The First Steps You Have To Climb When You Go Into Practice

As a student, residency is this seemingly unachievable goal. You spend so much time seeing residents running around, doing surgery, seeing hospital patients, being doctors. All we care about is what surgery we will be scrubbing in on. We never stop to think about the future after residency: Getting a job. Then the second year of residency just shows up. You don’t remember what happened or how you got here so fast. But now you realize that you need a job and you have no idea where to even begin.

When we see the senior residents seeking jobs, we hear a lot about contracts, on-call time, patient load, etc. As I have found, we have to climb a staggering number of steps to climb just to be able to see your first patient. I have spent a considerable amount of time searching for a list to give me direction as to where to begin. Unfortunately, I have not found anything that details the specifics of some of our most essential first steps to starting work in a practice.

First and foremost, you need a state license. I am from Ohio so I will use this state as my example. The Ohio Medical Board requires completion of one year of residency and passing the American Podiatric Medical Licensing Examination (APMLE) Part 3 boards in order to apply for a DPM license. Every state has different requirements. I am fortunate to live in the state I want to practice in.

For those looking to work in a state other than where they are completing residency, some things may be more difficult. The easiest example is background checks. In Ohio, I can do mine electronically. It is quick and easy. Out of state, they may require your background check to happen in that state. This can be difficult to organize as a resident as well as expensive in terms of travel costs. Make sure you know all the ins and outs so you can allot that time when applying, not to mention the application cost. In Ohio, it is about $305.

Ok. You have your license for your state. What about malpractice insurance? I made a call to PICA to find out what I needed to do. I was worried that as soon as I had my full DPM license, I had to get a full malpractice policy and then my residency insurance wouldn’t be enough. PICA had me call my state medical board, explaining that every state has its own requirements in this matter. For example, Ohio does not require you to purchase a DPM policy if you are a resident as long as all your activities fall within the realm of your residency training. If you do any moonlighting, you need to purchase the full policy. Why does this matter? In this example, PICA offers a substantial discount for your first year of practice and I did not want to waste that inexpensive year while I was in residency. Again, each state is different.

Why does getting your state license early matter so much? Two reasons. First, it takes time. Second, you need that to get on insurance plans and that takes a lot of time. The last thing you want is to land an amazing job and then not be able to see patients because all of your applications are still being processed. I want to be ready to hit the ground running on day one. Nothing makes you look more appealing to an employer when you already having everything done.

Credentialing is another daunting task. There are so many insurance companies. Luckily, there are some organizations that take care of the credentialing for you. They have a contract with a vast majority of the insurance companies so you fill out one standard application and the organization sends it to all the agencies you designate. Many hospitals will do this for you but if you are going into private practice as a sole practitioner or a small group, this service is invaluable.

These are just the beginning steps of getting your feet on the ground. As I work more toward employment, I will try to document all of the steps I have to take in hopes that it may give someone out there a better idea of how to get everything done and make this process as easy and transparent as possible.