Nicholas Kusnezov, MD, shares his advice on how to get licensed in a new state as a locum tenens physician.

Over the years, I have amassed a collection of state medical licenses in the process of pursuing various locum assignments. Based on this experience, I believe that there are a few things that you need to know about getting licensed in a new state.

1. Start early

As soon as an assignment becomes available that you are able to commit to — either presently or at some point in the future — notify the locums company and get started on obtaining a license. Some states may take a month to process a new license, while others may take over a year. For example, my Texas medical license took three months from start to finish, but my Alaska license — which a locum company applied for over two years ago — is still processing.

Further, licensing procedures vary widely from state to state, and sometimes supplemental certifications or credentials are required prior to approval or even applying for a state medical license. Texas for instance requires you to pass a juris prudence exam, for which you need to budget time into your schedule; it is a medical-legal exam you must prepare for and then take a formal standardized test at a testing center. Similarly, California, endowed with perhaps the most cumbersome state licenses of all — but with one of the best licensing departments — requires a fluoroscopic supervisor and operator permit in hand for orthopaedics prior to applying. Similar to the juris prudence exam, this takes planning to schedule and prepare for.

2. Communicate well and often

It’s important to keep an open line of communication with the licensing departments. While some are well run, others are not. Often, medical licensing departments will request additional documentation, as documents may get lost in transit or expire by the time the license in its entirety is reviewed for approval.

Be sure to keep track of the forward progress of your application. I would recommend contacting your licensing representative directly, even if the locums coordinator is on top of it. In many cases, the licensing department will only deal directly with you.

Additionally, make sure that your information is up to date. Licensing departments will often still mail you deficiency letters. The last thing you want is to not receive this, your licensing materials, or your eventual license because your address or phone number was not up to date. Good communication prevents these avoidable issues.

3. You don’t have to use it

It is worth knowing that just because you are getting licensed does not mean you are locked into an assignment. In fact, when you are applying for a license for a new assignment in a state where you have never worked before, it’s not uncommon for that assignment to already be filled by the time you get the license. This is an important consideration when taking time off from your primary practice, and it’s often not explicitly explained to you.

4. Plan ahead

Finally, you can imagine how quickly you might accumulate state medical licenses in the process of accepting locum assignments. However, I would recommend that you give serious thought to which states you would ultimately like to work in. You will be bombarded with a flurry of opportunities to work all over the country, and the locums company will typically coordinate and pay for licensing, but if the job is in a state that you have no intention of working in, it will be a waste of your time and effort.

Additionally, every license you apply for and every hospital you credential at will require you to report all previous licenses, whether active or inactive, so the process becomes increasingly cumbersome the more state medical licenses you accrue.

That being said, when you are just starting out, in my opinion it is always a better idea to just bite the bullet and get the license ahead of time. You can always decline to renew it if the distance, travel, or location is not to your liking. Having an active state medical license in-hand may make the difference between you and another physician getting a sought-after assignment.

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