how to obtain full medical license - uw health · pdf fileplease refer to the next slides for...
TRANSCRIPT
How to Obtain Full Medical License
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Apply either using the OLAS online system or the paper application.
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Select appropriate application method Wisconsin Department of Safety and
Professional Services: http://dsps.wi.gov/LicensesPermitsRegistrations/Credentialing-Division-Home-Page/Health-Professions/Physician/
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Has your name changed since obtaining your medical school diploma?
If so, supporting documentation will need to be included (e.g. marriage certificate, divorce decree, ECFMG Certificate, if applicable etc.).
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What does the GME Office pay for?
The hospital will reimburse the initial license application fee $75 (Endorsement of Steps 1,2,3). Any renewals while at UWHC will be the responsibility of the resident/fellow.
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Click “Start a New Application” Click “Start a New Application”
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The test resident selected “no” after entering his verified FSMB username and having it not work.
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Check “Physician”
License Type, Physician
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This may be filled in for you already
This may be filled in for you already
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Likely “no”
Select specialty of current training
If no, select “no” and do not fill anything else in on this line or your application may get hung up
Check the box
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Enter start of current residency/fellowship in “From” Enter current date in “To”
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Carefully make selections
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Please refer to the next slides for specifics on filling out the forms listed.
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Form #2164 Medical Education Verification
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The medical school, needs to complete and then return directly to: DSPS Attn: Medical Examining Board P.O. Box 8935 Madison, WI 53708-8935 Or fax/email with facility cover sheet/letter to: (608) 261-7083 or [email protected]. Submit to Medical School (even if submitted for an REL).
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Form #2165 Certificate of Post Graduate Training
PG-1 & PG-2 year completed at UWHC: • Request program coordinator & program director to complete and
submit to DSPS. PG-2s with a transitional year: • Request transitional program to complete form. • The program coordinator will complete the form after successful
completion of 12 months and the expectation of continuation to the next PG level.
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• Form 2167 Hospital, Facility and Employer Verification (Not required for applicants who have only been employed in a strictly training capacity and have not engaged in any moonlighting outside of their training)
• Form 3046 Joint Commission Certified Hospital, Facility, and Employer
Verification (This form is only to be used for employment agencies.) • Form 3074 License Transition Addendum (Applies to individuals who
currently hold a Physician credential, and are requesting the credential transition to an Administrative Physician credential).
The following forms may not need to be completed, read the directions carefully.
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FSMB: Requesting a Transcript of USMLE Scores
If you have already passed Step 3, request your transcript at any time.
The transcripts are sent electronically to the DSPS. The electronic transcript is posted to a secure website and is available to the medical board for 45 days from the day it is posted
http://www.fsmb.org/licensure/transcripts/
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USMLE Step 3
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USMLE Bulletin November 18, 2015: Beginning the week of January 18, 2016, the number of items on the Step 3 examination will decrease. There will be a delay in reporting scores for exams administered between January 18 and April 30, 2016. The target date for reporting Step 3 scores for most examinees testing during this time period is May 25, 2016.
Resident must receive a passing score no later than March 1, 2016 to be fully licensed by PG-3 year. After passing Step 3, request a USMLE transcript be sent directly to the DSPS. Provide a copy of the Step 3 score report to your program coordinator for entry into MedHub.
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Congratulations, this part is finished!
Don’t forget to submit relevant forms.
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Physician Access of Profiles
https://commerce.ama-assn.org/amaprofiles/ AMA Credentialing Services grants physicians the option to access a self-inquiry profile and/or request that a profile be delivered to a
medical licensing board. Self-inquiry profile
All physicians, regardless of AMA membership status, can request a free self-inquiry profile. Medical licensing board requests
Requests to send a profile to a medical licensing board are free to AMA members and $39 for nonmembers. Identification verification requirement on the new AMA Profiles Hub
The American Medical Association is dedicated to protecting the identity of physicians, especially in an electronic world where identity theft is an ever growing concern. To help protect a physician’s identity and prevent illegal access to his or her profile data, a new security measure will be implemented when the AMA Profiles Hub launches.
When a physician signs in to his or her AMA account to access AMA Profiles Hub for the first time, the system will present four data statements. The statements are based on information held within the AMA Masterfile. For example, one of the four statements may ask a physician to provide the medical school graduation year. Answers that the physician provides must be correct for all four statements before he or she can access the Hub.
