidence, I thought that maybe I could get on the licensing board’s good side by being “generous.” Probably didn’t make a difference, but worth a gamble.
4. Application submission
Since you are mailing your application and documents to a physical address, and not a P.O. box, you should send everything via certified mail or FedEx. Unlike Live Scan fingerprinting, there is no benefit to dropping off the application in person in Sacramento. I have heard that the medical board actually prefers that you mail in your application.
Make sure you confirm that the medical board has received your initial application (L1A-L1F) and application fee receipt before submitting your supplemental application (form L2-L4) and supporting documents. Once the medical board receives your payment and initial application, they will mail you an ATS number, which will allow you to track your application status online. It also confirms that your file is officially active and open. Once you have your ATS number, go ahead and submit your supplemental application forms and supporting documents. I made the mistake of sending these things before my ATS number was assigned, and they all got lost! I had to obtain signatures and hospital seals all over again for forms L2-L4. I also had to pay for all my transcripts again as well. If you send your supplemental documents together with the initial application, that’s ok too. They won’t get lost then. Also, don’t let secretaries send out your proof of training. Gather all the documents, and send them out yourself. Minimize as many middle men as you can.
In terms of your medical school diploma, the board wants either your original diploma or a certified photocopy, sent directly by your medical school. Just send your original diploma. It’s so much easier than asking your medical school to send a certified copy. They do mail it back to you. Even if it gets lost, you can easily get another original for $25 or so.
Once everything is complete, you just have to wait. The medical board recommends that you don’t call to inquire your application status within the first 60 days. Listen to them. Nothing good comes of being a squeaky wheel in this situation. The online application status is fairly up to date and accurate. I had a few items that were still considered “not received.” I just sent them again, and the status changed to “received” promptly.
In my next post, Medical License (2017 Update), I’ll go over how the application process has changed today.