What Medical Residents Should Know about Physician Credentialing, Licensing & Certification

What Medical Residents Should Know about Physician Credentialing, Licensing & Certification

Credentialing is an integral part of the process of entering the world of physician employment after finishing a residency and/or fellowship. With that in mind, what should today's medical residents and fellows know about the physician credentialing process?

In basic terms, physician credentialing is the process by which an employer determines whether a physician has the appropriate licensing, education, certification and experience to work a certain position.

Although the specifics of physician credentialing do differ in details — depending on location, job type, facility type — and may or may not include certain factors like peer references and Medicare sanction information, there are certain universal standards. Most healthcare employers will follow standards set forth by regulatory and accreditation organizations such as the National Committee for Quality Assurance (NCQA) and The Joint Commission (TJC), and most experts agree that, to be ready to meet these standards, physicians should always be equipped with:

  • A current CV with detailed work history (including explanations on any gaps in employment — read more on constructing a physician CV here)
  • A list of current certifications
  • A list of all licenses
  • Current references
  • Malpractice insurance
  • Hospital privileges and attestations

Not having this information at hand can often lead to delays when you're applying for a new physician; a credentialing manager for Anthem of Virginia told Physicians Practice that 85 percent of physician applications are missing critical required for application processing.

It's worth noting here that physician employment agencies like Staff Care not only work actively with organizations like NCQA and TJC to ensure that the physician credentialing process is as fast and smooth as possible, but we also offer access to friendly, industry-savvy physician recruiters who guide you through the entire process, and who also take on the much of the onerous task of gathering paperwork, references, documentation of employment history, etc. on your behalf.

What Residents & Fellows Should Know about Licensing & Certification

The most important elements within the physician credentialing process are physician licensing and certification. How are these different? Physician licensure is necessary to practice medicine, whereas certification is not — although the latter can be required to receive a license, particularly among specialists.

Resources for Medical Residents and Fellows from Staff CarePhysician licensing is granted and monitored by government agencies (at state and local levels, as opposed to federal); board certification is by a professional organization.

As we've noted before here at the Locums Link Blog, physician licensing requirements can vary quite a bit from state to state. They usually involve graduation from a certified medical program, and also, more variably, they can also require new physicians to:

Regarding the last point, even when it isn't required to maintain a state license, many physicians choose to pursue CEI/CME as a necessary means to keep up with the ever-changing healthcare industry. As the American Association of Medical Colleges (AAMC) puts it, the "rapid pace of change in medicine makes continuing medical education programs essential." (Read more about physician CEI/CME programs here.)

Board certification is sometimes required for licensing, depending on the state. Either way, many physicians — particularly specialists — undergo board certification in their specialty. "I wouldn't expect a doctor to become a pediatrician, or any other specialty, and not get board certified," Dr. Michael Eisenfeld told Angie's List.

If you're wondering what certifications are available to you given the direction you're leaning regarding specialization, the American Board of Medical Specialties® (ABMS®) — a nationally-recognized not-for-profit organization that comprises 24 certifying member boards — is a good place to start. Visit the ABMS website here.

it's always good to start the physician licensing process as early as possible. "Physicians seeking initial licensure or applying for a medical license in another state should anticipate delays due to the investigation of credentials and past practice as well as the need to comply with licensing standards," the American Medical Association (AMA) notes.

Remember, Staff Care arranges all state licensing for our locum tenens physicians. These locum positions are sometimes available to residents, with more opportunities available for new physicians with a few years of experience under their belts. New physicians with a couple of years of industry experience who want to explore other opportunities — and other states — are prime candidates for locum tenens positions. Regardless of your level of experience, if you're eligible for a locum tenens job with Staff Care, we'll do the work of arranging the state licensing, including the payment of any applicable fees!

For more information on working a locums assignment as a resident or new physician, check out our recent article on locum tenens jobs for residents. You can also read more about how we handle the state licensing process here. And we encourage you to learn more about the benefits of locum tenens work here.

If you're a medical resident seeking locum tenens jobs, you may be eligible for urgent care opportunities: You can view all our urgent care jobs here, or contact us directly via this form for more information.

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