Physicians are allowed two opportunities to pass the identity quiz before being locked out of the system. If locked out, they will receive a message instructing them to contact the AMA Unified Service Center (USC) at (800) 665-2882, Monday through Friday from 7 am to 6 pm (central time). The AMA USC will unlock the account and provide any additional assistance as needed.
Upon successful completion of the quiz, physicians will need to read and accept the AMA Profiles Hub licensing agreement. Those physicians who do not have an established AMA account when AMA Profiles Hub launches must create an account. After
creating the account, these physicians may visit AMA Profiles Hub at which time they will be asked to sign in again and complete the identity quiz.
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How to monitor your license application progress
You should check the DSPS website weekly to monitor your application status.
Keep in mind it may take the DSPS 2-3 weeks to update your application status.
http://online.drl.wi.gov/LicenseLookup/IndividualCredentialSearch.aspx
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http://online.drl.wi.gov/ApplicationStatus/CredentialApplicationStatus.aspx
>Enter your last name >Select Profession: Medicine & Surgery MD (20) Medicine & Surgery DO (21)
How to check your status!
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As you see by the title – Requirements not met these items need to be addressed. Therequirements are in red in the left column.
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These are Requirements Met, they are in green on the left column.
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Wisconsin Statutes and Rules Examination
From your application status page the login and password
will be provided. This is an on-line open book exam. You can stop and start
the exam as often as you like. It may take from 2-3 hours to complete.
If you fail the exam, there is a $75 fee to reset the exam. http://online.drl.wi.gov/LicenseLookup/IndividualCredential
Search.aspx 26 2016
Indicate which no-requirement state licensing agency you will be taking Step 3 through.
2 x 2 colored picture attached Needs to be notarized Send to the address at the bottom
of the form. For Notarization: Do NOT sign your form ahead of time. Bring your unsigned form to a notary (they can be found at banks and government establishments) along with an ID such as a driver’s license.
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Only Continue if Completing a Paper
Application
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Form 570 Page 1 of 5
Select which endorsement is appropriate: MD or DO– Endorsement of Steps 1,2,3 of USMLE •Applying to take USMLE Step 3 through a no requirement state •Have already taken Step 3 Check the blue box Include a check for $75 DO – Endorsement of NBOME Taking COMLEX 3 Check the red box Include a check for $150 Program Specialty Code on next page. Attach check made out to Safety & Professional Services Envelope addressed to: Wisconsin Dept of Safety & Professional Service P.O. Box 8935 Madison, WI 53708-8935
Program Specialty
X
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Form 570 Page 2 of 5 Self-explanatory
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Form 570
Page 3 of 5 If you have been previously licensed,
complete the middle section . You will also need to
Obtain documentation from that Licensing Board.
Enter any institutions where you had staff privileges in the last 5 years – e.g. moonlighting. Do not list if you were only there as a trainee Researcher / Nurse / Pharmacist
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Form 570
Page 4 of 5
Failed a USMLE /COMLEX Exam? Provide an explanation
Conviction for DWI, disorderly conduct , underage drinking?
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Form 570 Page 5 of 5
Questions 14-15-16 are
poorly worded answer Yes or N/A
(instead of No)
N/A
N/A
N/A
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Documents submitted in the DSPS envelope Form 570 Application to Practice Medicine & Surgery (include in envelope after being
notarized) Form 571 Authorization and Waiver Form 1934 Work History Form 2167 Hospital Facility and Employer Verification only if not applicable Form 2252 Convictions and Pending Charges, if applicable Form 2829 Malpractice Suits or Claims Form Diploma and translation if applicable ECFMG certificate, if applicable Name change documentation, if applicable Staple the check to Page 1 of the application. Check is made out to the Dept of Safety &
Professional Services for $75 Documents submitted in separate envelopes FSMB – Disciplinary Inquiry Report Form 2164 Medical Education Verification addressed to Medical School If prior GME – Certificate of Post-Graduate Training address envelope
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After passing Step 3 – Request official transcript of USMLE Step 1, 2 CK/CS and 3 scores
http://www.fsmb.org/transcripts.html All requests are processed as they are received. FSMB issues
transcripts within three business days of receiving the completed transcript request and appropriate fee. The FSMB will not hold a transcript request pending the release of scores at a later date. If you have recently taken an exam and need that score to appear on your transcript, do not send the request until you have received your official score report for that exam.
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DO’s Only - After passing COMLEX Request official transcript
For NBOME transcripts: go to http://www.nbome.org/transcript-request.asp?m=can
.
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Licensing Session Complete the NPDB self query after your USMLE/COMLEX scores have been posted on your DSPS application status page.
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